title: Participant experiences in a breastmilk biomonitoring study: a qualitative assessment.
abstract: BACKGROUND
  Biomonitoring studies can provide information about individual and population-wide exposure. However they must be designed in a way that protects the rights and welfare of participants. This descriptive qualitative study was conducted as a follow-up to a breastmilk biomonitoring study. The primary objectives were to assess participants' experiences in the study, including the report-back of individual body burden results, and to determine if participation in the study negatively affected breastfeeding rates or duration.
  
  
  METHODS
  Participants of the Greater Boston PBDE Breastmilk Biomonitoring Study were contacted and asked about their experiences in the study: the impact of study recruitment materials on attitudes towards breastfeeding; if participants had wanted individual biomonitoring results; if the protocol by which individual results were distributed met participants' needs; and the impact of individual results on attitudes towards breastfeeding.
  
  
  RESULTS
  No participants reported reducing the duration of breastfeeding because of the biomonitoring study, but some responses suggested that breastmilk biomonitoring studies have the potential to raise anxieties about breastfeeding. Almost all participants wished to obtain individual results. Although several reported some concern about individual body burden, none reported reducing the duration of breastfeeding because of biomonitoring results. The study literature and report-back method were found to mitigate potential negative impacts.
  
  
  CONCLUSIONS
  Biomonitoring study design, including clear communication about the benefits of breastfeeding and the manner in which individual results are distributed, can prevent negative impacts of biomonitoring on breastfeeding. Adoption of more specific standards for biomonitoring studies and continued study of risk communication issues related to biomonitoring will help protect participants from harm.
authors.affiliation: Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA. nerissa.wu@cdph.ca.gov
authors.forename: Nerissa
authors.initials: N
authors.lastname: Wu
authors.forename: Michael D
authors.initials: MD
authors.lastname: McClean
authors.forename: Phil
authors.initials: P
authors.lastname: Brown
authors.forename: Ann
authors.initials: A
authors.lastname: Aschengrau
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Webster
mesh_terms: D000328:Adult; D001822:Body Burden; D001900:Boston; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D004522:Educational Status; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008895:Milk, Human / Q000737:chemistry*; D011075:Polybrominated Biphenyls / Q000032:analysis* / Q000493:pharmacokinetics; D036301:Qualitative Research; D035842:Research Subjects / Q000523:psychology*; D012907:Smoking / Q000453:epidemiology; D055815:Young Adult
chemical_list: D011075:Polybrominated Biphenyls