National Health and Nutrition Examination Survey

 Both the lab data and questionnaire items will be released in this file.  

Volatile Organic Compound Questions:
The volatile organic compound section of the Mobile Examination Center (MEC) Interview and Phlebotomy Component (PH) provide personal interview data.

Volatile Organic Compounds (Home Tap Water):
In addition to assessing levels of VOCs in blood, VOC levels were measured in home tap water specimens provided by NHANES participants. Specifically, trihalomethanes (THMs) and the fuel additive methyl tertiary-butyl ether (MTBE) are measured in these samples.

Participants aged 12 years and older on a one-half sample had questions administered and water specimens tested.

Measurements of Trihalomethanes (THMs) and MTBE in Tap Water:
This automated analytical method uses headspace solid-phase microextraction (SPME) coupled with capillary gas chromatography and mass spectrometry (Cardinali et al. 2004). This method quantitated trace levels of THMs (chloroform, bromodichloromethane, dibromochloromethane, and bromoform) and MTBE in tap water. Detection limits of less than 0.15 ng/mL for all analytes and linear ranges of three orders of magnitude are adequate for measuring the THMs in tap water samples tested from across the United States. THMs are stable for extended periods in tap water samples after quenching of residual chlorine and buffering to pH 6.5, thus enabling larger epidemiologic field studies with simplified sample collection protocols.

Mobile Examination Centers (MECs)
Laboratory team performance is monitored using several techniques. NCHS and contract consultants use a structured quality assurance evaluation during unscheduled visits to evaluate both the quality of the laboratory work and the quality-control procedures. Each laboratory staff person is observed for equipment operation, specimen collection and preparation; testing procedures and constructive feedback are given to each staff. Formal retraining sessions are conducted annually to ensure that required skill levels were maintained. 

The NHANES QA/QC protocols meet the 1988 Clinical Laboratory Improvement Act mandates. Detailed QA/QC instructions are discussed in the NHANES LPM.

Analytical Laboratories
NHANES uses several methods to monitor the quality of the analyses performed by the contract laboratories. In the MEC, these methods include performing second examinations on previously examined participants and blind split samples collected on “dry run” sessions.

NCHS developed and distributed a quality control protocol for all the contract laboratories which outlined the Westgard rules used when running NHANES specimens. Progress reports containing any problems encountered during shipping or receipt of specimens, summary statistics for each control pool, QC graphs, instrument calibration, reagents, and any special considerations are submitted to NCHS and Westat quarterly. The reports are reviewed for trends or shifts in the data. The laboratories are required to explain any identified areas of concern.

Measures of volatile organic compounds in blood and water were assessed in a subsample of participants aged 12 years and older. Use the special weights (WTSVOC2Y) included in this data file when analyzing data. Please refer to the Analytic Guidelines for further details on the use of sample weights and other analytic issues.

The analysis of NHANES laboratory data must be conducted with the key survey design and basic demographic variables. The recommended procedure for variance estimation requires use of stratum and PSU variables (SDMVSTRA and SDMVPSU, respectively), which are included in the demographic data file for each data release. The NHANES Household Questionnaire and Demographic Data Files contain demographic data, health indicators, and other related information collected during household interviews. The phlebotomy file includes auxiliary information such as the conditions precluding venipuncture. The demographic, household questionnaire and phlebotomy files may be linked to the laboratory data file using the unique survey participant identifier SEQN.

Detection limits
The detection limit was variable for many of the analytes in the data set. In addition two variables are provided for each of these analytes. The variable named LBD___LC indicates whether the result was below the limit of detection. There are three values: “0”, “1”, and “2”. “0” means that the result was at or above the limit of detection. “1” indicates that the result was below the limit of detection. “2” means the result was above the limit of detection and exceeds calibrated range of assay.

The other variable named LBX___ provides the analytic result for that analyte. In cases, where the result was below the limit of detection, the value for that variable is the detection limit divided by the square root of two.