Attachment 17-1 thru 17-19 BEEA Supplementary Participant Materials Letters s

Attachments 17.1-17.19: BEEA Supplementary Participant Materials Letters
(Intro Letter, Pre-Visit Mailing Letter, Urine Directions, Results Letters)
17.1) BEEA Introductory Letter for Iowa (RSG & REG Group Respondents)
17.2) BEEA Introductory Letter for North Carolina (RSG & REG Group Respondents)
17.3) BEEA Consent Mailing Cover Letter for Iowa Respondents (All Groups)
17.4) BEEA Consent Mailing Cover Letter for North Carolina Respondents (All Groups)
17.5) BEEA Consent Mailing Cover Letter for Iowa Respondents (REG Group – Air Monitoring
Visit)
17.6) BEEA Consent Mailing Cover Letter for North Carolina Respondents (REG Group – Air
Monitoring Visit)
17.9) BEEA Directions for Urine Specimen Collection for Iowa Respondents (All Groups)
17.10) BEEA Directions for Urine Specimen Collection for North Carolina Respondents (All
Groups)
17.11) BEEA CBC Lymphocyte Assay Results Letters for Iowa (REG and Control Groups)
17.11a) Notice of Normal Results (REG and Control Groups)
17.11b) Notice of Essentially Normal Results (REG and Control Groups)
17.11c) Notice of Abnormal Results/To Contact Provider (REG and Control Groups)
17.11d) Notice of Abnormal Results/Not to Contact Provider (REG and Control Groups)
17.11e) Provider Communication of Abnormal Results (REG Group)
17.11f) Provider Communication of Abnormal Results (Control Group)
17.12) BEEA ‘Contact Us’ Letter for Iowa RSG & REG Groups Respondents
17.13) BEEA ‘Contact Us’ Letter for North Carolina RSG & REG Groups Respondents
17.14) BEEA Introductory Letter for Iowa Control Group Respondents
17.15) BEEA Introductory Letter for North Carolina Control Group Respondents
17.18) BEEA ‘Contact Us’ Letter for Iowa Control Group Respondents
17.19) BEEA ‘Contact Us’ Letter for North Carolina Control Group Respondents

FOR IRB USE ONLY
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Attachment 17-1: BEEA IA Introductory Letter for Randomly Selected and
Recently Exposed Group Participants
Date
To:
Mr.
From: Charles Lynch, M.D., Ph.D.
Director, Agricultural Health Study in Iowa
Thank you for your participation in the Agricultural Health Study (AHS). We appreciate
the time you have already taken over the years to complete the study interviews and
questionnaires.
A new study is underway for the AHS that is designed to measure biologic effects in
relation to different farming exposures and activities. Overall, 2,200 Agricultural Health Study
members and controls will be enrolled over the next several years of the study. The study is being
funded by the National Cancer Institute.
This study will examine the properties of blood, saliva, and urine as well as dust samples
from a subset of households that may be related to environmental or occupational factors and lifestyle characteristics. Improving our understanding of these relationships will help us in our
evaluation of possible links between pesticide exposure and disease. We are particularly
interested in cancers. We believe our long-term study of rural Iowans may help us better
understand these illnesses and eventually prevent them.
We plan to call you within a couple of weeks to determine if you are truly eligible to
participate in this study. Up to 5 call attempts will be made at different times of the day and at
different days to reach you. Among the questions we will ask are three aimed toward improving
our understanding of your cancer screening practices. The call will take 10 minutes or less.
Once we determine your eligibility for the study and you tell us that you are interested in
participating, we will schedule a home visit with you, with the possibility of completing two
additional home visits for a select number of participants. Prior to the home visit, you will receive
materials from us including two copies of the consent document, a reminder card for key
elements of the questionnaire, and urine collection materials. At the time of the home visit we
will obtain your signed consent to participate in this study. We will also conduct a 30-minute
interview to obtain information about your recent medication use, medical conditions, smoking
status, alcohol consumption, and pesticide use during the current/previous growing season. We
will ask you to provide about 4 tablespoons of blood, saliva, and a first morning sample of urine.
This will take about 30 minutes. In all, the visit would take about 1.5 to 2 hours of your time.
All of the information we collect will be used only for research purposes and will be kept
strictly confidential. However, federal regulatory agencies and the University of Iowa
Institutional Review Board (a committee that reviews and approves research studies) may inspect
and copy records pertaining to this research. Neither your name nor any personal information
will ever appear in any reports generated from this study. The physical risks associated with the
study are minimal and include those associated with blood collection. Rarely, there may be
swelling or bruising. It is also possible, but very unlikely, that there may be a risk of loss of
confidentiality of your information collected during this study. There should be no risk for
answering the questions regarding the cancer screening practices. You will not benefit from
being in this study. However, we hope that, in the future, other people might benefit from this
study because of the knowledge gained.
Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify.
We will keep your participation in this research study confidential to the extent permitted by law.

FOR IRB USE ONLY
$STAMP_IRB
$STAMP_IRB_ID
$STAMP_APPRV_DT
$STAMP_EXP_DT

You should not have any costs for being in this study. You will receive $100.00 for each
visit as a thank you for your participation in the main portion of the research study. You will not
receive financial incentive for answering the questions regarding cancer screening practices.
We want you to know that your participation in any activity of the Agricultural Health
Study is always voluntary. Be assured that there will be no penalties if you decide not to respond,
either to the information collection as a whole or to any particular question.
If you have any questions, concerns or do not want to participate, please contact
Deb Lande, study coordinator at 1-800-217-1954. Please specify that you are calling about
the Biomarkers of Exposures and Effects in Agriculture (BEEA) Study. If you have
questions or concerns about your rights as a research subject please contact the Human Subjects
Office, 105 Hardin Library for the Health Sciences, 600 Newton Road, University of Iowa, Iowa
City, IA 52242-1098, (319) 335-6564, or e-mail [email protected]. This study’s IRB number is
201002777. Again, we want to thank you for your assistance in making the Agricultural Health
Study an important and successful study of health in the agricultural community. We look
forward to speaking with you soon.

Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify.
We will keep your participation in this research study confidential to the extent permitted by law.

Attachment 17-2: BEEA NC Introductory Letter for Randomly Selected and
Recently Exposed Group Participants
Date
To:
Mr.
From: Marsha Dunn, MPH
Director, Agricultural Health Study in North Carolina
Thank you for your participation in the Agricultural Health Study (AHS). We appreciate
the time you have already taken over the years to complete the study interviews and
questionnaires.
A new study is underway for the AHS that is designed to measure biologic effects in
relation to different farming exposures and activities. Overall, 2,200 Agricultural Health Study
members and controls will be enrolled over the next several years of the study. The study is being
funded by the National Cancer Institute and the US Environmental Protection Agency.
This study will examine the properties of blood, saliva, and urine as well as dust samples
from a subset of households that may be related to environmental or occupational factors and lifestyle characteristics. Improving our understanding of these relationships will help us in our
evaluation of possible links between pesticide exposure and disease. We are particularly
interested in cancers. We believe our long-term study may help us better understand these
illnesses and eventually prevent them.
We plan to call you within a couple of weeks to determine if you are truly eligible to
participate in this study. Up to 5 call attempts will be made at different times of the day and at
different days to reach you. Among the questions we will ask are three aimed toward improving
our understanding of your cancer screening practices. The call will take 10 minutes or less.
Once we determine your eligibility for the study and you tell us that you are interested in
participating, we will schedule a home visit with you, with the possibility of completing two
additional home visits for a select number of participants. Prior to the home visit, you will receive
materials from us including two copies of the consent document, a reminder card for key
elements of the questionnaire, and urine collection materials. At the time of the home visit we
will obtain your signed consent to participate in this study. We will also conduct a 30-minute
interview to obtain information about your recent medication use, medical conditions, smoking
status, alcohol consumption, and pesticide use during the current/previous growing season. We
will ask you to provide about 4 tablespoons of blood, saliva, and a first morning sample of urine.
This will take about 30 minutes. In all, the visit would take about 1.5 to 2 hours of your time.
All of the information we collect will be used only for research purposes and will be kept
strictly confidential. However, federal regulatory agencies and the Westat Institutional Review
Board (a committee that reviews and approves research studies) may inspect and copy records
pertaining to this research. Neither your name nor any personal information will ever appear in
any reports generated from this study. The physical risks associated with the main portion of the
study are minimal and include those associated with blood collection. Rarely, there may be
swelling or bruising. It is also possible, but very unlikely, that there may be a risk of loss of
confidentiality of your information collected during this study. There should be no risk for
answering the questions regarding the cancer screening practices. You will not benefit from
being in this study. However, we hope that, in the future, other people might benefit from this
study because of the knowledge gained.
You should not have any costs for being in this study. You will receive $100.00 for each
visit as a thank you for your participation in the main portion of the research study. You will not
Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify.
We will keep your participation in this research study confidential to the extent permitted by law.

receive a financial incentive for answering the questions regarding cancer screening practices.
We want you to know that your participation in any activity of the Agricultural Health
Study is always voluntary. Be assured that there will be no penalties if you decide not to respond,
either to the information collection as a whole or to any particular question.
If you have any questions, concerns or do not want to participate, please contact
Amy Miller, study coordinator, at 1-800-4AGSTUDY (1-800-424-7883). Please specify that
you are calling about the Biomarkers of Exposures and Effects in Agriculture (BEEA)
Study. If you have questions or concerns about your rights as a research subject please contact
the Westat Human Subjects Protections Office, 1-888-920-7631. Please leave a message with
your full name, the name of the research study that you are calling about (the Biomarkers of
Exposures and Effects in Agriculture or BEEA Study), and a phone number beginning with the
area code. Someone will return your call as soon as possible. Again, we want to thank you for
your assistance in making the Agricultural Health Study an important and successful study of
health in the agricultural community. We look forward to speaking with you soon.

Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify.
We will keep your participation in this research study confidential to the extent permitted by law.

FOR IRB USE ONLY
$STAMP_IRB
$STAMP_IRB_ID
$STAMP_APPRV_DT
$STAMP_EXP_DT

Attachment 17-3: BEEA IA Consent Mailing Cover Letter for Randomly Selected,
Recently Expose, and Control Group Participants
Date
To:
Mr.
From: Charles Lynch, M.D., Ph.D.
Director, Agricultural Health Study in Iowa
I want to thank you for taking the time to speak with us recently and for
expressing interest in participating in the Agricultural Health Study’s Study of
Biomarkers of Exposures and Effects in Agriculture (BEEA).
This letter is to confirm our appointment at your home, {address}, on
{Day of week, DATE}
{TIME}
for a home visit for the BEEA Study. Before the appointment, please take some time to
review the enclosed materials, which include a home visit preparation sheet, directions
for collection of the urine sample, a questionnaire concerning collection of the vacuum
dust sample, and a consent form. The consent form describes what will happen during the
home visit, foreseeable benefits and risks (such as possible bruising after a blood draw),
an explanation of the study’s confidentiality procedures and who to contact for answers
to questions about the home visit. We will collect the signed consent form at your visit,
and you may also request a copy for your records.
We will be calling you within the next week to confirm the appointment and
verify receipt of these materials. We will be happy to answer any questions you have at
that time. Please read the information sheet on preparation for the home visit and the
vacuum dust sample questionnaire carefully and follow the instructions precisely. If you
have any questions about the instructions, please ask them when we call you.
If you have any questions or concerns, please contact Deb Lande, study coordinator
at 1-800-217-1954. Please specify that you are calling about the Biomarkers of
Exposures and Effects in Agriculture (BEEA) Study. If you have questions or
concerns about your rights as a research subject please contact the Human Subjects
Office, 105 Hardin Library for the Health Sciences, 600 Newton Road, University of
Iowa, Iowa City, IA 52242-1098, (319) 335-6564, or e-mail [email protected]. Again, we
want to thank you for your assistance in making the Agricultural Health Study an
important and successful study of health in the agricultural community. We look forward
to speaking with you soon.

Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify.
We will keep your participation in this research study confidential to the extent permitted by law.

Attachment 17-4: BEEA NC Consent Mailing Cover Letter for Randomly Selected,
Recently Exposed, and Control Group Participants

Date
To:
Mr.
From: Marsha Dunn, MPH.
Director, Agricultural Health Study in North Carolina
I want to thank you for taking the time to speak with us recently and for
expressing interest in participating in the Agricultural Health Study’s Study of
Biomarkers of Exposures and Effects in Agriculture (BEEA).
This letter is to confirm our appointment at your home, {address}, on
{Day of week, DATE}
{TIME}
for a home visit for the BEEA Study. Before the appointment, please take some time to
review the enclosed materials, which include a home visit preparation sheet, directions
for collection of the urine sample, a questionnaire concerning collection of the vacuum
dust sample, and a consent form. The consent form describes what will happen during the
home visit, foreseeable benefits and risks (such as possible bruising after a blood draw),
an explanation of the study’s confidentiality procedures and who to contact for answers
to questions about the home visit. We will collect the signed consent forms at your visit,
and you may also request a copy for your records.
We will be calling you within the next week to confirm the appointment and
verify receipt of these materials. We will be happy to answer any questions you have at
that time. Please read the information sheet on preparation for the home visit and the
vacuum dust sample questionnaire carefully and follow the instructions precisely. If you
have any questions about the instructions, please ask them when we call you.
If you have any questions or concerns, please contact Amy Miller, study
coordinator at 1-800-4AGSTUDY (1-800-424-7883). Please specify that you are
calling about the Biomarkers of Exposures and Effects in Agriculture (BEEA)
Study. If you have questions or concerns about your rights and welfare as a research
participant please contact the Westat Human Subjects Protections Office, by calling 1888-920-7631. Please leave a message with your full name, the name of the research
study that you are calling about (the Biomarkers of Exposures and Effects in Agriculture
or BEEA Study), and a phone number beginning with the area code. Someone will return
your call as soon as possible. Again, we want to thank you for your assistance in making
the Agricultural Health Study an important and successful study of health in the
agricultural community. We look forward to speaking with you soon.
Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify.
We will keep your participation in this research study confidential to the extent permitted by law.

FOR IRB USE ONLY
$STAMP_IRB
$STAMP_IRB_ID
$STAMP_APPRV_DT
$STAMP_EXP_DT

Attachment 17-5: BEEA IA Consent Mailing Cover Letter for Recently Exposed
Group - Air Monitoring Visit
Date
To:
Mr.
From: Charles Lynch, M.D., Ph.D.
Director, Agricultural Health Study in Iowa
I want to thank you for taking the time to speak with us recently and for
expressing interest in participating in the Agricultural Health Study’s Study of
Biomarkers of Exposures and Effects in Agriculture (BEEA).
This letter is to confirm our appointments for the BEEA Study
Farm Visit: at {address}, on {Day of week, DATE} at {TIME}
Home Visit: at {address}, on {Day of week, DATE} at {TIME}
Before the appointments, please take some time to review the enclosed materials, which
include a home visit preparation sheet, directions for collection of the urine sample, a
questionnaire concerning collection of the vacuum dust sample, and two consent forms.
The consent forms describe what will happen at each type of visit, foreseeable benefits
and risks (such as possible bruising after the home visit blood draw), an explanation of
the study’s confidentiality procedures and who to contact for answers to questions about
the home visit. We will collect the signed consent form at your visit, and you may also
request a copy for your records.
We will be calling you a few days before the first visit to confirm the appointment
and verify receipt of these materials. We will be happy to answer any questions you have
at that time. You do not have to do any preparation for the air monitoring visit, but prior
to the home visit please read the information sheet on preparation for the home visit and
the vacuum dust sample questionnaire carefully and follow the instructions precisely. If
you have any questions about the instructions, please ask them when we call you.
If you have any questions or concerns, please contact Deb Lande, study coordinator
at 1-800-217-1954. Please specify that you are calling about the Biomarkers of
Exposures and Effects in Agriculture (BEEA) Study. If you have questions or
concerns about your rights as a research subject please contact the Human Subjects
Office, 105 Hardin Library for the Health Sciences, 600 Newton Road, University of
Iowa, Iowa City, IA 52242-1098, (319) 335-6564, or e-mail [email protected]. Again, we
want to thank you for your assistance in making the Agricultural Health Study an
Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify.
We will keep your participation in this research study confidential to the extent permitted by law.

FOR IRB USE ONLY
$STAMP_IRB
$STAMP_IRB_ID
$STAMP_APPRV_DT
$STAMP_EXP_DT

important and successful study of health in the agricultural community. We look forward
to speaking with you soon.

Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify.
We will keep your participation in this research study confidential to the extent permitted by law.

Attachment 17-6: BEEA NC Consent Mailing Cover Letter for Recently Exposed
Group -Air Monitoring Visit
Date
To:
Mr.
From: Marsha Dunn, MPH.
Director, Agricultural Health Study in North Carolina
I want to thank you for taking the time to speak with us recently and for
expressing interest in participating in the Agricultural Health Study’s Study of
Biomarkers of Exposures and Effects in Agriculture (BEEA).
This letter is to confirm our appointments for the BEEA Study
Farm Visit: at {address}, on {Day of week, DATE} at {TIME}
Home Visit: at {address}, on {Day of week, DATE} at {TIME}
Before the appointments, please take some time to review the enclosed materials,
which include a home visit preparation sheet, directions for collection of the urine
sample, a questionnaire concerning collection of the vacuum dust sample, and two
consent forms. The consent forms describes what will happen at each type of visit,
foreseeable benefits and risks (such as possible bruising after a blood draw), an
explanation of the study’s confidentiality procedures and who to contact for answers to
questions about the home visit. We will collect the signed consent forms at your visits,
and you may also request copies for your records.
We will be calling you within the next week to confirm the appointment and
verify receipt of these materials. We will be happy to answer any questions you have at
that time. You do not have to do any preparation for the air monitoring visit, but prior to
the home visit, please read the information sheet on preparation for the home visit and the
vacuum dust sample questionnaire carefully and follow the instructions precisely. If you
have any questions about the instructions, please ask them when we call you.
If you have any questions or concerns, please contact Amy Miller, study
coordinator at 1-800-4AGSTUDY (1-800-424-7883). Please specify that you are
calling about the Biomarkers of Exposures and Effects in Agriculture (BEEA)
Study. If you have questions or concerns about your rights and welfare as a research
participant please contact of the Westat Human Subjects Protections Office, by calling 1888-920-7631. Please leave a message with your full name, the name of the research
study that you are calling about (the Biomarkers of Exposures and Effects in Agriculture
or BEEA Study), and a phone number beginning with the area code. Someone will return
your call as soon as possible. Again, we want to thank you for your assistance in making
the Agricultural Health Study an important and successful study of health in the
agricultural community. We look forward to speaking with you soon.
Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify.
We will keep your participation in this research study confidential to the extent permitted by law.

Attachment 17-9: BEEA IA Directions for Urine Collection for All Groups

DIRECTIONS FOR URINE COLLECTION
Please follow the directions below. You may request help reading the instructions from a member
of your household, but please do not permit anyone else to handle the collection materials.
Here is a list of what you should find in the package we mailed to you:
• 1 Liter screw top collection container
• 1 leak-proof plastic bag containing 1 piece of absorbent tissue
• Brown paper bag

If you have not received all of these materials, please call us at 1-800-2171954. Please specify that you are calling about the Biomarkers of Exposures
and Effects in Agriculture (BEEA) Study.
1.

To help you remember to collect your urine sample, leave the collection container on the toilet
seat lid the night before your home visit.

2.

Collect the sample only when you wake and get up for the day.

3.

Wash your hands before opening the collection container.

4.

Urinate directly into the container.

5.

Replace the top on the collection container and screw it on tightly. Place the sample inside the
leak-proof plastic bag with the absorbent tissue and then inside the brown paper bag.

6.

Store the sample in a refrigerator or at a refrigerated temperature.

7.

We will collect the sample at your home visit.

THANK YOU FOR YOUR HELP!

Attachment 17-10: BEEA NC Directions for Urine Collection for All Groups

DIRECTIONS FOR URINE COLLECTION
Please follow the directions below. You may request help reading the instructions from a member of
your household, but please do not permit anyone else to handle the collection materials.
Here is a list of what you should find in the package we mailed to you:
• 1 liter screw top collection container
• 1 leak-proof plastic bag containing 1 piece of absorbent tissue
• Brown paper bag

If you have not received all of these materials, please call us at 1-800-4247883. Please specify that you are calling about the Biomarkers of Exposures
and Effects in Agriculture (BEEA) Study.
1.

To help you remember to collect your urine sample, leave the collection container on the toilet
seat lid the night before your home visit.

2.

Collect the sample only when you wake and get up for the day.

3.

Wash your hands before opening the collection container.

4.

Urinate directly into the container.

5.

Replace the top on the collection container and screw it on tightly. Place the sample inside the
leak-proof plastic bag with the absorbent tissue and then inside the brown paper bag.

6.

Store the sample in a refrigerator or at a refrigerated temperature.

7.

We will collect the sample at your home visit.

THANK YOU FOR YOUR HELP!

FOR IRB USE ONLY
$STAMP_IRB
$STAMP_IRB_ID
$STAMP_APPRV_DT
$STAMP_EXP_DT

Attachment 17-11a: BEEA IA Sample Letter to Subject for Communication of Lab Test Results
that are Normal (REG and Control Groups)
Date:
To:
Mr. [Subject's name]
From: Charles Lynch, M.D., Ph.D.
Director, Iowa Field Station

Thank you for your participation in the Biomarkers of Exposures and Effects in Agriculture
(BEEA) Study.
When you signed a consent form for this study, you indicated that you were interested in receiving
the results of the clinical tests run on your blood. A standard panel of complete blood cell count was
performed on a blood sample collected from you on [month/day/year]. As you can see from the
accompanying report, your levels of platelets (PLT), white blood cells (WBC), and red blood cells
(RBC) were all within the normal range for people in your sex and age group. Platelets are important in
assisting your blood to clot when you bleed. Mean platelet volume (MPV) is the average size of
platelets found in your blood. White blood cells are important in fighting infectious organisms. Your
red blood cells carry oxygen to your tissues and contain hemoglobin (HB) to help them perform this
task.
These red blood cells are a major constituent of your blood, and the volume of your blood occupied
by these cells is measured by the hematocrit (HCT). The mean cell volume (MCV), mean cell
hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC) are also each specific to your
red blood cells. The red blood cell distribution width (RDW and RDWSD) is a measure of variability in
red blood cell size. Nucleated red blood cells (NRBC) are immature cells that normally do not enter
your blood. All of these red blood cell indices were within the normal range in your blood.
Your white blood cells consist of neutrophils (NEUT), lymphocytes (LYMPH), monocytes
(MONO), eosinophils (EOS), basophils (BASO), and immature granulocytes (IMMATURE GRAN).
Immature granulocytes are considered normal up to 2% of your WBC count. Thus, these WBC types
were all within the normal range in your blood.
Liver function tests are lab blood tests designed to provide information about the state of your liver.
The parameters measured included total protein, albumin, alkaline phosphatase, total bilirubin, direct
bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Results of these tests
were normal.
In summary, the results of your routine blood tests are all normal. If you have any questions or
concerns, please contact Dr. Charles Lynch at (319-384-1558). Please specify that you are calling about
the Biomarkers of Exposures and Effects in Agriculture (BEEA) Study.

Page 1 of 9

FOR IRB USE ONLY
$STAMP_IRB
$STAMP_IRB_ID
$STAMP_APPRV_DT
$STAMP_EXP_DT

Attachment 17-11b: BEEA IA Sample Letter to Subject for Communication of Lab Test Results
that are Essentially Normal (REG and Control Groups)
Date:
To:
Mr. [Subject's name]
From: Charles Lynch, M.D., Ph.D.
Director, Iowa Field Station

Thank you for your participation in the Biomarkers of Exposures and Effects in Agriculture
(BEEA) Study.
When you signed a consent form for this study, you indicated that you were interested in receiving
the results of the clinical tests run on your blood. A standard panel of complete blood cell count was
performed on a blood sample collected from you on [month/day/year]. As you can see from the
accompanying report, your levels of platelets (PLT), white blood cells (WBC), and red blood cells
(RBC) were all within the normal range for people in your sex and age group [with the exception of the
[type(s) of measure], which was/were slightly [above/below] the normal range]. Platelets are important
in assisting your blood to clot when you bleed. Mean platelet volume (MPV) is the average size of
platelets found in your blood. White blood cells are important in fighting infectious organisms. Your
red blood cells carry oxygen to your tissues and contain hemoglobin (HB) to help them perform this
task.
These red blood cells are a major constituent of your blood, and the volume of your blood occupied
by these cells is measured by the hematocrit (HCT). The mean cell volume (MCV), mean cell
hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC) are also each specific to your
red blood cells. The red blood cell distribution width (RDW and RDWSD) is a measure of variability in
red blood cell size. Nucleated red blood cells (NRBC) are immature cells that normally do not enter
your blood. All of these red blood cell indices were within the normal range in your blood [with the
exception of the [type(s) of measure], which was/were slightly [above/below] the normal range].
Your white blood cells consist of neutrophils (NEUT), lymphocytes (LYMPH), monocytes
(MONO), eosinophils (EOS), basophils (BASO), and immature granulocytes (IMMATURE GRAN).
Immature granulocytes are considered normal up to 2% of your WBC count. Thus, these WBC types
were all within the normal range in your blood [with the exception of the [type(s) of measure], which
was/were slightly [above/below] the normal range]. [INCLUDE THE FOLLOWING IF PERFORMED:
A drop of your blood was used to make a peripheral smear. This was examined and reported to have
[report what was stated on report]].
Liver function tests are lab blood tests designed to provide information about the state of your liver.
The parameters measured included total protein, albumin, alkaline phosphatase, total bilirubin, direct
bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Results of these tests
were normal [with the exception of the [type(s) of measure], which was/were slightly [above/below] the
normal range].
In summary, the results of your routine blood tests are essentially normal. Your [types of measure]
were slightly [above/below] the normal range, but we ran many tests here and are not surprised to find
[number] out of the normal range. The normal range represents a 95% confidence interval. Thus, if you
ran 20 tests, we would expect one to be outside the normal range by chance alone. This is what I believe
has occurred with your [type of measure]. If you have any questions or concerns, please contact Dr.
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Charles Lynch at (319-384-1558). Please specify that you are calling about the Biomarkers of
Exposures and Effects in Agriculture (BEEA) Study.

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Attachment 17-11c: BEEA IA Sample Letter to Subject for Communication of Lab Test Results
that are Abnormal When Health Care Provider to be Contacted (REG and Control Groups)
Date:
To:
Mr. [Subject's name]
From: Charles Lynch, M.D., Ph.D.
Director, Iowa Field Station

Thank you for your participation in the Biomarkers of Exposures and Effects in Agriculture
(BEEA) Study.
When you signed a consent form for this study, you indicated that you were interested in receiving
the results of the clinical tests run on your blood. A standard panel of complete blood cell count was
performed on a blood sample collected from you on [month/day/year]. As you can see from the
accompanying report, your levels of platelets (PLT), white blood cells (WBC), and red blood cells
(RBC) were all within the normal range for people in your sex and age group [with the exception of the
[type(s) of measure], which was/were [above/below] the normal range]. Platelets are important in
assisting your blood to clot when you bleed. Mean platelet volume (MPV) is the average size of
platelets found in your blood. White blood cells are important in fighting infectious organisms. Your
red blood cells carry oxygen to your tissues and contain hemoglobin (HB) to help them perform this
task.
These red blood cells are a major constituent of your blood, and the volume of your blood occupied
by these cells is measured by the hematocrit (HCT). The mean cell volume (MCV), mean cell
hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC) are also each specific to your
red blood cells. The red blood cell distribution width (RDW and RDWSD) is a measure of variability in
red blood cell size. Nucleated red blood cells (NRBC) are immature cells that normally do not enter
your blood. All of these red blood cell indices were within the normal range in your blood [with the
exception of the [type(s) of measure], which was/were [above/below] the normal range].
Your white blood cells consist of neutrophils (NEUT), lymphocytes (LYMPH), monocytes
(MONO), eosinophils (EOS), basophils (BASO), and immature granulocytes (IMMATURE GRAN).
Immature granulocytes are considered normal up to 2% of your WBC count. Thus, these WBC types
were all within the normal range in your blood [with the exception of the [type(s) of measure], which
was/were [above/below] the normal range]. [INCLUDE THE FOLLOWING IF PERFORMED: A drop
of your blood was used to make a peripheral smear. This was examined and reported to have [report
what was stated on report]].
Liver function tests are blood tests designed to provide information about the state of your liver. The
parameters measured included total protein, albumin, alkaline phosphatase, total bilirubin, direct
bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Results of these tests
were normal [with the exception of the [type(s) of measure], which was/were [above/below] the normal
range].
{Add the following paragraph regarding lymphocyte subset test results if abnormal: Lymphocyte
subset blood tests were performed. These consist of B-cells and types of T-cells, which are important in
maintaining your health status. These were all within the normal range in your blood [with the
exception of the [type(s) of measure], which was/were [above/below] the normal range]}.

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In summary, some of the results of your routine blood tests are outside of clinically-defined normal
ranges. In particular this applies to [list abnormal tests]. There are many reasons why such abnormal
tests could occur. When you enrolled in this study you indicated that you wanted any such test results
sent to:
[List name and address of Health Care Provider]
We have done this and included this letter and its accompanying results in the mailing to your health
care provider. We recommend that you consult with your health care provider to discuss your blood test
results further. If you have any questions or concerns, please contact Dr. Charles Lynch at (319-3841558). Please specify that you are calling about the Biomarkers of Exposures and Effects in
Agriculture (BEEA) Study.

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Attachment 17-11d: BEEA IA Sample Letter to Subject for Communication of Lab Test Results
that are Abnormal When Health Care Provider is Not to be Contacted (REG and Control
Groups)
Date:
To:
Mr. [Subject's name]
From: Charles Lynch, M.D., Ph.D.
Director, Iowa Field Station

Thank you for your participation in the Biomarkers of Exposures and Effects in Agriculture
(BEEA) Study.
When you signed a consent form for this study, you indicated that you were interested in receiving
the results of the clinical tests run on your blood. A standard panel of complete blood cell count was
performed on a blood sample collected from you on [month/day/year]. As you can see from the
accompanying report, your levels of platelets (PLT), white blood cells (WBC), and red blood cells
(RBC) were all within the normal range for people in your sex and age group [with the exception of the
[type(s) of measure], which was/were [above/below] the normal range]. Platelets are important in
assisting your blood to clot when you bleed. Mean platelet volume (MPV) is the average size of
platelets found in your blood. White blood cells are important in fighting infectious organisms. Your
red blood cells carry oxygen to your tissues and contain hemoglobin (HB) to help them perform this
task.
These red blood cells are a major constituent of your blood, and the volume of your blood occupied
by these cells is measured by the hematocrit (HCT). The mean cell volume (MCV), mean cell
hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC) are also each specific to your
red blood cells. The red blood cell distribution width (RDW and RDWSD) is a measure of variability in
red blood cell size. Nucleated red blood cells (NRBC) are immature cells that normally do not enter
your blood. All of these red blood cell indices were within the normal range in your blood [with the
exception of the [type(s) of measure], which was/were [above/below] the normal range].
Your white blood cells consist of neutrophils (NEUT), lymphocytes (LYMPH), monocytes
(MONO), eosinophils (EOS), basophils (BASO), and immature granulocytes (IMMATURE GRAN).
Immature granulocytes are considered normal up to 2% of your WBC count. Thus, these WBC types
were all within the normal range in your blood [with the exception of the [type(s) of measure], which
was/were [above/below] the normal range]. [INCLUDE THE FOLLOWING IF PERFORMED: A drop
of your blood was used to make a peripheral smear. This was examined and reported to have [report
what was stated on report]].
Liver function tests are lab blood tests designed to provide information about the state of your liver.
The parameters measured included total protein, albumin, alkaline phosphatase, total bilirubin, direct
bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Results of these tests
were normal [with the exception of the [type(s) of measure], which was/were [above/below] the normal
range].
{Add the following paragraph regarding lymphocyte subset test results if abnormal: Lymphocyte
subset blood tests were performed. These consist of B-cells and types of T-cells, which are important in
maintaining your health status. These were all within the normal range in your blood [with the
exception of the [type(s) of measure], which was/were [above/below] the normal range]}.
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In summary, some of the results of your routine blood tests are outside of clinically-defined normal
ranges. In particular this applies to [list abnormal tests]. There are many reasons why such abnormal
tests could occur. We recommend that you consult with your health care provider to discuss your blood
test results further. If you have any questions or concerns, please contact Dr. Charles Lynch at (319384-1558). Please specify that you are calling about the Biomarkers of Exposures and Effects in
Agriculture (BEEA) Study.

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Attachment 17-11e: BEEA IA Sample Letter to Subject's Physician for
Communication of Abnormal Lab Test Results (REG Group)

Date:
To:
Dr. [Name]
From: Charles Lynch, M.D., Ph.D.
Director, Iowa Field Station

The Agricultural Health Study is a cohort study of almost 90,000 licensed pesticide applicators and
their spouses in Iowa and North Carolina. The study is sponsored by the National Institutes of Health,
the National Institute of Environmental Health Sciences, and the Environmental Protection Agency. We
are currently conducting a substudy within the cohort, called the Biomarkers of Exposures and Effects
in Agriculture (BEEA) Study. Your patient, [Subject's name], is participating in this study. The
contact information we have for this patient is as follows:
[Contact Information]
A standard panel of complete blood cell count (CBC) with automated differential, liver function
tests, and [if applicable, state “lymphocyte subset tests”] were performed on a blood sample collected
from [Subject's name] on [month/day/year]. Some of the results of these lab tests were outside of
clinically-defined normal ranges and considered abnormal. As requested and authorized by the patient
when he enrolled in this study, we are providing you the letter sent to him and its accompanying results.
We recommended that he consult with you to discuss his test results further.
If you have any questions or concerns, please contact Dr. Charles Lynch at (319) 384-1558. Please
specify that you are calling about the Biomarkers of Exposures and Effects in Agriculture (BEEA)
Study.

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Attachment 17-11f: BEEA IA Sample Letter to Subject's Physician for
Communication of Abnormal Lab Test Results (Control Group)

Date:
To:
Dr. [Name]
From: Charles Lynch, M.D., Ph.D.
Director, Iowa Field Station

The Biomarkers of Exposures and Effects in Agriculture (BEEA) Study is a research study
currently being conducted in Iowa and North Carolina to investigate biologic changes associated with
farming practices and exposures. The study is sponsored by the National Cancer Institute, the National
Institute of Environmental Health Sciences, and the Environmental Protection Agency. Your patient,
[Subject's name], is participating in this study. The contact information we have for this patient is as
follows:
[Contact Information]
A standard panel of complete blood cell count (CBC) with automated differential, liver function
tests, and [if applicable, state “lymphocyte subset tests”] were performed on a blood sample collected
from [Subject's name] on [month/day/year]. Some of the results of these lab tests were outside of
clinically-defined normal ranges and considered abnormal. As requested and authorized by the patient
when he enrolled in this study, we are providing you the letter sent to him and its accompanying results.
We recommended that he consult with you to discuss his test results further.
If you have any questions or concerns, please contact Dr. Charles Lynch at (319) 384-1558. Please
specify that you are calling about the Biomarkers of Exposures and Effects in Agriculture (BEEA)
Study.

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Attachment 17-12: BEEA IA “Contact Us” Letter for Randomly Selected and
Recently Exposed Groups
Date
To:
Mr.
From: Charles Lynch, M.D., Ph.D.
Director, Agricultural Health Study in Iowa
Thank you for your participation in the Agricultural Health Study (AHS). We appreciate
the time you have already taken over the years to complete the study telephone interviews and
questionnaires.
We recently sent you a letter to invite you to take part in a new study designed to measure
biologic effects in relation to different farming exposures and activities. We would like to tell you
more about the study and find out if you may be eligible for the study and interested in
participating. If so, we will schedule a home visit with you which will take about 90 minutes of
your time, with the possibility of completing two additional home visits for a select number of
participants. You will receive $100.00 for each visit as a thank you for your participation in this
research study.
We tried to reach you to determine if you are truly eligible to participate in this study.
Unfortunately, your telephone number was no longer in service. Could you please call Deb
Lande, study coordinator, at 1-800-217-1954 to let us know whether or not you are
interested in participating in this study, or if you have any questions? Please specify that
you are calling about the Biomarkers of Exposures and Effects in Agriculture (BEEA)
Study.
Again, we want to thank you for your assistance in making the Agricultural Health Study
an important and successful study of health in the agricultural community. We look forward to
speaking with you soon.

Attachment 17-13: BEEA NC “Contact Us” Letter for Randomly Selected and
Recently Exposed Groups
Date
To:
Mr.
From: Marsha Dunn, MPH.
Director, Agricultural Health Study in North Carolina
Thank you for your participation in the Agricultural Health Study (AHS). We appreciate
the time you have already taken over the years to complete the study telephone interviews and
questionnaires.
We recently sent you a letter to invite you to take part in a new study designed to measure
biologic effects in relation to different farming exposures and activities. We would like to tell you
more about the study and find out if you may be eligible for the study and interested in
participating. If so, we will schedule a home visit with you which will take about 90 minutes of
your time, with the possibility of completing two additional home visits for a select number of
participants. You will receive $100.00 for each visit as a thank you for your participation in this
research study.
We tried to reach you to determine if you are truly eligible to participate in this study.
Unfortunately, your telephone number was no longer in service. Could you please call Amy
Miller, study coordinator, at 1-800-4AGSTUDY (1-800-424-7883) to let us know whether
or not you are interested in participating in this study, or if you have any questions? Please
specify that you are calling about the Biomarkers of Exposures and Effects in Agriculture
(BEEA) Study.
Again, we want to thank you for your assistance in making the Agricultural Health Study
an important and successful study of health in the agricultural community. We look forward to
speaking with you soon.

Attachment 17-14: BEEA IA Introductory Letter for Control Group Participants
Date:
To:
Mr.
From: Charles Lynch
Director, Agricultural Health Study in Iowa
We are writing to ask you to consider participating in an important study that our group is doing
in Iowa and North Carolina, looking at the possible health effects of farming. The participants in
the study are both farmers and non-farmers.
The study, called Biomarkers of Exposure and Effect in Agriculture (BEEA), is funded by the
National Cancer Institute.
Farmers are exposed to chemicals and other substances that may affect their health. In our study
we are measuring the possible effects of those different exposures. We want to know if they
affect farmers’ risk of getting cancer and other chronic diseases.
A comparison group of non-farmers, who are similar in age and live in the same area as the
farmers in the study, can help us understand if any health changes we might see in the farmers are
related to farming or something else.
You are receiving this letter because we randomly picked your name from a list of men age 50
and older who are registered voters in your area. We hope to enroll 200 non-farmers in the next
several years in our study.
We will call you in the next couple of weeks to see if you are eligible and want to be in the study.
The call will take 10 minutes or less. If you do volunteer for the study, the caller will schedule a
home visit.
Prior to the home visit we will send you materials including a consent form, a card highlighting
key elements of the visit, a questionnaire, and a container you would use for collecting a urine
sample.
The home visit takes about 90 minutes. During the visit, a trained professional will:
•
•
•
•

Ask you about your work history, general health, and any recent use of tobacco, alcohol,
or medications;
Take a blood and a saliva sample;
Take a sample of dust from your home; and
Ask you to read and sign a consent form that describes your rights as a study participant
and confirms that you want to be in the study.

You will receive $100 as a thank you for your participation in the home visit portion of the
research study. You will not have any costs for being in this research study.
The only physical risks from participating in the study are possible swelling or bruising from the
blood draw, which occurs rarely.
Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify. We
will keep your participation in this research study confidential to the extent permitted by law.

All of the information we collect will be used for research purposes only and will be kept strictly
confidential. Federal agencies and the University of Iowa Institutional Review Board (a
committee that reviews and approves research studies) may inspect and copy records from the
study. Your name and personal information won’t be in any reports that come out of this study.
It’s possible, although very unlikely, that the privacy of your information could be compromised.
You won’t directly benefit from being in the study. However, we hope that people will benefit in
the future from knowledge that comes from the study.
Your participation in any part of this study is voluntary. There would be no penalties for not
responding to the questionnaire or to any question.
If you have questions, concerns or don’t want to participate, please call Deb Lande, study
coordinator, at 1-800-217-1954). Please say that you are calling about the Biomarkers of
Exposures and Effects in Agriculture (BEEA) Study.
If you have questions or concerns about your rights as a study participant please contact the
Human Subjects Office, 105 Hardin Library for the Health Sciences, 600 Newton Road,
University of Iowa, Iowa City, IA 52242-1098, (319) 335-6564, or e-mail [email protected].
Thank you for considering helping us better understand the health of our farmers. We look
forward to speaking with you soon.

Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify. We
will keep your participation in this research study confidential to the extent permitted by law.

Attachment 17-15: BEEA NC Introductory Letter for Control Group Participants
Date:
To:
Mr.
From: Marsha Dunn, MPH
Director, Agricultural Health Study in North Carolina
We are writing to ask you to consider participating in an important study that our group is doing
in Iowa and North Carolina, looking at the possible health effects of farming. The participants in
the study are both farmers and non-farmers.
The study, called Biomarkers of Exposure and Effect in Agriculture (BEEA), is funded by the
National Cancer Institute and the U.S. Environmental Protection Agency.
Farmers are exposed to chemicals and other substances that may affect their health. In our study
we are measuring the possible effects of those different exposures. We want to know if they
affect farmers’ risk of getting cancer and other chronic diseases.
A comparison group of non-farmers, who are similar in age and live in the same area as the
farmers in the study, can help us understand if any health changes we might see in the farmers are
related to farming or something else.
You are receiving this letter because we randomly picked your name from a list of men age 50
and older who are registered voters in your area. We hope to enroll 200 non-farmers in the next
several years in our study.
We will call you in the next few weeks to see if you are eligible and want to be in the study. The
call will take 10 minutes or less. If you do volunteer for the study, the caller will schedule a home
visit.
Prior to the home visit we will send you materials including a consent form, a card highlighting
key elements of the visit, a questionnaire, and a container you would use for collecting a urine
sample.
The home visit takes about 90 minutes. During the visit, a trained professional will:
•
•
•
•

Ask you about your work history, general health, and any recent use of tobacco, alcohol,
or medications;
Take a blood and a saliva sample;
Take a sample of dust from your home; and
Ask you to read and sign a consent form that describes your rights as a study participant
and confirms that you want to be in the study.

You will receive $100 as a thank you for your participation in the home visit portion of the
research study. You will not have any costs from being in this research study. The only physical
risks from participating in the study are possible swelling or bruising from the blood draw, which
occur rarely.
Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify. We
will keep your participation in this research study confidential to the extent permitted by law.

All of the information we collect will be used for research purposes only and will be kept strictly
confidential. Federal agencies and the Westat Institutional Review Board (a committee that
reviews and approves research studies) may inspect and copy records from the study. Your name
and personal information won’t be in any reports that come out of this study. It’s possible,
although very unlikely, that the privacy of your information could be compromised.
You won’t directly benefit from being in the study. However, we hope that people will benefit in
the future from knowledge that comes from the study.
Your participation in any part of this study is voluntary. There would be no penalties for not
responding to the questionnaire or to any question.
If you have questions, concerns or don’t want to participate, please call Amy Miller, study
coordinator, at 1-800-4AGSTUDY (1-800-424-7883). Please say that you are calling about
the Biomarkers of Exposures and Effects in Agriculture (BEEA) Study.
If you have questions or concerns about your rights and welfare as a study participant please
contact the Westat Human Subjects Protections Office, 1-888-920-7631. Please leave a message
with your full name, the name of the research study that you are calling about (the Biomarkers of
Exposures and Effects in Agriculture or BEEA Study), and a phone number beginning with the
area code. Someone will return your call as soon as possible.
Thank you for considering helping us better understand the health of our farmers. We look
forward to speaking with you soon.

Privacy Act Notification: 42 U.S.C. 285a of the Public Health Service Act authorizes collection of this information. It
will be used to evaluate the role of agricultural exposures and other factors in the development of cancer, neurological
disease, birth defects and other chronic diseases. All information is voluntary and if you decide not to provide all or
any part of the requested information you will not be penalized or lose any benefits for which you otherwise qualify. We
will keep your participation in this research study confidential to the extent permitted by law.

Attachment 17-18: BEEA IA “Contact Us” Letter for Control Group Participants
Date
To:
Mr.
From: Charles Lynch
Director, Agricultural Health Study in Iowa
We recently sent you a letter to invite you to take part in an important scientific study
being conducted in Iowa and North Carolina. The study is designed to measure biologic effects in
relation to different farming exposures and activities, and includes both farmers and non-farmers.
We invited you to participate in this study because your name was randomly picked from a list of
men age 50 and older who are registered voters in your area.
We would like to tell you more about the study and find out if you may be eligible for the
study and interested in participating. If so, we will schedule a home visit with you which will take
about 90 minutes of your time. You will receive $100.00 as a thank you for your participation in
this research study.
We tried to reach you to determine if you are truly eligible to participate in this study.
Unfortunately, your telephone number was not in service. Could you please call Deb
Lande, study coordinator, at 1-800-217-1954 and leave a message to let us know whether
or not you are interested in participating in this study, or if you have any questions? Please
specify that you are calling about the Biomarkers of Exposures and Effects in Agriculture
(BEEA) Study and please leave an updated telephone number so we may return your call.
Again, we want to thank you for your assistance with this important study of health in the
agricultural community. We look forward to speaking with you soon.

Attachment 17-19: BEEA NC “Contact Us” Letter for Control Group Participants
Date
To:
Mr.
From: Marsha Dunn, MPH.
Director, Agricultural Health Study in North Carolina
We recently sent you a letter to invite you to take part in an important scientific study
being conducted in Iowa and North Carolina. The study is designed to measure biologic effects in
relation to different farming exposures and activities, and includes both farmers and non-farmers.
We invited you to participate in this study because your name was randomly picked from a list of
men age 50 and older who are registered voters in your area.
We would like to tell you more about the study and find out if you may be eligible for the
study and interested in participating. If so, we will schedule a home visit with you which will take
about 90 minutes of your time. You will receive $100.00 as a thank you for your participation in
this research study.
We tried to reach you to determine if you are truly eligible to participate in this study.
Unfortunately, your telephone number was not in service. Could you please call Amy
Miller, study coordinator, at 1-800-4AGSTUDY (1-800-424-7883) and leave a message to
let us know whether or not you are interested in participating in this study, or if you have
any questions? Please specify that you are calling about the Biomarkers of Exposures and
Effects in Agriculture (BEEA) Study and please leave an updated telephone number so we
may return your call.
Again, we want to thank you for your assistance with this important study of health in the
agricultural community. We look forward to speaking with you soon.