1. Selection of biological matrix(ces)
UN Environment
National Research Council of Italy - Institute of Atmospheric Pollution Research
World Health Organization (WHO)
Workshop “Elements to consider when designing
a Global Monitoring Plan for Mercury”
13 – 14 February 2018, Rome, Italy
Selection of biological matrix(ces)
Kyrgyz Republic
Prepared by Prof. Ainash Sharshenova (M.D., Ph.D.)
Head, Centre for Environmental medicine and human ecology
Scientific and Production Centre for Preventive Medicine (SPCPM), MoH KR

2. Criteria for selection of biological matrices
Scientific value
For HBM surveys, non-invasive matrices are preferred.
Selected biomarkers collected at birth or soon after the birth indicate exposure throughout the pregnancy.
The selection of biological matrix for assessing human exposure depends:
on mercury compounds (organic vs. inorganic),
exposure pattern (chronic or acute),
on time of sampling after the exposure (UNEP and WHO, 2008).
Conclusion
When choosing the type of biomatrix, the main thing is to determine
What will be investigated?
Which population group?

3. Criteria for selection of matrices
Feasibility of collection
The difficulties in selecting hair samples were in some countries because of cultural traditions (superstition):
Ghana – braided hair (with hairpieces);
India – due to cultural issue, collection of hair sample from pregnant was difficult;
Mongolia - pregnant women think that use metal scissors for hair it will be adversely affected to their fetus.
As a result: due to the team effort and
understanding of the participants,
the samples were selected.

4. Feasibility, applicability of matrices
Samples/
country
HAIR
(HM)
CORD BLOOD
(CB)
URINE
(UM)
Cultural
differences
Russia
good
Kyrgyz Republic
Mongolia
difficult *
India
Ghana
All three bio-matrices
(CB, HM, UM) are applicable.

5. overfilling of freezer cameras Inadequate space in laboratories
Other criteria
Biomatrix
WHO SOPs
STORAGE
In hospital
in laboratory
Maternal
scalp hair (HM)
3 cm of scalp hair
taken close to the scalp,
registration form (RF)
in envelopes,
zip-lock bags
Room t
Under normal conditions
Cord
Blood (CB)
Collection: ex-utero and in-utero
Tubes: B1 polypropylene 50mL
with 0.5mL EDTA CB -10ml;
B2 polypropylene metal-free tube 10ml
CB - 2ml and (RF)
t= + 4° C
up to
2 hours
t ≤ - 20° C
until analysis
Maternal urine (UM)
First morning UM sample or
5 hours since last urination.
Place: maternity ward prior to child birth or up to 14 days after birth (RF).
UM aliquote: minimum – 50 m;
Tube U2 (Hg) – 5-10ml no pipetting
Tube U4 (creatinine) -5-10ml.
up to 2 hours;
t≤ -20° C
Challenges
Participants noted a problem in the lack of space for storing cord blood and urine samples
overfilling of freezer cameras
(1per month)
Inadequate space in laboratories

6. Transportation and safety measures
MATRIX
SAFETY
measures
IN-LAND
transportation
Maternal
scalp hair (HM)
should be 2 samples
ID code
do not require any special
transport conditions
Cord
Blood (CB)
samples should be at least 2 aliquots before freezing for Hg analysis in the national & the reference laboratories ID code
Refrigerated bags, refrigerants,
correct packing and shipment of samples,
special transport
Maternal urine (UM)
samples should be at least 3 aliquots before freezing for Hg and creatinine analysis in the national & the reference laboratories. ID code.
special transport.
Challenges:
1) Limited finance;
additional costs for transportation from the field to the laboratory.
2) Logistics from local small hospitals to Central (Russia).
3) Long distance (>900 km), hard-to-reach region, highlands (Kyrgyz Republic).
OUT-LAND transportation
Compliance the international transport regulations – IATA, WHO Guidance for the transport of Infectious substances (Biological Substances, Category B, UN codes, packed according instruction 650, etc.).
All samples should the correct packing and shipment.

7. Sampling quality control
Training: the team and medical staff of the hospitals
Control of field work quality:
regular visits NC/LA, good collaboration with doctors and nurses;
compliance with requirements of WHO SOPs;
ID codes, sampling check, filling the forms, protocols, check-lists.
Usefulness of WHO SOPs - Useful.
Challenges: WHO SOPs were too complicated for
Understanding by local staff; need to be simplified; to make
additions for the international shipments (IATA).
In the questionnaire, it is necessary to rank education in detail;
review questions on sources for heating, cooking and nutrition.

8. THANK YOU VERY MUCH for WHO/UNEP project and
Summary
Choose criteria
Hair
Blood
Urine
General population
+++ -
Occupational exposure and some hot spots (industrial) +
Easiness to collect ++
Storage (t -regime, space, conditions)
Transportation
Cultural complications
THANK YOU VERY MUCH for WHO/UNEP project and
all teams!