The Third National Health and Nutrition Examination Survey (NHANES III), 1988-94, Series 11, No. 16A (Diphtheria Antibody Data and Documentation) Data Release. The National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention (CDC) collects, analyzes, and disseminates data on the health status of U.S. residents. The results of surveys, analyses, and studies are made known through a number of data release mechanisms including publications, mainframe computer data files, CD-ROMs (Search and Retrieval Software, Statistical Export and Tabulation System (SETS), and the Internet. The National Health and Nutrition Examination Survey (NHANES) is a periodic survey conducted by NCHS. The third National Health and Nutrition Examination Survey (NHANES III), conducted from 1988 through 1994, was the seventh in a series of these surveys based on a complex, multi-stage sample plan. It was designed to provide national estimates of the health and nutritional status of the United States' civilian, noninstitutionalized population aged two months and older. This data release, Series 11 No. 16A, contains the NHANES III Diphtheria Antibody data file and documentation. This data release does not replace the previous NHANES III data releases. The released data is in flat text format. A SAS program is provided to read the flat data. The user is advised to have someone familiar with SAS data step adapt the provided SAS program to his or her specific SAS environment. The following table summarizes the NHANES III data releases which are currently available. Table 1. Available NHANES III Data +----------------------+--------+---------+------------------------------------+ |Data Release Number |Release |Size in |Data Files / Description | | |Date |Megabytes| | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |August | 0.4 |Diphtheria antibody (IU/ml) data | |Series 11, No. 16A, |2002 | |file and documentation | |ASCII Version (This | | | | |release) | | | | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |August | 0.2 |Antibody to measles data file and | |Series 11, No. 15A, |2002 | |documentation | |ASCII Version | | | | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |June | 0.2 |Antibody to human Papillomavirus-16 | |Series 11, No. 14A, |2002 | |data file and documentation | |ASCII Version | | | | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |March | 0.5 |Dental Pathogen data file | |Series 11, No. 13A, |2002 | |and documentation | |ASCII Version | | | | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |January | 0.2 |Serum leptin data file and | |Series 11, No. 12A, |2002 | |documentation | |ASCII Version | | | | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |October | 0.2 |Knee osteoarthritis X-ray data file | |Series 11, No. 11A, |2001 | |and documentation | |ASCII Version | | | | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |October | 0.2 |Hepatitis C virus genotype data | |Series 11, No. 10A, |2001 | |file and documentation | |ASCII Version | | | | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |June | 240 |Raw spirometry data file and | |Series 11, No. 9A, |2001 | |documentation | |ASCII Version | | | | +----------------------+------ -+---------+------------------------------------+ |NHANES III, 1988-94, |TBA | 9.7 |Natality data file and | |Series 11, No. 8A, | | |documentation | |ASCII Version | | | | +----------------------+------ -+---------+------------------------------------+ |NHANES III, 1988-94, |June | 78.8 |Multiply Imputed Data Files and | |Multiply Imputed Data |2001 | |reports | |Set, Series 11, No. | | | | |7A, ASCII version | | | | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |January | 2.7 |Healthy Eating Index (HEI) Data File| |Series 11, No. 6A, |2000 | |and documentation includes number | |ASCII Version | | |of servings by Food Guide Pyramid | | | | |food groups and HEI | |----------------------|--------|---------|------------------------------------+ |NHANES III, 1988-94, |April | 54 |Supplemental Nutrition Survey of | |Series 11, No. 5A, |2000 | |older Americans (SNS)contains | |ASCII Version | | |subsets of individual foods | | | | |and total nutrients intake data | | | | |files and documentation | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |Septem- | 0.5 |Priority toxicant reference range | |Series 11, No. 4A, |ber 2000| |study data file and documentation | |ASCII Version | | | | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |July | 33 |Second exam sample files for | |Series 11, No. 3A, |1999 | |dietary recall, examination, | |ASCII Version | | |laboratory, additional laboratory | | | | |analytes and documentation | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |April | 407 |Dietary recall (replacement), | |Series 11, No. 2A, |1998 | |electrocardiography, laboratory | |ASCII Version | | |(additional analytes), and | | | | |vitamins/medicines data files and | | | | |documentation | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |October | 285 |Adult and youth household | |Series 11, No. 1, |1997 | |questionnaire, examination, and | |Revised SETS Version | | |laboratory data files and | |1.22a | | |documentation, plan and operation, | | | | |analytic and reporting guidelines, | | | | |weighting and estimation | | | | |methodology, field operations, | | | | |non-response bias | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |July | 454 |Adult and youth household | |Series 11, No. 1A, |1997 | |questionnaire, dietary recall, | |ASCII Version | | |examination, and laboratory data | | | | |files and documentation | +----------------------+--------+---------+------------------------------------+ |NHANES III, 1988-94, |July | 285 |Adult and youth household | |Series 11, No. 1, |1997 | |questionnaire, examination, and | |SETS Version 1.22a * | | |laboratory data files and | | | | |documentation | +----------------------+--------+---------+------------------------------------+ |NHANES III Reference |October | 152 |Plan and operation, analytic and | |Manuals and Reports |1996 | |reporting guidelines, weighting and | |October 1996 | | |estimation methodology, field | | | | |operations, non-response bias | +----------------------+--------+---------+------------------------------------+ * Do not use this CD-ROM. It had technical problems and has been superseded by the revised SETS version 1.22a, Series 11, No. 1, released in October 1997. The first release of NHANES III data is available on three different CD-ROMs. The first CD-ROM, Series 11, No. 1 SETS Version 1.22a contains data accessible through the Statistical Export and Tabulation System (SETS) retrieval software as well as documentation. This CD-ROM had technical problems and should not be used; it has been superseded by the Series 11, No. 1 Revised SETS Version 1.22a. This revised CD-ROM includes corrections to the SETS software and also contains the NHANES III Reference Manuals and Reports. A third CD-ROM, Series 11, No. 1A, contains the same data and documentation (except the Reference Manuals and Reports) as on the Series 11, No. 1 Revised Sets Version 1.22a CD-ROM plus the expanded dietary recall data and documentation. All data on the Series 11, No. 1A CD-ROM are in ASCII format only. Series 11, No. 1A and later releases (Series 11, No. 2A, Series 11, No. 3A, etc.) are also available at http://www.cdc.gov/nchs/about/major/nhanes/nh3data.htm. Background information on the procedures, survey components, questionnaires, examination and laboratory methods, and statistical analysis guidelines is available on the NHANES III Reference Manuals and Reports (CD-ROM and at http://www.cdc.gov/nchs/about/major/nhanes/nhanes3/cdrom/main.pdf). All data users are strongly encouraged to review these reference materials and reports before analyzing NHANES III data. Guidelines for Data Users o NHANES III survey design and demographic variables are found on the Household Adult Data File, Household Youth Data File, the Laboratory Data File and the Examination Data File. In preparing a data set for analysis, other data files should be merged with either or both of the Adult Household Data File or the Youth Household Data File to obtain many important analytic variables. o All of the NHANES III public use data files are linked with the common survey participant identification number (SEQN). Merging information from multiple NHANES III data files using this variable ensures that the appropriate information for each survey participant is linked correctly. o NHANES III public use data files do not have the same number of records on each file. The Household Questionnaire Files (divided into two files, Adult and Youth) contain more records than the Examination Data File because not everyone who was interviewed completed the examination. The Laboratory Data File contains data only for persons aged one year and older. The Individual Foods Data File based on the dietary recall, the Prescription Medication Data File, and The Vitamin and Minerals Data File all have multiple records for each person rather than the one record per sample person contained in the other data files. o For each data file, SAS program code with standard variable names and labels is provided as separate text files on the CD-ROM that contains the data files. This SAS program code can be used to create a SAS data set from the data file. o Modifications were made to items in the questionnaires, laboratory, and examination components over the course of the survey; as a result, data may not be available for certain variables for the full six years. In addition, variables may differ by phase since some changes were implemented between phases. Users are encouraged to read the Notes sections of the file documentation carefully for information about changes. o Extremely high and low values have been verified whenever possible, and numerous consistency checks have been performed. Nonetheless, users should examine the range and frequency of values before analyzing data. o Some data were not ready for release at the time of this publication due to continued processing of the data or analysis of laboratory specimens. A listing of those data are available in the general information section of each data file. o Confidential and administrative data are not available or released to the public. Additionally, some variables have been recoded to protect the confidentiality of the survey participants. For example, all age-related variables were recoded to 90+ years for persons who were 90 years of age or older. o Some variable names may differ from those used in the Phase 1 NHANES III Provisional Data Release and some variables included in the Phase 1 provisional release may not appear on these files. Do not use the Phase 1 provisional release; use the current (six-year) release. o Although the data files have been edited carefully, it is possible that errors may still exist. Please notify NCHS staff (301-458-4636) of any suspected errors in the data file or the documentation. Refer to the NCHS website at http://www.cdc.gov/nchs/about/major/nhanes/nh3data.htm for updates to these data files. Analytic Considerations o NHANES III (1988-94) was designed so that the survey's first three years, 1988-91, its last three years, 1991-94, and the entire six years were national probability samples. Analysts are encouraged to use all six years of survey results. o Sample weights are available for analyzing NHANES III data. One of the following three sample weights will be appropriate for nearly all analyses: interviewed sample final weight (WTPFQX6), examined sample final weight (WTPFEX6), and mobile examination center (MEC)- and home-examined sample final weight (WTPFHX6). Choosing which of these sample weights to use in any analysis depends on the variables being used. A good rule of thumb is to use "the least common denominator" approach. In this approach, the user checks the variables of interest. The variable that was collected on the smallest number of persons is the "least common denominator," and the sample weight that applies to that variable is the appropriate one to use for that analysis. For more detailed information, see the Analytic and Reporting Guidelines for NHANES III (U.S. DHHS, 1996). Referencing or Citing NHANES III Data o In publications, please acknowledge NCHS as the original data source. For instance, the reference for this Serum Diphtheria Data File in this release is: U.S. Department of Health and Human Services (DHHS). National Center for Health Statistics. Third National Health and Nutrition Examination Survey, 1988-1994, NHANES III diphtheria antibody data file (Series 11, No. 16A). Hyattsville, MD: Centers for Disease Control and Prevention, 2001. Problems Using the Data NHANES III is a wonderfully rich source of data and NCHS encourages you to use the data for research and analysis. However, the dataset is large and complex and familiarity with data file manipulation and analysis is required. NCHS does not have the resources to perform analyses, check results, debug programs or do literature review for your work. Thorough review of the extensive documentation on the planning of the survey, analytic guidelines and individual datasets should resolve most questions. If you still have questions after careful review of the documentation, please contact the Data Dissemination Branch at (301)458-4636. -------------------------------------------------------------------------------- NHANES III Diphtheria Component Index ------------------------------------------------------------------------ Variable Description Name Positions ------------------------------------------------------------------------ Respondent identification number ............ SEQN 1-5 Diphtheria antibody (IU/ml) ................. DIP 6-11 NHANES III Examination Data File ------------------------------------------------------------------------ Positions Item description SAS name Counts and code Notes ------------------------------------------------------------------------ 1-5 Respondent identification number SEQN 21396 00003-53623 6-11 Diphtheria antibody (IU/ml) DIP 21396 0.0037-0008.1 Special Notes to Diphtheria Antibody Data Surplus Sera Collection NHANES III collected blood from sample participants to perform numerous assays. Because of the possibility of out-of-range results that need to be repeated, more blood volume was collected than is usually needed for the assays to be performed. Since most sampled participants did not have out-of-range results, surplus serum specimens have been stored. Blank Result Field This laboratory test was performed on the 21,396 persons ages 6 or more years from NHANES III (1988-1994) surplus sera collection. If there was not sufficient sera for the assay then the sample person will have a blank in the result field. Laboratory Tests: Serum Diphtheria Antitoxin DIP IU/ml Antibody levels to diphtheria toxin were determined by a neutralization assay in VERO monkey kidney cells. Diphtheria antitoxin titers were converted to international units per milliliter after standardization with reference sera provided by the Center for Biologics Evaluation Research, US Food and Drug Administration using a standard technique (1). The lowest level of detection for the diphtheria assay was 0.0038 International Units/mL (IU/mL), and the upper limit was 5.6 and 8.0 IU/mL on different runs of the assay. An antibody concentration of >0.10 IU/mL defined as a fully protective and 0.01 IU/mL as minimally protective.(2,3) 1. Ipsen J. Circulating antitoxin at the onset of diphtheria in 425 patients. J Immunol 1946:54:325-47. 2. Ipsen J. Immunization of adults against diphtheria and tetanus. N Engl J Med 1954;251:459-66. 3. Orenstein WA, Weisfeld JS, Halsey NA. Diphtheria and tetanus toxoids and pertussis vaccine, combined. Publication no. 451. Washington, DC: Pan American Health Organization, World Health Organization, 1983:30-51.