Innovative Non- or Mlnimallv-lnvasive Technologies for Monitoring Health and Nutritional Status in Mothers and Young Children
Use of Filter Paper for the Collection and Analysis of Human Whole Blood Specimens
Joanne V. Mei,2 J. Richard Alexander, Barbara W. Adam and W. Harry Hannon
Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341
ABSTRACT The Centers for Disease Control and Prevention and its partners have been operating the Newborn
materials and proficiency-testing materials for the external evaluation of screening programs. The Newborn
and Drug Administration for the collection of blood for clinical tests. These activities have created a mechanism for the validation of the filter paper blood collection device and the standardization of materials and methods for the analysis of dried blood spots. J. Nutr. 131: 1631S-1636S, 2001.
KEY wORDS: . newborn screening : dried blood spots : blood collection : quality assurance
The use of filter paper for the collection and analysis of human blood dates back to the early 1960s, when Dr. Robert Guthrie used dried blood spot specimens to measure phenyl- alanine in newborns for the detection of phenylketonuria (Guthrie and Susi 1963). This novel application for collecting blood led to the population screening of newborns for the detection of treatable, inherited metabolic diseases. Today, state public health laboratories screen >95% of all newborns in the largest genetic testing effort in the United States. Filter paper has been used to collect blood for public health purposes for almost 40 y. The paper is made from high purity cotton linters and is manufactured to give accurate and reproducible absorption of blood specimens according to Natjonal Commit- tee on Clinical Laboratory Standards (NCCLS)3 specifications (Hannon et al. 1997). The filter paper blood collection device has achieved the same level of precision and reproducibility that analytical scientists and clinicians have come to expect from standard methods of collecting blood, such as vacuum
tubes and capillary pipettes. Like these devices, filter paper has associated with it some level of imprecision that can be char- acterized to standardize the device and to minimize the vari- ation in measurements due to the filter paper matrix. In addition, the ease of collection, transport and storage make dried blood spot specimens a cost-effective choice for many clinical applications. Here we describe the efforts of the New. born Screening Quality Assurance Program (NSQAP) at the Centers for Disease Control and Prevention (CDC) to provide external quality assurance for the filter paper blood collection device, for newborn-screening laboratories and for epidemio- logical research using dried blood spots.
Quality assurance for newborn-screening tests
In collaboration with its partners, the NSQAP at the CDC has served, for over 20 years, the laboratories that use dried blood spot specimens for newborn-screening tests by providing technical assistance, consultation and training for laboratory methods, evaluation and distribution of reference and quality control dried blood spot materials, a mechanism for the voluntary evaluation of laboratory performance (proficiency testing), the transfer of new technologies and the