National Health and Nutrition 

Examination Survey 

Biospecimen Program: 

NHANES III (1988–1994) and 

NHANES 1999–2014

Vital and Health StatisticsSeries 2, Number 170 July 2015 
Copyright information 

All material appearing in this report is in the public domain and may be 

reproduced or copied without permission; citation as to source, however, is 

appreciated. 

Suggested citation 

McQuillan GM, McLean JE, Chiappa M, Lukacs SL. National Health and 

Nutrition Examination Survey biospecimen program: NHANES III (1988–1994) 

and NHANES 1999–2014. National Center for Health Statistics. Vital Health Stat 

2(170). 2015. 

Library of Congress Cataloging-in-Publication Data 

National Health and Nutrition Examination Survey biospecimen program : 

NHANES III (1988-1994) and NHANES 1999-2014 / U.S. Department of Health 

and Human Services, Centers for Disease Control and Prevention, National 

Center for Health Statistics. 

p. ; cm. -- (Vital and health statistics, series 2, data evaluation and methods 

research ; number 170) 

Includes bibliographical references and index. 

ISBN 0-8406-0671-0 (alk. paper) 

I. National Center for Health Statistics (U.S.), issuing body. II. Series: Vital and 

health statistics. Series 2, Data evaluation and methods research ; no. 170. 

[DNLM: 1. National Health and Nutrition Examination Survey (U.S.) 2. 

Biological Specimen Banks--organization & administration--United States. 3. 

Health Surveys--United States. 4. Program Development--methods--United 

States. 5. Specimen Handling--methods--United States. W2 A N148vb 170 

2015] 

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For sale by the U.S. Government Printing Office 

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Printed on acid-free paper. 
 

Vital and Health Statistics 

Series 2, Number 170 

National Health and Nutrition 

Examination Survey 

Biospecimen Program: 

NHANES III (1988–1994) and 

NHANES 1999–2014 

Data Evaluation and Methods Research 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Center for Health Statistics 

Hyattsville, Maryland 

July 2015 

DHHS Publication No. 2015–1370 
National Center for Health Statistics 

Charles J. Rothwell, M.S., M.B.A., Director 

Nathaniel Schenker, Ph.D., Deputy Director 

Jennifer H. Madans, Ph.D., Associate Director for Science 

Division of Health and Nutrition Examination Surveys 

Kathryn S. Porter, M.D., M.S., Director 
 

 

 

 

 

 

 

 

 

 

 

iii

Contents

Acknowledgment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv

Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NHANES III (1988–1994) and NHANES 1999–2014. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Development of Biorepositories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Establishing the Serum, Plasma, and Urine Biorepositories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Establishing a DNA Biorepository. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Ethics, Privacy, and Confidentiality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Informed Consent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Biospecimen Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Blood Collection for Serum or Plasma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Urine Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Pristine Biospecimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Surplus Biospecimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

DNA Specimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Access to Biospecimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Research Proposal Review Process for Serum, Plasma, and Urine Specimens . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Research Proposal Review Process for DNA Specimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Linked Genetic Data Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Appendix I. Supporting Figures and Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Appendix II. Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Text Table

Overview of NHANES biospecimens, by survey cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

List of Appendix Figures

I. Flow chart of NHANES biospecimen operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

II Flow chart for DNA specimen request proposals and Research Data Center genetic data proposals. . . . . . . . . . . . . .8

List of Appendix Tables

I. Pristine and surplus serum specimens available, from NHANES III . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

II. Pristine serum, plasma, and urine specimens available, from NHANES 1999–2014 . . . . . . . . . . . . . . . . . . . . . 10

III. Surplus serum, plasma, and urine specimens available, from NHANES 1999–2012 . . . . . . . . . . . . . . . . . . . . . 12

IV. Biospecimens available for participants aged 0–2 years, from NHANES 2003–2006 . . . . . . . . . . . . . . . . . . . . 13

V. NHANES DNA specimens available . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Acknowledgment
 

The authors gratefully acknowledge 

the assistance of Dr. Kathryn Porter in the 

preparation of this report. 

iv 
Abstract 

Background 

The National Health and Nutrition 

Examination Survey’s (NHANES) 

biospecimen program was formed 

to manage the collection of 

biospecimens (including serum, 

plasma, urine, and DNA) from 

NHANES cycles, the storage 

of biospecimens in NHANES 

biorepositories, accessing of 

biospecimens by researchers, 

and the providing of resulting data 

to future researchers. Data from 

biospecimen research can be 

combined with existing NHANES 

data. 

Objective 

This report provides background 

on the development of NHANES 

biorepositories and describes the 

collection, processing, and storing of 

biospecimens; ethical considerations 

and informed consent; and the 

proposal process for accessing 

biospecimens and resulting data. 

The number and types of 

biospecimens collected in each 

survey cycle from NHANES III (1988– 

1994) through NHANES 1999–2014 

are discussed so that researchers 

can understand what biospecimens 

are available if they are considering 

using NHANES biospecimens in their 

research. 

Keywords: DNA • serum • plasma • 

urine 

National Health and Nutrition 

Examination Survey 

Biospecimen Program: 

NHANES III (1988–1994) and 

NHANES 1999–2014 

by Geraldine M. McQuillan, Ph.D., and Jody E. McLean, M.P.H., 

National Center for Health Statistics; Michele Chiappa, B.A., Harris 

Corporation; and Susan L. Lukacs, D.O., M.S.P.H., National Center for 

Health Statistics 

Introduction 

The National Health and Nutrition 

Examination Survey (NHANES) is one 

of a series of health-related surveys 

conducted by the Centers for Disease 

Control and Prevention’s (CDC) National 

Center for Health Statistics (NCHS). 

NHANES collects data on the health, 

nutritional status, and health behaviors of 

the civilian noninstitutionalized resident 

population of the United States (1). The 

survey is unique in that it combines a 

personal interview with a standardized 

physical examination that includes a 

blood draw and urine collection for 

laboratory analysis. 

This report describes the origins 

and characteristics of the NHANES 

biorepositories, which store biospecimens 

obtained during NHANES III (1988– 

1994) and NHANES 1999–2014, as well 

as the process for obtaining access to 

the biospecimens for testing and use in 

research. Blood and urine specimens will 

continue to be collected in NHANES 

2015–2016. The NHANES website 

(http://www.cdc.gov/nchs/nhanes/ 

genetics/stored_specimens.htm) will 

provide the most current information 

about the biospecimen program. 

Appendix I contains supporting 

figures and tables, and Appendix II 

provides a glossary of key terms used in 

this report. 

NHANES III 

(1988–1994) and 

NHANES 1999–2014 

NHANES III was conducted from 

1988 through 1994 and included persons 

aged 2 months and over. As with previous 

NHANES cycles, NHANES III focused 

on health and nutrition. Data were also 

collected on environmental exposures, 

to examine the effect of environment on 

overall health (2). NHANES III gathered 

data on 30,000 survey participants across 

the United States. It was conducted in 

two phases—Phase I (October 1988– 

October 1991) and Phase II (October 

1991–October 1994)—each nationally 

representative of the U.S. population (2). 

In 1999, NHANES became a 

continuous annual survey. Approximately 

5,000 participants of all ages are 

examined each year, and data are 

released in 2-year cycles (3). The focus 

of NHANES 1999–2014 was to provide 

prevalence data on selected diseases 

and risk factors for the U.S. population; 

monitor trends in selected diseases, 

behaviors, and environmental exposures; 

explore emerging public health needs; 

and maintain a national probability 

sample of baseline information on health 

and nutritional status (3). 
Page 2  Series 2, No. 170 

Development of 

Biorepositories 

Biorepositories were created to store 

NHANES participants’ blood (serum 

or plasma), urine, and DNA for future 

research. Resulting research data can 

be combined with existing NHANES 

data. One biorepository stores pristine 

serum, plasma, and urine that have 

not undergone freezing or thawing; a 

second stores surplus serum, plasma, 

and urine that have undergone freezing 

and thawing; and a third stores DNA 

specimens (see Table). 

Establishing the Serum, 

Plasma, and Urine 

Biorepositories 

During NHANES III, either 1 or 

2 ml of serum from each participant, 

depending on age group, were aliquoted 

into four vials in the NHANES Mobile 

Examination Center (MEC) and sent 

to NHANES’ serum biorepository 

in Lawrenceville, Ga. There, the 

biospecimens were re-aliquoted into 

0.5-ml vials and stored as pristine sera, 

even though they had undergone one 

freeze-thaw cycle. This biorepository for 

pristine sera was established in 1988 at 

the start of the survey. 

In 1989, the laboratories that were 

testing the serum specimens as part of 

NHANES informed NCHS’ Division 

of Health and Nutrition Examination 

Surveys (DHANES) that they could no 

longer keep residual biospecimens in 

their laboratory freezers and that there 

was a sufficient volume of serum in 

each vial that could be made available 

for future testing. This was due to 

changes in laboratory methodology that 

required less specimen per individual 

laboratory test and because few tests 

needed to be repeated. At that point, 

DHANES contracted with a commercial 

biorepository and in 1989 began to store 

the surplus serum that was returned from 

the various laboratories. 

In 1999, the biorepositories 

expanded to include both pristine and 

surplus serum, plasma, and urine. Pristine 

serum specimens were aliquoted in the 

MEC into 0.5-ml vials that have never 

undergone a freeze-thaw cycle. 

Establishing a DNA 

Biorepository 

In 1991, NHANES developed 

a biorepository to maintain DNA 

specimens for future studies. This would 

allow genetic information to be combined 

with other NHANES data to improve 

knowledge of human disease. Prior to 

establishing the DNA biorepository, 

blood specimens were collected from 

participants during NHANES III Phase 

I to validate a DNA processing and 

extraction method. A molecular genetic 

technique using crude cell lysates from 

cell lines was used to extract the DNA. 

Small samples of cells obtained from 

8 ml of blood collected from participants 

Table. Overview of NHANES biospecimens, by survey cycle 

Specimen type 

Pristine1 Surplus2 

NHANES cycle Serum Plasma Urine Serum Plasma Urine DNA 

aged 12 and over were sent to CDC’s 

National Center for Environmental 

Health (NCEH) molecular biology 

laboratory for extraction. With the 

knowledge gained, blood was then 

collected from participants during 

NHANES III Phase II, DNA was 

extracted, and specimens were stored for 

future genetic research (4). Starting in 

1999, blood specimens for isolating DNA 

from whole blood were collected from 

participants during NHANES 1999–2002, 

2007–2008, 2009–2010, and 2011–2012. 

Ethics, Privacy, and 

Confidentiality

The NCHS Ethics Review Board 

(ERB) protects the rights and welfare of 

NHANES participants. The NHANES 

protocol, and the protocol to make 

DNA available for research, comply 

with the U.S. Department of Health and 

Human Services’ Policy for Protection 

of Human Research Subjects (45 CFR 

46), available from: http://www.hhs.gov/ 

ohrp/humansubjects/guidance/45cfr46. 

html (3). Additionally, three federal 

laws protect information collected from 

individuals: 

●		 Privacy Act of 1974 (5 USC 552a) 

●		 Section 308(d) of the Public Health 

Service Act (42 USC 242m) 

●		 Confidential Information Protection 

and Statistical Efficiency Act 

(CIPSEA) (PL 107–347, enacted 

in 2002) (2). 

The Public Health Service Act 

stipulates that “...no information may 

be used for any purpose other than 

the purpose for which it was supplied 

unless ...[a] person consented to 

its use for such other purpose, and 

further that it cannot be released or 

III (1988–1994) X ... ... X ... 

1999–2000 X X X X X 

2001–2002 X X X X X 

2003–2004 X X X X ... 

2005–2006 X X X X ... 

2007–2008 X X X X ... 

2009–2010 X X X X ... 

2011–2012 X ... X X ... 

2013–2014 X ... X X ... 

... X published in a form that the particular 

X 

X 

X 

X ...person supplying the information 

... ... or described in it is identifiable unless 

... ... such ...person has consented....” These ... 

... 

... 

X 

X 

X 

strict prohibitions, forbidding even 

unintentional unauthorized disclosures, 

... ... guide the behavior of all NCHS staff 

and contractors (3). ... Category not applicable.
 1

Biospecimens immediately frozen for storage, did not undergo laboratory testing. In addition to scientific review, 2

Biospecimens were surplus after laboratories had completed testing.
 all research protocols proposing to use SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2015. 
NHANES biospecimens are reviewed 

by the NCHS Confidentiality Officer for 

disclosure risk and by the NCHS Human 

Subjects Contact and ERB for protection 

of the rights and welfare of NHANES 

participants, including vulnerable 

populations such as children, pregnant 

women, and older Americans (3). 

Once a protocol is approved, it is 

reviewed annually by the ERB. After 

5 years of annual continuations, if there is 

need for continued use of biospecimens 

to complete the study protocol, a new 

protocol is required. If at any time after 

approval a researcher wants to change the 

protocol, an amendment to the protocol is 

required and undergoes the same review 

process as the initial protocol. 

Informed Consent 

During NHANES III, participants 

aged 12 and over signed a form 

consenting to storage of a sample of their 

blood for future research (a parent or 

guardian also signed the consent form if 

the participant was under age 18); genetic 

research was not specifically mentioned. 

Beginning with NHANES 1999, 

participants aged 7 and over signed a 

form consenting to have blood and urine 

specimens stored for use in future studies 

(a parent or guardian also signed the 

consent form if the participant was under 

age 18). On the same form, participants 

aged 20 and over could consent to have 

blood stored for future genetic studies 

(3). 

Beginning in 2007, these consents 

were separated into two forms and 

participants signed one consent form 

for storing blood and urine for future 

nongenetic studies and a different form 

for storing blood for use in future genetic 

studies. The consent form for nongenetic 

studies highlights the need for research 

using stored biospecimens to help find 

new ways to prevent, treat, and cure 

many diseases. The genetics consent 

form informs participants that their DNA 

will be used for genetic research to help 

understand genetic links to medical 

conditions. On all consent forms from 

1999 through 2014, participants were 

informed that there was no plan to 

contact them with the results of future 

tests. 

Biospecimen 

Operations 

This section describes the collection, 

processing, storing, and shipping of 

biospecimens during the NHANES 

cycles. All biospecimens are collected 

and processed at the MEC by a laboratory 

team consisting of a phlebotomist and 

medical technologists who are certified 

in accordance with the guidelines of the 

American Society for Clinical Pathology 

(3). 

Blood Collection for Serum 

or Plasma 

Blood is collected from NHANES 

participants aged 1 year and over by a 

phlebotomist. Prior to blood collection 

(venipuncture), the participant (or parent 

or guardian) completes a questionnaire 

to screen for conditions that would 

exclude him or her from the blood draw, 

such as hemophilia, having received 

chemotherapy in the previous 4 weeks, 

and various reasons that would preclude 

the use of the participant’s arms for a 

blood draw. The amount of blood drawn 

varies by age and survey year, ranging 

from 7 ml in participants aged 1 to 3 in 

NHANES III to not more than 

128 ml in participants aged 12 and over 

in NHANES 1999–2014 (2,3). Blood is 

processed by centrifuging and separating 

serum or plasma from the appropriate 

collection tube, and then aliquoting the 

specimens into vials. As a biospecimen 

vial is processed, it is barcoded with 

a label for the participant and given a 

laboratory number. All vials are verified 

for correct labeling. Vials are stored 

under appropriate cold (4°C–8°C) 

or freezing (–20°C) conditions in 

preparation for shipment to the testing 

laboratories (2,3). 

In each NHANES cycle, more 

than 25 laboratories receive NHANES 

biospecimens for testing. Biospecimens 

are packed in wet or dry ice, depending 

on the analyte to be tested, and shipped 

at least once a week, again depending on 

the analyte. Each shipment contains a log 

transmittal form or shipping manifest. 

Extra serum or plasma are aliquoted 

Series 2, No. 170  Page 3 

into cryovials for long-term storage. 

These biospecimens are considered 

pristine and are directly stored in vaporphase liquid nitrogen (–80°C or below) 

and shipped to the CDC and Agency 

for Toxic Substances and Disease 

Registry (ATSDR) Specimen Packaging, 

Inventory, and Repository (CASPIR) for 

long-term storage. 

Urine Collection 

Starting in 1999, a random urine 

specimen was collected by having 

participants aged 6 and over void into a 

sterile container (2,3). Urine specimens 

are processed by aliqoting varied amounts 

of urine into vessels appropriately sized 

for specific laboratory assays. During 

NHANES 1999–2014, a 5-ml aliquot 

of extra urine was placed in a cryovial 

for long-term storage. In NHANES 

2009–2012, participants aged 6 and over 

also provided a first morning void urine 

specimen from home. Preprinted bar code 

labels for each participant are affixed to 

the urine vessels. The vessels are stored 

in specific containers, frozen, and shipped 

weekly or at the completion of a survey 

location. Each shipment contains a log 

transmittal form or shipping manifest. 

Pristine Biospecimens 

Pristine biospecimens from 

NHANES III and NHANES 1999–2014 

were shipped from the MEC and stored 

at CASPIR. On average, six vials of 0.5-

to 1.0-ml serum per vial per participant 

aged 3 or over (and one 0.5-ml plasma 

per vial from participants aged 6 and 

over from NHANES 1999–2010) are 

stored in vapor-phase liquid nitrogen 

(–80°C or below). Pristine NHANES III 

biospecimens underwent one freeze-thaw 

cycle (for aliquoting only) before storage; 

pristine biospecimens from NHANES 

1999–2014 have not undergone any 

freeze-thaw cycles (3). Pristine urine 

specimens from NHANES 1999–2014 

(one or two vials of 5-ml urine per 

participant aged 6 or over) are stored at 

CASPIR in vapor-phase liquid nitrogen 

(–80°C or below). Additionally, two 

aliquots of 5-ml urine collected from 

first void home urine specimens from 

NHANES 1999–2012 participants, 
Page 4  Series 2, No. 170 

processed at the University of Minnesota, 

were sent to CASPIR for storage. See 

Table. 

Surplus Biospecimens 

After laboratories complete their 

testing, surplus serum, plasma, and 

urine specimens are shipped to the 

NHANES biorepository (a commercial 

biorepository under contract to 

NCHS) for long-term storage. These 

biospecimens have been through at 

least two freeze-thaw cycles prior to 

being shipped to the biorepository. 

At the biorepository, surplus serum or 

plasma specimens are stored at –80 °C. 

During NHANES 1999–2002, surplus 

urine specimens (one or two vials 

of 0.2- to 5-ml urine per participant 

aged 6 or over) were shipped from the 

testing laboratories to the NHANES 

biorepository for long-term storage. See 

Table. 

DNA Specimens 

Blood collection for the extraction 

of DNA (NHANES III Phase II and 

NHANES 1999–2002, 2007–2008, 

2009–2010, and 2011–2012) followed 

the same NHANES screening procedures 

described previously for blood collected 

for serum and plasma. Blood specimens 

for DNA extraction were shipped to 

CDC’s NCEH Division of Laboratory 

Sciences for processing and long-term 

storage. For NHANES III Phase II, DNA 

was extracted from crude lysates of cell 

lines from participants aged 12 and over. 

For these specimens, DNA concentrations 

vary and are estimated to range from 

7.5 to 65 ng/μl, with an average of 

approximately 4 μg in 100 μl (4). For 

NHANES 1999–2002, 2007–2008, 

2009–2010, and 2011–2012, DNA was 

purified from the blood of consenting 

participants aged 20 and over. DNA 

was isolated from two 10-ml aliquots of 

whole blood per participant. A master 

set of DNA specimens per survey cycle 

was stored at –80°C. A partial second 

DNA set from the second aliquot of blood 

was also frozen and stored at –80°C. 

Additionally, aliquots of purified DNA 

were normalized to concentrations of 

approximately 50 ng/μl (4). 

Forty microliters of each DNA 

specimen were supplied to researchers 

who had an approved project. To prepare 

a complete DNA set for researchers, a 

96-well plate map format is created to 

document the location of each DNA 

sample and to incorporate blanks and 

blind duplicates for quality control. For 

all survey cycles, each 96-well plate is 

barcoded and labeled with a readable 

identifier. These plate replicates are 

sealed in bags for shipping and frozen 

at –20°C. To prepare for shipping, plate 

replicates are retrieved from storage, the 

manifest listing is verified, and plates 

are packaged with appropriate shipping 

labels. Each shipment contains a shipping 

manifest. 

For a flow chart of NHANES 

biospecimen operations, see Figure I in 

Appendix I. 

Access to 

Biospecimens 

Research Proposal Review 

Process for Serum, Plasma, 

and Urine Specimens 

All NHANES serum, plasma, and 

urine specimens from NHANES III and 

the 2-year survey cycles from NHANES 

1999–2014 (Appendix I, Tables I–IV) 

are available to researchers. Those 

interested in using serum, plasma, or 

urine specimens for research must submit 

a proposal to the DHANES Biospecimen 

Program Project Officer (5). The proposal 

includes specific aims, background and 

public health significance, research 

design and methods, clinical significance 

of results, qualifications of the principal 

investigator, period of performance, 

and proposed or received funding. All 

proposals are evaluated by a technical 

panel for scientific merit, public health 

significance, and clinical significance. 

The panel consists of scientists from 

within and outside NCHS. 

Because NHANES participants 

receive the results of their survey 

laboratory tests 12–16 weeks after 

examination at the MEC and have no 

further contact with NHANES staff, 

there is no plan to contact participants 

with results of future tests resulting 

from research on biospecimens. 

Therefore, researchers wishing to access 

biospecimens cannot test for analytes 

that could have clinical significance 

for participants. A laboratory analyte 

is considered clinically significant 

if laboratory tests are performed by 

a Clinical Laboratory Improvement 

Amendments (CLIA)-certified laboratory 

and therefore deemed valid, the findings 

have significant implications for the 

participant’s health, and a course of 

action is readily available to treat the 

associated health concern (5). 

After a proposal is approved by 

the technical panel, it is evaluated by 

the NCHS Confidentiality Officer for 

disclosure risk, and by the NCHS Human 

Subjects Officer and the ERB for any 

potential human subjects concerns. 

The technical panel, Human Subjects 

Officer, and ERB also evaluate whether 

the test has clinical significance. The 

ERB reviews the proposal even if it was 

previously approved by the researcher’s 

institutional review panel. Researchers 

can request changes to the protocol only 

through an ERB amendment process. 

After 5 years of annual 

continuations, if there is need for 

continued use of biospecimens to 

complete the protocol study, a new 

protocol is required. This protocol is 

reviewed by the technical panel to assure 

the ERB that the sole purpose of the new 

protocol is to complete the original study. 

More information on the proposal process 

is available on the biospecimen program 

website at http://www.cdc.gov/nchs/ 

nhanes/genetics/stored_specimens.htm 

and on the Federal Register website (5). 

Once their proposal is approved, 

researchers complete and sign the 

Material Transfer Agreement (MTA) and 

send payment for the biospecimens. After 

the MTA and payment are received, the 

request to send samples to the researcher 

is authorized. If the researcher is within 

the federal government, biospecimens 

are provided after receipt of a signed 

Interagency Agreement rather than an 

MTA. If an approved project is unable to 

obtain funding, the project is canceled. 
Series 2, No. 170  Page 5 

The researcher confirms the approved 

study population for testing with 

the DHANES Biospecimens Project 

Officer, who ensures that the requested 

biospecimens are available at CASPIR 

or the contract biorepository. The 

project officer places the researcher 

in contact with the biorepository 

to schedule overnight delivery of 

biospecimens. 

After laboratory testing is 

complete, all results are sent to NCHS 

to be linked to the sequence number 

(SEQN) ID (the linking identifier on 

the public-use data files), and a data 

file is prepared. The data file, linked to 

NHANES public-use data, is returned 

to the researcher for quality control 

testing. See the NHANES biospecimen 

program website (http://www.cdc. 

gov/nchs/nhanes/genetics/stored_ 

specimens.htm) for updated guidelines. 

The researcher has up to 90 days to 

complete this testing, after which the 

data are released to the public on the 

NHANES website. 

Research Proposal 

Review Process for DNA 

Specimens 

DNA specimens were stored in 

NCEH’s molecular biology laboratory. 

In 1999, NHANES announced that 

it would provide the public with an 

anonymized set of genetic data (from 

the DNA specimens collected in 

NHANES III Phase II) with a limited 

number of demographic variables (i.e., 

age, race, and sex) for analyses. This 

minimized the research potential for 

genetic data by limiting access to the 

full array of NHANES data. In 2002, 

NHANES obtained approval from the 

NCHS ERB to allow researchers to 

request DNA samples for approved 

research. Resulting genetic data could 

be linked with other NHANES data 

through NCHS’ Research Data Center 

(RDC). 

In 2012, the ERB suspended the 

NHANES DNA Specimen Program 

from receiving new proposals due to 

concerns about reporting of incidental 

findings from research results. As of 

March 2015, DHANES has received 

approval to reopen the program. Refer to 

the NHANES website 

(http://www.cdc.gov/nchs/nhanes/ 

genetics/genetic.htm) in late 2015 for 

the updated Federal Register notification 

(Table V). 

From 2002 through 2012, researchers 

could submit a new research proposal 

on either January 1 or July 1 of each 

year to request DNA specimens (4). 

The proposal was first submitted to the 

DHANES Genetics Project Officer. It 

was then sent to the Genetics Technical 

Panel, comprised of experts in the 

genetics field, for review. When the 

comments and questions from the panel 

had been appropriately addressed by 

the requesting researcher, the approved 

proposal was sent to the NCHS Human 

Subjects Contact, Confidentiality Officer, 

and ERB for review and approval. Once 

a research proposal was approved—and 

after receipt of a completed and signed 

MTA and payment—the biospecimens 

were shipped to the researcher. If 

the researcher was within the federal 

government, biospecimens were provided 

after receipt of a signed Interagency 

Agreement rather than an MTA. For 

projects requiring funding, DNA 

specimens were not provided to the 

requesting researcher until the project had 

received funds. Requests from approved 

projects that were unable to obtain 

funding were canceled. For a flow chart 

showing the NHANES DNA request 

proposal process, see Figure II. 

Following approval, researchers 

were shipped an approved and complete 

set of participants’ samples, plus quality 

control samples that represented 5% of 

the complete set. Quality control samples 

are blinded to the researchers. All test 

results from DNA specimens are returned 

to NCHS for quality control review. The 

first step in quality control review is to 

test the percentage of the quality control 

specimens that were discordant with their 

corresponding specimens in the complete 

set; if more than 5% are discordant, 

then the genetic variable failed quality 

control (i.e., 95% or greater duplicate 

concordance is required). The second 

step is to assess deviations from HardyWeinberg proportions separately for 

each of the three main race and ethnicity 

groups (non-Hispanic white, nonHispanic black, and Mexican-American) 

using chi-square goodness-of-fit tests. 

If two of the three race and ethnicity 

groups deviate from Hardy-Weinberg 

proportions at p < 0.001, the genetic 

variable fails quality control (6). 

Test results that pass quality 

control review are linked to NHANES 

data by SEQN ID. After 6 months, 

the genetic data are deposited in the 

NHANES Genetic Data Repository and 

made available, by proposal, to other 

researchers. 

Researchers depositing genetic 

data or researchers wanting to analyze 

secondary genetic data in the NHANES 

Genetic Data Repository are required to 

submit a proposal and access the data 

through the NCHS RDC. All proposals 

are reviewed for potential disclosure 

issues. All analyses are performed in the 

RDC at NCHS in Hyattsville, Md.; in 

the RDC on the CDC campus in Atlanta, 

Ga.; or through the NCHS remote access 

system. A fee is charged to use RDC 

services. 

For more information on gaining 

access to NHANES’ Genetic Data 

Repository for research, see http://www. 

cdc.gov/nchs/nhanes/genetics/genetic_ 

access.htm. For a flow chart showing the 

RDC genetic proposal process, see 

Figure II. 

Linked Genetic Data Sets 

Linking of NHANES III Phase II, 

NHANES 1999–2002, and NHANES 

2007–2008 public-use and restricted 

data with the genetic information 

available in the NHANES Genetic Data 

Repository provides researchers with 

the opportunity to conduct a vast array 

of outcome studies to investigate the 

association between a wide variety of 

health factors and genetic variation (7). 

The linkage process continues as more 

genetic variation information becomes 

available. Data in the repository can be 

accessed through the RDC. The majority 

of genetic data in the repository are single 

nucleotide polymorphisms (7). 
Page 6  Series 2, No. 170 

Summary 

This report has provided an overview 

of the collection, storage, and availability 

for research of biospecimens collected 

through NHANES. More detailed 

information is available on the NHANES 

website at http://www.cdc.gov/nchs/ 

nhanes.htm. 

References 

1.	 National Center for Health Statistics. 

About the National Health and 

Nutrition Examination Survey. 

Hyattsville, MD. 2014. Available 

from: http://www.cdc.gov/nchs/ 

nhanes/about_nhanes.htm. 

2.	 National Center for Health Statistics. 

Plan and operation of the Third 

National Health and Nutrition 

Examination Survey, 1988–94. Vital 

Health Stat 1(32). 1994. Available 

from: http://www.cdc.gov/nchs/data/ 

series/sr_01/sr01_032.pdf. 

3.	 Zipf G, Chiappa M, Porter KS, et 

al. National Health and Nutrition 

Examination Survey: Plan and 

operations, 1999–2010. National 

Center for Health Statistics. Vital 

Health Stat 1(56). 2013. Available 

from: http://www.cdc.gov/nchs/data/ 

series/sr_01/sr01_056.pdf. 

4.	 CDC. National Health and Nutrition 

Examination Survey (NHANES) 

DNA samples: Guidelines for 

proposals to use samples and cost 

schedule. Fed Regist 75 FR 32191– 

5. 2010. Available from: https:// 

federalregister.gov/a/2010-13517. 

5.	 CDC. National Health and Nutrition 

Examination Survey (NHANES) 

stored biologic specimens: 

Guidelines for proposals to use 

samples and proposed cost schedule. 

Fed Regist 74(138):35872–5. 2009. 

Available from: http://www.cdc.gov/ 

nchs/data/nhanes/Fed_Reg_Serum. 

pdf. 

6.	 National Center for Health Statistics. 

National Health and Nutrition 

Examination Survey (NHANES) 

DNA quality control protocol. 

Hyattsville, MD. 2010. Available 

from: http://www.cdc.gov/nchs/data/ 

nhanes/genetics/Quality_Control_ 

Public.pdf. 

7.	 National Center for Health Statistics. 

NHANES genetic data. Hyattsville, 

MD. 2011. Available from: http:// 

www.cdc.gov/nchs/nhanes/genetics/ 

genetic.htm. 
Series 2, No. 170  Page 7 

Appendix I. Supporting Figures and Tables 

 

 

 

 

 

 

 

 

 

 

 

Figure I. Flow chart of NHANES biospecimen operations 
Page 8  Series 2, No. 170 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure II. Flow chart for DNA specimen proposals and Research Data Center genetic data proposals 
Series 2, No. 170  Page 9 

Table I. Pristine and surplus serum specimens available, from NHANES III 

Age group and specimen source 

3–5 years 

Participants...................................................

........................................................

...................................................

........................................................

...................................................

........................................................

...................................................

........................................................

Vials

6–11 years 

Participants

Vials

12–19 years 

Participants

Vials

20 and over 

Participants

Vials

Pristine serum 

... 

... 

2,469 

12,781 

2,586 

16,308 

15,029 

140,806 

Surplus serum 

1,381 

2,955 

2,568 

6,342 

2,918 

16,667 

16,035 

103,706 

... Category not applicable. 

NOTES: Specimens accessible for testing under approved protocols. Numbers are current based on data available at publication.
 

Vials contain ≥0.2 ml.
 

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2015.
 
Page 10  Series 2, No. 170 

Table II. Pristine serum, plasma, and urine specimens available, from NHANES 1999–2014 

Survey cycle, age group, and specimen source Serum Plasma Urine 

1999–2000 

6–11 years: 

Participants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

705 730 788 

Vials 2,381 730 1,492 

12–19 years: 

Participants 1,846 1,825 1,919 

Vials 20,701 1,825 3,577 

20 and over: 

Participants 3,724 1,305 3,839 

Vials 41,327 1,305 7,336 

2001–2002 

6–11 years: 

Participants 917 968 1,017 

Vials 2,578 968 1,753 

12–19 years: 

Participants 2,017 2,081 2,105 

Vials 20,116 2,081 3,475 

20 and over: 

Participants 4,398 4,527 4,511 

Vials 43,259 4,527 7,950 

2003–2004 

3–5 years: 

Participants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

315 ... ... 

Vials 315 ... ... 

6–11 years: 

Participants 719 489 850 

Vials 1,299 489 1,513 

12–19 years: 

Participants 1,899 1,200 1,995 

Vials 16,732 1,200 3,393 

20 and over: 

Participants 4,244 2,545 4,260 

Vials 37,106 2,545 8,383 

2005–2006 

3–5 years: 

Participants 302 ... ... 

Vials 302 ... ... 

6–11 years: 

Participants 789 845 935 

Vials 2,773 845 935 

12–19 years: 

Participants 1,884 1,859 1,899 

Vials 16,534 1,859 1,899 

20 and over: 

Participants 4,252 4,151 4,160 

Vials 36,706 4,151 4,812 

2007–2008 

3–5 years: 

Participants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

329 ... ... 

Vials 1,269 ... ... 

6–11 years: 

Participants 866 864 526 

Vials 5,190 864 526 

12–19 years: 

Participants 955 967 532 

Vials 9,815 967 532 

20 and over: 

Participants 4,832 4,840 2,638 

Vials 49,060 4,840 2,638 

See footnotes at end of table. 
Series 2, No. 170  Page 11 

Table II. Pristine serum, plasma, and urine specimens available, from NHANES 1999–2014 

—Con. 

Survey cycle, age group, and specimen source 

2009–2010 

3–5 years: 

Participants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Vials

6–11 years: 

Participants

Vials 

12–19 years: 

Participants

Vials 

20 and over: 

Participants

Vials 

2011–2012 

3–5 years: 

Participants

Vials 

6–11 years: 

Participants

Vials 

12–19 years: 

Participants

Vials 

20 and over: 

Participants

Vials 

2013–2014 

3–5 years: 

Participants

Vials

6–11 years: 

Participants

Vials 

12–19 years: 

Participants

Vials 

20 and over: 

Participants

Vials 

Serum 

347 

772 

811 

1,003 

1,008 

4,618 

5,072 

25,026 

259 

461 

749 

1,350 

916 

3,327 

4,273 

16,195 

334 

651 

852 

1,688 

1,026 

4,013 

4,771 

18,786 

Plasma 

... 

... 

869 

869 

1,020 

1,020 

5,129 

5,129 

... 

... 

... 

... 

... 

... 

... 

... 

... 

... 

... 

... 

... 

... 

... 

... 

Urine 

... 

... 

973 

1,111 

1,062 

1,246 

5,181 

6,137 

... 

... 

958 

1,901 

990 

1,968 

4,470 

8,886 

... 

... 

934 

1,719 

1,085 

2,000 

4,785 

9,765 

... Category not applicable.
 

NOTES: Specimens accessible for testing under approved protocols. Numbers are current based on data available at publication.
 

Vials contain ≥0.2 ml.
 

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2015.
 
Page 12  Series 2, No. 170 

Table III. Surplus serum, plasma, and urine specimens available, from NHANES 1999–2012 

Survey cycle, age group, and specimen source Serum Plasma Urine 

1999–2000 

3–5 years: 

Participants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

351 240 ... 

Vials 929 240 ... 

6–11 years: 

Participants 867 638 975 

Vials 3,447 638 1,440 

12–19 years: 

Participants 2,110 1,460 2,125 

Vials 12,758 1,506 3,660 

20 and over: 

Participants 4,173 3,663 4,242 

Vials 21,767 5,529 7,582 

2001–2002 

3–5 years: 

Participants 431 ... ... 

Vials 1,063 ... ... 

6–11 years: 

Participants 1,007 ... 764 

Vials 3,928 ... 764 

12–19 years: 

Participants 2,203 ... 2,281 

Vials 17,990 ... 2,375 

20 and over: 

Participants 4,835 2,960 4,492 

Vials 36,743 3,200 4,925 

2003–2004 

3–5 years: 

Participants 444 ... ... 

Vials 1,509 ... ... 

6–11 years: 

Participants 838 ... ... 

Vials 3,784 ... ... 

12–19 years: 

Participants 2,048 ... ... 

Vials 12,078 ... ... 

20 and over: 

Participants 4,473 ... ... 

Vials 22,587 ... ... 

2005–2006 

3–5 years: 

Participants 482 ... ... 

Vials 1,783 ... ... 

6–11 years: 

Participants 926 ... ... 

Vials 4,505 ... ... 

12–19 years: 

Participants 1,978 ... ... 

Vials 12,532 ... ... 

20 and over: 

Participants 4,490 ... ... 

Vials 29,248 ... ... 

2007–2008 

3–5 years: 

Participants 406 ... ... 

Vials 552 ... ... 

6–11 years: 

Participants 986 ... ... 

Vials 1,477 ... ... 

12–19 years: 

Participants 1,074 ... ... 

Vials 4,429 ... ... 

20 and over: 

Participants 5,342 ... ... 

Vials 24,888 ... ... 

See footnotes at end of table. 
Series 2, No. 170  Page 13 

Table III. Surplus serum, plasma, and urine specimens available, from NHANES 1999–2012 

—Con. 

Survey cycle, age group, and specimen source Serum Plasma Urine 

2009–2010 

3–5 years: 

Participants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

323 ... ... 

Vials 323 ... ... 

6–11 years: 

Participants 887 ... ... 

Vials 1,646 ... ... 

12–19 years: 

Participants 1,177 ... ... 

Vials 3,585 ... ... 

20 and over: 

Participants 5,708 ... ... 

Vials 19,105 ... ... 

2011–2012 

6–11 years: 

Participants 845 ... ... 

Vials 898 ... ... 

12–19 years: 

Participants 1,035 ... ... 

Vials 1,510 ... ... 

20 and over: 

Participants 4,605 ... ... 

Vials 6,759 ... ... 

... Category not applicable. 

NOTES: Specimens accessible for testing under approved protocols. Numbers are current based on data available at publication. 

Vials contain ≥0.2 ml. Total number of surplus specimens (participants and vials) for 2013–2014 was not available at time of 

publication. Updates are available on the NHANES website at http://www.cdc.gov/nchs/nhanes.htm. 

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2015. 

Table IV. Biospecimens available for 

participants aged 0–2 years, from NHANES 

2003–2006 

Specimen source1 

Participants 

Vials 

Surplus serum 

873 

1,214 

1

Specimens only available for 4 years combined. 

NOTE: Additional specimens for 2002 available by special 

request. 

SOURCE: CDC/NCHS, National Health and Nutrition 

Examination Survey, 2015. 

Table V. NHANES DNA specimens available 

Survey cycle Age group Participants DNA source 

NHANES III 

1999–2002 

2007–2008 

2009–2010 

12 and over 

20 and over 

20 and over 

20 and over 

7,159 

7,839 

4,615 

3,898 

Crude cell lysates 

Blood 

Blood 

Blood 

NOTE: Total number of participants for 2011–2012 was not available at time of publication. 

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2015. 
Page 14  Series 2, No. 170 

Appendix II. Glossary 

Biorepository—A place where 

biologic specimens are stored and made 

available for research purposes. 

Biospecimens—Materials taken from 

the human body. 

CASPIR—Centers for Disease 

Control and Prevention (CDC) and 

Agency for Toxic Substances and 

Disease Registry (ATSDR) Specimen 

Packaging, Inventory, and Repository for 

biospecimens. 

Civilian noninstitutionalized 

population—Includes all people living 

in U.S. households and excludes those 

living in institutionalized group quarters 

and persons on active duty with the 

military. 

DNA—Deoxyribonucleic acid, the 

hereditary material in humans and almost 

all other organisms. 

Ethics Review Board—A committee 

within NCHS that performs ethical 

review of proposed research. 

National Center for Health Statistics 

(NCHS)—The principal health statistics 

agency in the United States. NCHS 

compiles statistical information to help 

guide public health and health policy 

decisions to improve the health of 

the American people. It also designs, 

develops, and maintains a number of 

systems that produce data related to 

demographic and health concerns, 

including data on registered births and 

deaths collected through the National 

Vital Statistics System (NVSS), as 

well as data from the National Health 

Interview Survey (NHIS), the National 

Health and Nutrition Examination Survey 

(NHANES), the National Health Care 

Surveys (NHCS), and the National 

Survey of Family Growth (NSFG), 

among others. NCHS is part of the 

U.S. Department of Health and Human 

Services’ Centers for Disease Control and 

Prevention. 

Plasma—The pale yellow liquid 

component of nonclotted blood after the 

blood settles. 

Pristine biospecimen—A 

biospecimen that, once frozen, has never 

been thawed. 

Public-use data—An electronic 

data set containing participant records 

from a survey, with a subset of variables 

collected in the survey that have been 

reviewed by analysts within NCHS to 

ensure participant identity is protected. 

Research Data Center (RDC)—An 

NCHS entity that provides researchers 

access to restricted data from NCHS 

surveys. 

Restricted-use data—An electronic 

data set containing participant records 

from a survey that contain some 

information that may, if released to the 

public, risk disclosure of individual 

participants. These data are available 

through the NCHS RDC and include 

data sets with (a) data items that were 

collected for an odd number of calendar 

years (1, 3, or 5 years); (b) data linked 

geographically to some other contextual 

data file (often supplied by the data user); 

and (c) data items that are determined 

to be too sensitive or too detailed 

to be released to the public due to 

confidentiality restrictions. 

Serum—The clear liquid portion of 

blood after it clots. 

Surplus biospecimen—A 

biospecimen that was used for other 

laboratory tests and is now available for 

future research. 

Urine—Waste material secreted by 

the kidneys. 
Vital and Health Statistics

Series Descriptions

ACTIVE SERIES

Series 1.	 Programs and Collection Procedures—This type of report

describes the data collection programs of the National Center

for Health Statistics. Series 1 includes descriptions of the

methods used to collect and process the data, definitions, and

other material necessary for understanding the data.

Series 2.	 Data Evaluation and Methods Research—This type of

report concerns statistical methods and includes analytical

techniques, objective evaluations of reliability of collected

data, and contributions to statistical theory. Also included are

experimental tests of new survey methods, comparisons of

U.S. methodologies with those of other countries, and as of

2009, studies of cognition and survey measurement, and final

reports of major committees concerning vital and health

statistics measurement and methods.

Series 3.	 Analytical and Epidemiological Studies—This type of

report presents analytical or interpretive studies based on vital

and health statistics. As of 2009, Series 3 also includes

studies based on surveys that are not part of continuing data

systems of the National Center for Health Statistics and

international vital and health statistics reports.

Series 10.	 Data From the National Health Interview Survey—This

type of report contains statistics on illness; unintentional

injuries; disability; use of hospital, medical, and other health

services; and a wide range of special current health topics

covering many aspects of health behaviors, health status, and

health care utilization. Series 10 is based on data collected in

this continuing national household interview survey.

Series 11.	 Data From the National Health Examination Survey, the

National Health and Nutrition Examination Surveys, and

the Hispanic Health and Nutrition Examination Survey—

In this type of report, data from direct examination, testing,

and measurement on representative samples of the civilian

noninstitutionalized population provide the basis for (1)

medically defined total prevalence of specific diseases or

conditions in the United States and the distributions of the

population with respect to physical, physiological, and

psychological characteristics, and (2) analyses of trends and

relationships among various measurements and between

survey periods.

Series 13.	 Data From the National Health Care Survey—This type of

report contains statistics on health resources and the public’s

use of health care resources including ambulatory, hospital,

and long-term care services based on data collected directly

from health care providers and provider records.

Series 20.	 Data on Mortality—This type of report contains statistics on

mortality that are not included in regular, annual, or monthly

reports. Special analyses by cause of death, age, other

demographic variables, and geographic and trend analyses

are included.

Series 21.	 Data on Natality, Marriage, and Divorce—This type of

report contains statistics on natality, marriage, and divorce

that are not included in regular, annual, or monthly reports.

Special analyses by health and demographic variables and

geographic and trend analyses are included.

Series 23.	 Data From the National Survey of Family Growth—These

reports contain statistics on factors that affect birth rates,

including contraception and infertility; factors affecting the

formation and dissolution of families, including cohabitation,

marriage, divorce, and remarriage; and behavior related to

the risk of HIV and other sexually transmitted diseases.

These statistics are based on national surveys of women and

men of childbearing age.

DISCONTINUED SERIES

Series 4.	 Documents and Committee Reports—These are final

reports of major committees concerned with vital and health

statistics and documents. The last Series 4 report was

published in 2002. As of 2009, this type of report is included

in Series 2 or another appropriate series, depending on the

report topic.

Series 5.	 International Vital and Health Statistics Reports—This

type of report compares U.S. vital and health statistics with

those of other countries or presents other international data of

relevance to the health statistics system of the United States.

The last Series 5 report was published in 2003. As of 2009,

this type of report is included in Series 3 or another series,

depending on the report topic.

Series 6.	 Cognition and Survey Measurement—This type of report

uses methods of cognitive science to design, evaluate, and

test survey instruments. The last Series 6 report was

published in 1999. As of 2009, this type of report is included

in Series 2.

Series 12.	 Data From the Institutionalized Population Surveys—

The last Series 12 report was published in 1974. Reports

from these surveys are included in Series 13.

Series 14.	 Data on Health Resources: Manpower and Facilities—

The last Series 14 report was published in 1989. Reports on

health resources are included in Series 13.

Series 15.	 Data From Special Surveys—This type of report contains

statistics on health and health-related topics collected in

special surveys that are not part of the continuing data

systems of the National Center for Health Statistics. The last

Series 15 report was published in 2002. As of 2009, reports

based on these surveys are included in Series 3.

Series 16.	 Compilations of Advance Data From Vital and Health

Statistics—The last Series 16 report was published in 1996.

All reports are available online, and so compilations of

Advance Data reports are no longer needed.

Series 22.	 Data From the National Mortality and Natality Surveys—

The last Series 22 report was published in 1973. Reports

from these sample surveys, based on vital records, are

published in Series 20 or 21.

Series 24.	 Compilations of Data on Natality, Mortality, Marriage, and

Divorce—The last Series 24 report was published in 1996.

All reports are available online, and so compilations of reports

are no longer needed.

For answers to questions about this report or for a list of reports published

in these series, contact:

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Centers for Disease Control and Prevention

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online at: http://www.cdc.gov/nchs/govdelivery.htm.
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