Doctors don't know exactly what causes many of the chronic diseases that account for seven of 10 deaths in the United States, but environmental factors such as pesticides and air pollution are increasingly being suspected of contributing to such illnesses.
Efforts are under way in a handful states and the federal government to develop bio-monitoring programs to measure the level of environmental chemicals in our bodies to help discover whether exposure to these substances causes diseases such as asthma, leukemia and Alzheimer's.
The first such laboratories are to be built in New York, New Hampshire and New Mexico. Meanwhile, California is considering legislation to build the nation's first statewide bio-monitoring system.
Bio-monitoring involves precisely measuring the level of chemicals such as lead, mercury and arsenic that accumulate in bodily fluids such as blood, urine and breast milk.
Researchers say the data, combined with existing disease-tracking and pollution-monitoring information, are key to helping determine whether environmental pollutants cause chronic diseases and could potentially help doctors and public health officials prevent or cure such diseases.
"Bio-monitoring is one of the best public health tools that has emerged to allow us to track harmful toxins that are being stored in our bodies," said California state Sen. Deborah Ortiz (D), who is trying to pass legislation to make her state a leader in bio-monitoring.
The Centers for Disease Control and Prevention (CDC), which runs the world's largest bio-monitoring laboratory and is coordinating state efforts, plans to release in January 2005 a report that will offer the broadest snapshot ever of more than 150 chemicals absorbed by the average American. However, the Third National Report on Human Exposure to Environmental Chemicals will cover only a small sample of the population and does not offer state-by-state or even regional exposure estimates.
The CDC hopes to dramatically boost the collection of bio-monitoring data by helping states create their own programs.
"State bio-monitoring programs are necessary because the CDC does not have the resources to compile national samples broad enough to do state-by-state breakdowns," said Glen Anderson, an environmental health expert with the National Conference of State Legislators.
Starting in 2001, the CDC awarded $10 million in grants to help 33 states develop plans to set up bio-monitoring programs. Most of these states have submitted proposals to create their own labs, but the CDC has allocated only $2.6 million in 2004 to begin limited operations in New Hampshire, New York and a consortium of Rocky Mountain states: Arizona, Colorado, Montana, New Mexico, Nevada and Utah. A spokesperson for the CDC said the agency expects to receive more money from Congress next year to continue assisting states.
The state projects will focus on local health issues, such as measuring the effectiveness of New York's Clean Indoor Air Act, which banned smoking in bars and restaurants in 2003. The state's new bio-monitoring lab will measure levels of cotinine, a marker of tobacco smoke, in the saliva of 1,000 non-smokers over several years to determine whether the ban lowers the risk of smoking-related illnesses.
New Mexico is to be the home of the Rocky Mountian bio-monitoring consortium, which when built, will track arsenic and pesticide levels in residents. Rocky Mountain states have some of the nation's highest levels of arsenic in drinking water, caused by mining and smelting operations, as well as ash from prehistoric volcanic activity.
Meanwhile, California is the only state so far to consider creating its own bio-monitoring program to track dozens of chemicals in residents statewide.
But an annual price tag of $12 million and strong opposition from chemical manufacturers so far have derailed the bio-monitoring bill proposed by Sen. Ortiz.
Ortiz's bill passed the Senate earlier this year but was stalled in an Assembly committee last month after intense opposition from the chemical industry and the state Chamber of Commerce, which placed the bill on its list of "job killer" legislation. Ortiz initially had proposed paying for the program by levying a fee on chemical manufacturers, but the industry continued to oppose the plan even after the fee was dropped.
"California has always been regarded as a national leader in health and environmental policy, so it's unfortunate that we're now at a time that other states are looking at us for leadership but powerful business interests are dictating this policy," Ortiz said.
The chemical industry has largely supported bio-monitoring efforts and developed much of the technology that makes it possible, said Chris VandenHeuvel, a spokesperson for the American Chemistry Council, which represents major chemical manufacturers.
"We as an industry have totally embraced bio-monitoring because it takes all the guessing out of what people are exposed to," VandenHeuvel said.
VandenHeuvel said the industry objects to Ortiz's legislation because it could lead to a state ban on certain chemicals found in humans without adequate scientific evidence of harm.
"Basically we have a fundamental problem setting up a program based on assumptions that if you find a certain chemical in the body that is clear evidence of medical harm," VandenHeuvel said. "No reasonable physician or scientific organization jumps to that conclusion."
There is also concern that bio-monitoring information could be misused to scare people and foster frivolous lawsuits, NCSL's Anderson said.
"Certainly there are a lot of concerns here because what bio-monitoring provides is something we haven't had in the past," he said. "This is just the beginning of determining what these chemicals do."
Ortiz said that California Gov. Arnold Schwarzenegger's administration has expressed interest in bio-monitoring, giving her hope that her bill will be revived.