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Laboratory procedures used by the Clinical Chemistry Division, Centers for Disease Control, for the Second Health and Nutrition Examination Survey (HANES II) 1976-1980
  • Published Date:
    First edition, 1981, revised edition, 1985
Filetype[PDF-3.60 MB]


Details:
  • Corporate Authors:
    Center for Environmental Health (U.S.), Nutritional Biochemistry Branch.
  • Description:
    I. Introduction -- II. FieId specimen collection -- III. FieId specimen processing -- IV. Analytical methods -- V. Quality control -- VI. References for analytical methods

    The second National Health and Nutrition Examination Survey (HANESII) was conducted from January 1976 to June 1980 by the National Center for Health Statistics (NCHS) on 27,801 persons interviewed at 64 different geographical locations. Mobile vans staffed by NCHS medical teams, who conducted extensive medical examinations of participants and collected blood and urine specimens, traveled to the different localities. Participants were identified in advance and initially contacted by the U.S. Bureau of the Census to represent a national probability sampling of the noninstitutionalized U.S. population between the ages of 6 months to 74 years old. In addition to a physician's examination and medical history, this survey also included taking body measurements; a dietary interview; and, dependent on the age of the participant, tests for hearing and certain allergies, a speech recording, x-rays of chest, neck or back, electrocardiogram, measure of breathing capacity, glucose tolerance test, breast examination, and test for venereal disease. The bulk of the specimens collected were shipped to the Centers for Disease Control for chemical analysis. Many of the analytes were vitamins and trace elements, which occur in minute amounts in biological meterials and whose analysis is difficult and complex. In general, they are attempted in only a few reference laboratories and research centers. In addition to performing most of the analyses, the Clinical Chemistty Division, Center for Environmental Health was responsible for developing and validating methods for analyzing specimens, determining how specimens should be collected and shipped, training collection t;ams and monitoring van operations, receiving and distributing samples, computer input of laboratory and other data, and design and implementation of internal and "blind" quality control surveillance. A total of 252,222 specimens were received and distributed; 357,415 chemical analyses were performed, and 138,854 data records were transmitted to the National Center for Health Statistics. Results of this survey, mandated by Congress to assesshealth problems and the nutritional status of the nation, will have considerable impact on Federal programs and health care delivery. Data tapes are made available to other government agencies and can be obtained by private concerns. Expected outputs include measurement of the extent of environmental toxicity of lead, for example, and the studies on Vitamins A and C may be used by the National Cancer Institute to assesspossible interrelationships of these substances with cancer. Results of glucose tolerance tests, analyzed by a modification of the glucose reference method, will address the magnitude of undiagnosed diabetes. And the nutritional aspects of the survey will help determine the augmentation of fortified food, since a focus of HANES II was on the extent and possible causes of anemia in the United States. The statistical design of the survey allows analysis of the data with respect to various demographic and socioeconomic factors. The extensive normative data base established will not only be used to identify current problems, but will also serve as a comparison to determine changes with time and effects of intervention efforts. This manual details the methods used by the Clinical Chemistry Division for the chemical analyses, plus the quality control data generated over the course of the entire survey. Its purpose is threefold: 1) to use in interpreting survey results, 2) to serve as a link to investigators who wish to tie in to this data base; and 3) to provide nutritional methods in a new and expanding area of clinical chemistry.

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