Sample Results Letter to a Pregnant Woman or Woman of Child Bearing Age (15 to

Attachment 6E: Sample Results Letter to a Pregnant Woman or Woman of Child Bearing Age (15 to <45 years) - Total Arsenic Below Follow-up Level

Flesch-Kincaid Reading level – 10.7

(ATSDR Letterhead)

DATE ________________

Name XXXXX

Address XXXX

Address XXXX

Dear ________ [Participant Name]___________,

Thank you for participating in the second Exposure Investigation in Winkelman, Arizona in MONTH, YEAR. The goal is to find out whether people living in Hayden and Winkelman, AZ are being exposed to arsenic.

Your arsenic results were below the investigation follow up level. You don’t need to take additional action. However, if you are still concerned about your results, talk with your doctor.

This package contains the results of your urine arsenic test from the current investigation and for comparison, also contains your results from the initial investigation conducted in April 2015, if applicable.

Results above the investigation exposure follow-up level appear in bold.

What do these results mean and should I follow up?

In this package, you can find:

• Test Results: Your arsenic test results from 2015, if applicable, and [Current investigation YEAR]

• What It Means: An explanation of what the YEAR results mean for your health

• Follow Up: Recommendations for following up on these results, if needed

• Factsheet: Tips to lower your exposure to arsenic

If you have questions about this Exposure Investigation or your child’s test results, please contact me at 770-488-0771 or BTierney@cdc.gov.

Sincerely,

Bruce C. Tierney, MD

Lead Investigator, ASARCO Hayden Smelter Exposure Investigation

ATSDR Division of Community Health Investigations, Exposure Investigation Team

TEST RESULTS

Your Total Urinary Arsenic Results, 2015

2015 Arsenic Test Results
Arsenic Type	Your result *	Investigation Exposure Follow-Up Level *
Total Urine Arsenic	XX.X µg/g of creatinine ** (or “Not Applicable” as appropriate)	28.4 µg/g creatinine †
* Results are reported in micrograms per gram of creatinine (µg/g). Creatinine adjustment is a standard method we use to report the amount of arsenic measured in urine samples. ** If your total urinary arsenic level was above 28.4 µg/g, further analysis was done to determine the amount of organic and inorganic arsenic in the total. † The total urine arsenic investigation exposure follow-up level is the lowest 95th percentile total urine arsenic value reported for all age groups in the 2009-2010 CDC National Health and Nutrition Examination Survey. The 95th percentile means that 95 percent of the population will have a value at or below the number indicated as the investigation exposure follow up level.

Your Total Urinary Arsenic Results, [current investigation YEAR]

YEAR Arsenic Test Results
Arsenic Type	Your result *	Investigation Exposure Follow-Up Level *
Total Urine Arsenic	XX.X µg/g of creatinine **	28.4 †
*1 Results are reported in micrograms per gram of creatinine (µg/g). Creatinine adjustment is a standard method we use to report the amount of arsenic measured in urine samples. **2 If your total urinary arsenic level was above 28.4 µg/g, further analysis was done to determine the amount of organic and inorganic arsenic in the total. † The total urine arsenic investigation exposure follow-up level is the lowest 95th percentile total urine arsenic value reported for all age groups in the 2009-2010 CDC National Health and Nutrition Examination Survey. The 95th percentile means that 95 percent of the population will have a value at or below the number indicated as the investigation exposure follow up level.

WHAT IT MEANS

What Your Total Urine Arsenic Result Means, [current investigation YEAR]

When arsenic gets into your body, it stays for a few days, and then most of it comes out through your urine. Your test results tell us about the most recent arsenic exposures you experienced, but not about exposures from a week, or even a year ago.

Your total urinary arsenic level was below the investigation exposure follow up level.

This means that your total arsenic results are similar to the results of most other females your age in the United States.

FOLLOW UP

How to Follow Up on Your Total Urine Arsenic Result

Based on these results, you don’t need to take additional action with your doctor on arsenic. However, if you are still concerned about your results, talk with your doctor. Take this letter with you and encourage your doctor to contact ATSDR with questions.

Hayden and Winkelman have more environmental arsenic than most towns across the United States, so everyone can take steps to reduce their exposure to arsenic. Use the tips in Enclosure 1 to do so.

As always, if you have questions for ATSDR, please contact us at 770-488-0771 or by email at BTierney@cdc.gov.

Enclosures (Attachment 11 - Tips for Reducing Exposure to Arsenic)