Transcript Slide 1

Canadian Health Measures Survey
New Health Data Source
Research Data Centre Workshop
Presentation
Colleen Bolger
Physical Health Measures Division
Presentation to Conference on Health over the
Life Course, University of Western Ontario,
London, Ontario, 14-16 October 2009
The CHMS goals…
 CHMS is the newest national health survey that adds
scientific data to existing self-report data sources like
CCHS/NPHS
 Conduct direct physical measures of Canadians’ health
in a mobile clinic, including:
• Heart and lung health, weight, etc.
• Laboratory tests of blood and urine samples
 Important health issues (obesity, environmental toxins,
physical inactivity, undiagnosed disease) cannot be
monitored without direct measures.
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CHMS preliminary results
Blood lead, mercury and cadmium
0.7
1
3.5
0.9
0.6
3
2.5
2
1.5
1
Blood Level (ug/L)
Blood Level (ug/L)
Blood Level (ug/dL)
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.5
0.5
0.4
0.3
0.2
0.1
0.1
0
0
0
Lead
Mercury
Cadmium
Source: Health Reports,
Statistics Canada, Nov. 2008
National Exposure Report: Summer 2010
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The mobile clinic experience
Urine Collection
Spirometry
Anthropometry
Phlebotomy
Blood Pressure
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More physical measures
Fitness Measures
Lab Measures
Oral Health
Activity Monitor
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Survey parameters
 Initial budget (with buy-ins) $37 million over 6 yrs,
now permanent funding for ongoing collection
 National estimates
 Atypical sample design (cost, logistics)
 24 months of data collection,
 Direct measures completed in mobile clinic
 Cycle 1: 2007 to 2009, 5,500 sample, age 6 to 79
 Cycle 2: 2009 to 2011, 5,700 sample, ages 3 to 79
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Participants and data sources
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Randomly selected to represent national population
All participation is voluntary
1-hour health questionnaire in home
2-3 hour visit to mobile clinic for physical measures
Activity monitor and indoor air sampler 1 week post
Receive their own reports of measurements
Are asked to participate in biosample storage for future
study, data-sharing with HC/PHAC, data-linking at
StatCan, longitudinal follow-up
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Analytical potential
 46 questionnaire modules containing 722
questions
 Approximately 50 physical measures variables
 Over 120 biospecimen analytes
 About a dozen Environment Canada weather /
pollution indicators
 Potential linkage to health records
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Questionnaire content
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Health status
General health, sleep, height and weight, weight change, health utility
index, chronic conditions, hepatitis, family medical history, oral health
status, phlegm, pregnancy, birth, breastfeeding information
Nutrition and food
Grain, fruit and vegetable consumption, meat and fish, dietary fat, salt,
water and soft drink, milk and dairy products
Medication use
Medications, other health products and herbal remedies
Health behaviours
Physical activities, sedentary activities, smoking, alcohol use, illicit drug
use, sexual behaviour, maternal breast-feeding, strengths and difficulties
Environmental factors
Exposure to second-hand smoke, sun exposure, housing characteristics,
hobbies, grooming-product use
Socio-economic information
Socio-demographic characteristics, education, labour force activity, income
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The mobile clinic
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CHMS sites 2007-2009
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Clarington, ON
Montérégie, QC
Moncton, NB
Toronto (North York), ON
Montréal centre, QC
Kitchener-Waterloo, ON
Vancouver, BC
Red Deer, AB
Williams Lake and Quesnel, BC
Edmonton, AB
South Mauricie, QC
Québec, QC
Northumberland County, ON
St. Catharines-Niagara, ON
Toronto (Don Valley), ON
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Physical measures
 Anthropometry
• Height, weight, waist and hip circumference, sitting height
• 5 skinfolds
 Cardiorespiratory Fitness
• Blood pressure, resting heart rate
• Modified Canadian Aerobic Fitness Test (step test)
• Spirometry
 Musculoskeletal Fitness
• Hand grip strength
• Sit-and-reach flexibility
• Curl-ups
 Physical Activity
• Accelerometry
 Oral Health Exam
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Lab measures (selected examples)
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BLOOD
Diabetes (Fasting glucose, Fasting insulin, HbA1c)
Cardiovascular (HDL, LDL, total cholesterol, triglycerides, Homocysteine)
Nutritional Status (RBC folate, Vitamin B12, Vitamin D, Calcium)
Infectious Disease Markers (Hepatitis A/B/C, HPV, Herpes, Chlamydia)
General (CBC, Blood chemistry panel, Surplus blood, DNA sample)
Environmental exposure
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Metals (Metals like Lead, Cadmium, Mercury, Arsenic, Nickel, Copper, Zinc,
Selenium, Uranium, Molybdenum, Manganese)
PCBs, pesticides
URINE
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Phthalates and metabolites (11)
Organophosphate pesticides and metabolites (6)
Phenoxy Herbicide (2,4-D)
Bisphenol A
Cotinine, Microalbumin, Creatinine, Iodine
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Biological Specimen Flow
INSPQ (Institut
Health Canada
Chronic Disease
Nutrition
National Microbiology
Laboratory
Infectious Disease
Biorepository
national de santé
publique du Québec)
Environmental
Biomarkers
CHMS Mobile
Clinic
CBC, Blood chemistry panel,
Storage samples
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Biorepository
 Storage of blood and urine for future health studies: all
consenting participants
 Storage of DNA: 20 years and above with consent
 National Microbiology Laboratory (NML) in Winnipeg
selected as biorepository for indefinite storage
 Access controlled by Statistics Canada
 Fall 2010 availability to researchers
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Response chart (cycle 1)
Met targets by age and sex…
a) 7500 people selected
b) 6600 complete household interview (88%)
c)
5600 complete clinic measures (85% of b, 75% of a)
High participation at the clinic…
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Over 95% participation in all measures except mCAFT exercise test at
91% participation
Consent remains high
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Data linking and sharing consent over 99%
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Storage consent: Blood & urine 97%, DNA (20+) 94%
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Cycle 1 data dissemination
Wave 1
Wave 2
Wave 3
Wave 4
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Household questionnaire &
physical measures data
2 articles on fitness
1 article on blood pressure
Laboratory data (nutrition, chronic
and infectious disease markers)
1 article on Vitamin D
Laboratory data (environmental
measures)
1 article - TBD
Activity monitoring data
1 article on physical activity
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January 2010
February 2010
March 2010
July 2010
November 2010
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Data products and services
 Master files in Research Data Centres
 Supporting documentation (Data dictionary with
variable frequencies, full User Guide)
 Data tables available for each release wave
 Capacity building workshops for researchers
 Custom tables
 CHMS Biobank access planned for fall 2010
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Studies underway
 Vitamin D, by Health Canada examining Dietary Reference Intake levels in
collaboration with USA, food fortification policies
 Lead, mercury and cadmium levels in Canadian population, in support of
the federal Chemicals Management Plan.
 Fitness-Child/Adult, Blood Pressure, Obesity
 Organohalogens in Leftover Pooled Serum Specimens (e.g., PCBs, dioxins and
furans)
 Volatile organic compounds in samples of indoor air in Canadian
Households (from Cycle 2 dress rehearsal)
 Nicotine and its metabolites, NNAL
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CHMS has the support of…
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the Canadian Medical Association
the Canadian Dental Association
the Canadian Red Cross
The Canadian Lung Association
Dietitians of Canada
the Heart and Stroke Foundation of Canada
the Canadian Hypertension Society
the Canadian Public Health Association
the College of Family Physicians of Canada
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Additional information
For more information on the CHMS, please contact :
Colleen Bolger at 613-951-2232,
[email protected]
or send an e-mail to [email protected].
Detailed information on the CHMS can also be found at
www.statcan.gc.ca/chms.
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