Sharing Unexpected Biomarker Results with Study Participants

Background: The Breast Cancer and the Environment Research Centers (BCERCs) include collaborators from basic sciences, epidemiology, and the community, conducting studies to investigate whether environmental exposures are associated with the timing of puberty. A pilot study of a subset of the study...

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Published in:	Environmental health perspectives Vol. 119; no. 1; pp. 1 - 5
Main Authors:	Hernick, Ann D., Brown, M. Kathryn, Pinney, Susan M., Biro, Frank M., Ball, Kathleen M., Bornschein, Robert L.
Format:	Journal Article
Language:	English
Published:	United States National Institute of Environmental Health Sciences 01-01-2011
Subjects:	Ammonium perfluorooctanoate Biological markers Biomarkers - blood Biomarkers - urine Blood Breast Breast cancer Cancer Caprylates - blood Caprylates - urine Chemical hazards Child Children Commentary Communities Disclosure - ethics Disclosure - standards Elevated Environmental Exposure - statistics & numerical data Environmental health Environmental Monitoring - ethics Environmental Pollutants - blood Environmental Pollutants - urine Epidemiology Ethics Exposure Female Flame Retardants - metabolism Fluorocarbons - blood Fluorocarbons - urine Format Girls Health aspects Humans Institutional review boards Management Oncology, Experimental Parents Reporting Research ethics Research Subjects United States USA, Ohio, Cincinnati
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Summary:	Background: The Breast Cancer and the Environment Research Centers (BCERCs) include collaborators from basic sciences, epidemiology, and the community, conducting studies to investigate whether environmental exposures are associated with the timing of puberty. A pilot study of a subset of the study participants assessed the feasibility of measuring selected biomarkers of exposure in blood and urine in girls 6-8 years of age. In the Greater Cincinnati study population, we found an elevated serum concentration of perfluorooctanoate (PFOA) among > 90% of young girls living in a small community. Objectives: The research team deliberated whether and how to report the PFOA findings to our study families. We will address the issues considered in our decision, as well as the formats we used to present the findings. Methods: The results were verified as we searched for potential sources of the elevated PFOA levels. As a research team, we grappled with issues regarding the reporting of unexpected results, derived from unknown sources and with unknown clinical significance. Ultimately, we did decide to present these findings to the study families through a well-developed communication plan. Discussion: Research team members came from a variety of experiences and backgrounds, which led to different interpretations about the clinical, ethical, and public health issues surrounding these findings. The ethical debates centered around the precautionary principle, the right to know, and do no harm. Conclusions: Given advances in environmental biomarker technologies and greater use of the transdisciplinary research model, a communication plan must be developed for those involved as study participants.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 A.D.H. and K.M.B. serve on the Board of Directors of the Breast Cancer Alliance of Greater Cincinnati (BCA), a nonprofit advocacy organization. M.K.B., S.M.P., F.M.B., and R.L.B. are members of the BCA.
ISSN:	0091-6765 1552-9924
DOI:	10.1289/ehp.1001988