Dear Editor
We read with great interest the paper by Morello-Frosch et al., on “Communicating results in post-Belmont era biomonitoring studies” (Morello-Frosch et al., 2015), and especially the section on Addressing incidental findings which described an unexpected finding of elevated serum perfluorooctanoic acid (PFOA) in the girls in our puberty cohort study (Pinney et al., 2013). We agree whole heartedly that the public health and regulatory infrastructure of biomonitoring research provides almost no guidance in situations similar to ours. Speculating (although not being 100% certain) that the source of PFOA exposure was public drinking water, we felt we had an ethical obligation to report the preliminary findings to the water departments, but there was no guidance for this step. There were potential risks that accompanied this action-property values in the area could have diminished, and we could have placed an “environmental stigma” on the residents of the area. In other communities, if the source of the environmental exposure was an industrial facility, informing public health agencies could result in curtailment of the industrial processes, and perhaps a loss of jobs.
Additionally, we struggled with questions such as “How do we inform the community physicians of our findings?” For study participants with very high serum concentrations of this or other environmental biomarkers, “do we have an ethical obligation to encourage communicating this information to their personal physicians?” Any communication of individual findings to the study participant's personal physician certainly would require first obtaining the permission of the study participant. However, there is no guidance regarding if or when we as researchers should be encouraging study participants to report their highly elevated environmental biomarker concentrations to their physicians, and how that should be done.
We look forward to further discussion of these issues.
Contributor Information
Susan M. Pinney, Department of Environmental Health University of Cincinnati, College of Medicine, United States
Frank M. Biro, Department of Pediatrics University of Cincinnati College of Medicine Interim Director of Research Division of Adolescent & Transition Medicine Cincinnati Children's Hospital Medical Center, United States
References
- Morello-Frosch R, Varshavsky J, Liboiron M, Brown P, Brody JG. Communicating results in post-Belmont era biomonitoring studies: Lessons from genetics and neuroimaging research. Environ. Res. 2015;136:363–372. doi: 10.1016/j.envres.2014.10.001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pinney SM, Biro FB, Windham G, Herrick RL, Yaghjyan L, Calafat AM, Succop P, Sucharew H, Ball KM, Kayoko K, Kushi LH, Bornschein R. Serum biomarkers of polyfluoroalkyl compounds in young girls in greater Cincinnati and the San Francisco Bay area. Environ. Pollut. 2013;184:327–334. doi: 10.1016/j.envpol.2013.09.008. (Epub 2013 October 1. PMID: 24095703) [DOI] [PMC free article] [PubMed] [Google Scholar]