National Aboriginal and Torres Strait Islander Health Measures Survey

The Australian Bureau of Statistics (ABS) is conducting the National Aboriginal and Torres Strait Islander Health Measures Survey. The survey is funded by the Commonwealth Department of Health. As part of the survey, we are asking people to voluntarily give a blood and urine sample.

The aim of the survey is to help us to understand the health of Australians, including the prevalence of long-term health conditions, and health risk factors, such as smoking, drinking alcohol, diet and physical activity. This information can then be used to improve health outcomes for Aboriginal and Torres Strait Islander Peoples.

Your blood samples will be tested for cholesterol and other lipids (fats) linked to heart disease, and for glucose levels linked to diabetes. Your urine samples will be tested to check for kidney disease.

Biomedical test results from the NATSIHMS will:

• Guide future healthcare policies, guidelines and public health programs; and
• Inform vital research into the relationship between nutrition, exercise and health outcomes.

Your participation in the survey is entirely voluntary. This means you can say yes, say no, or you can withdraw from the survey at any time without having to give a reason or feeling judged about your decision. If you say no or choose to withdraw this will not affect your health care or treatment in any way.

The survey involves collecting blood and/or urine samples from people aged 12 years and above. Children aged 5-11 years will only be asked to give a urine sample.

If at any time a participant decides to withdraw from the study, the samples will be placed into clinical waste for destruction as per Sonic Pathology Australia’s standard procedures. All other data will also be removed where it has not been de-identified.

The survey includes a range of biomedical (blood and urine) tests. As a participant you can choose to receive a copy of your test results.

Fasting Plasma Glucose

Measures the level of glucose in the blood after a period of fasting. Having high levels of glucose after fasting for 8-12 hours can mean that someone has diabetes or may be at risk of developing diabetes.

Glycated Haemoglobin (HbA1c)

Non-fasting blood test that measures glucose that is bound to haemoglobin (the protein that carries oxygen in your red blood cells). Used to diagnose Type 2 diabetes and to monitor how well diabetes is being managed.

Total Cholesterol

Non-fasting blood test that measures the total of all forms of cholesterol (LDL, HDL and triglycerides) in the blood. High total blood cholesterol is a risk factor for developing cardiovascular disease, but the overall risk depends on the relative amounts of each type of cholesterol (known as the lipid profile).

HDL Cholesterol

Non-fasting blood test that measures the level of HDL cholesterol in the blood. HDL cholesterol is important as it can protect the body from the damaging effects of LDL cholesterol. Low levels of HDL cholesterol can mean a higher risk of cardiovascular disease.

Fasting Triglycerides and LDL Cholesterol

Fasting blood test measures the level of triglycerides in the blood. The level of LDL cholesterol in the blood is not measured directly, it is calculated from results for total cholesterol, HDL cholesterol and fasting triglycerides. High levels of LDL cholesterol or triglycerides can mean a higher risk of cardiovascular disease.

Serum Creatinine and Estimated Glomerular Filtration Rate (eGFR)

Non-fasting blood test that measures the amount of creatinine, a waste product, in the blood. High levels of creatinine can mean the kidney may not be functioning well. The eGFR is calculated from the level of serum creatinine in the blood. The eGFR is used to assess kidney function and to identify kidney disease.

Urinary Albumin, Urinary Creatinine, and the Albumin Creatinine Ratio (ACR)

Urine tests measure the amount of albumin (a protein) and creatinine (a waste product) in the urine. The ratio of albumin to creatinine (ACR) is calculated. High levels of albumin protein in the urine mean the kidney is not functioning well. The albumin creatinine ratio is used to identify kidney disease.

Alanine Amino Transferase (ALT)

Non-fasting blood test that measures the amount of the enzyme alanine amino transferase in the blood. This is one of the tests used to assess liver function. Elevated levels of alanine amino transferase in the blood can indicate liver inflammation, poor liver function or damage.

Gamma-glutamyl Transferase (GGT)

Non-fasting blood test that measures the amount of gamma-glutamyl transferase enzymes in the blood. This is one of the tests used to assess liver function. Elevated levels of gamma-glutamyl transferase in the blood can indicate liver inflammation, poor liver function or damage.

Serum Folate

Non-fasting blood test that measures the level of folate in the blood as an indicator of recent folate intake. Folate is an essential vitamin, especially for the first three months of fetal development. Folic acid is added to wheat flour used to make bread in Australia and measuring folate helps to monitor the effectiveness of this food fortification program.

Vitamin B12

Non-fasting blood test to measure the level of vitamin B12 in the blood. Vitamin B12 is an essential vitamin for blood and neurological functions and deficiency can be related to dietary intake.

Serum Ferritin

Non-fasting blood test that measures iron (ferritin) stores. This test is one of several that form part of ‘Iron Studies’ used to assess iron levels. Iron is essential for haemoglobin which is the red cell protein that carries oxygen in the blood. Low ferritin can cause anaemia, a condition where the number of red blood cells and/or the amount of haemoglobin in blood cells is too low. High levels of serum ferritin may indicate inflammation.

C-reactive Protein (CRP)

Non-fasting blood test that measures the level of C-reactive protein in the blood. C-reactive protein is a marker of inflammation (which may be caused by infection). This test may help interpret high serum ferritin results.

Serum Transferrin Receptor (sTfR)

Non-fasting blood test that measures the amount of transferrin receptor in the blood. This test is one of several that form part of ‘Iron Studies’ used to assess iron levels. Transferrin is a protein that transports iron in the body. High levels of transferrin can indicate low iron levels or iron deficiency.

Haemoglobin

Non-fasting blood test that measures the level of haemoglobin in red blood cells. Haemoglobin is the oxygen carrying component of red blood cells. Haemoglobin levels can be abnormal in a large number of conditions e.g. low in anaemia or high in blood cancer.

Vitamin D

Non-fasting blood test that measures the level of vitamin D in the blood. This test is used to assess vitamin D deficiency. Vitamin D deficiency can impact bone health.

Biomedical tests used for population analyses only

Some blood and urine tests are only used to measure population levels rather than individual levels of the substance. What this means is that for these tests an individual result is not provided, instead these results are combined to provide a population level of each substance. The following tests are those which will not be reported in individual results.

Urinary Sodium

Urine test that measures the amount of sodium in the urine. Salt is a major source of sodium in the diet. This test is used to estimate the amount of sodium consumed across a population. High sodium diets can increase risk of high blood pressure and cardiovascular disease. As this is a test to measure levels across a population rather than individuals, individual results are not provided to participants.

Urinary Potassium

Urine test that measures the amount of potassium in the urine. This test is used to estimate the amount of potassium consumed across a population. As this is a test to measure levels across a population rather than individuals, individual results are not provided to participants.

Urinary Iodine

Urine test that measures the level of iodine in the urine. Iodine is found naturally in a range of foods and is required for the production of thyroid hormone. Because thyroid hormone is essential for many processes in the body, especially the normal physical and mental development of babies and children, Australian bread-making salt is supplemented with iodine. Measuring Iodine helps to monitor the effectiveness of this food fortification program. As this is a test to measure levels across a population rather than individuals, individual results are not provided to participants.

By taking part, the participant acknowledges participation (including the collection of the blood and urine samples) is at their own risk.

When giving a blood sample, there is a risk of a small amount of pain or discomfort from the needle. There may also be a small amount of bruising where the needle was inserted. There are no risks associated with giving a urine sample.

If, as a result of providing blood or urine samples as part of your participation in the survey, you experience any unexpected pain, other than from the risks described above, please immediately inform the ABS by calling 1800 225 437. If you require urgent medical attention please contact your medical service provider first, then notify the ABS.

There is a possibility that your sample results may reveal a medical condition that you were unaware of. If you have agreed, we will provide the test results to your regular doctor. If you have not agreed to your regular doctor being notified and test results find an incidental significant health risk, you will be notified with a recommendation to visit your doctor.

We take the security of your personal information seriously. More information about the personal information we collect can be found in the NATSIHMS Collection Notice.

Samples collected as part of the survey are held securely and tested by Sonic Pathology Australia. These samples will not be stored for future research. Any personal (identifiable) information about you will be treated and protected as required under the Privacy Act 1988 (Cth). Sonic have comprehensive information security management systems in place to support privacy and data security and even though your samples will be re-identifiable (identified by a code, without your name), they will be subject to Sonic Pathology’s security system. No information or samples will be shared with anyone else, and your personal information will not be shared or given to anyone. Once the tests have been completed, all samples in primary collection tubes (blood) and containers (urine) will be destroyed after 7 days of being received at the central laboratory according to Sonic’s standard clinical waste procedures. For more information, please see Sonic’s Privacy Policy.

Your test results will be joined up with data collected from the earlier interview that you completed; this will give a more comprehensive picture of your health. No information that can identify you will be made available to anyone outside of the ABS. Researchers will have access to information which will be used for research purposes only. You cannot be identified from this information.

Your test results are provided to the ABS and kept confidential under the Census and Statistics Act 1905. Under this Act, ABS staff are legally bound to protect your data. It is an offence to reveal any information collected under this Act. For more information, please see the ABS privacy policy.

This survey has received ethics approval from a number of human research ethics committees. We have provided a list below. Please note that more information will be coming soon.

Northern Territory

• Central Australian Human Research Ethics Committee (CAHREC) 

               Phone: (08) 8951 4700

               Email: cahrec@flinders.edu.au

• Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (Top End)

               Phone: (08) 8946 8687 or (08) 8946 8692

               Email: ethics@menzies.edu.au

New South Wales

• Aboriginal Health and Medical Research Council of NSW

               Phone: (02) 9212 4777

               Lodge complaint online

South Australia

• South Australian Aboriginal Health Research and Ethics Committee (AHREC)

               Phone: (08) 8273 7200

               Email: Manager, Research and Ethics at research@ahcsa.org.au

Western Australia

• Children and Adolescent Health Service (CAHS) Human Research Ethics Committee (HREC)

               Phone: (08) 456 0516

               Email: CAHS.ethics@health.wa.gov.au

You can also raise concerns or complaints about the survey directly with the ABS by calling 1800 225 437.

If you are interested in giving blood and/or urine samples, your ABS Interviewer will give you a Participant Information Brochure or show you a short information video. They will also provide you with a referral form. If you choose to take part, you will be asked to visit a participating collection centre or Health Service to give your samples.

Sonic Pathology Australia

You can find a participating collection centre most convenient to you, or call Sonic Pathology Australia on 1800 577 500. Remember to take your referral form with you to the collection centre.

Health Service

Please note a list of participating health services in non-remote areas will be added soon. If you live in remote locations arrangements may be made with local Health Services for the collection of samples.

Giving your samples should only take about 10-20 minutes and there is no charge to you. The tests are like other blood and urine samples you might have had before. Once you have provided your samples you will receive a $75 gift card to help you with any costs associated with visiting a collection centre, like childcare or travel expenses (no receipts are needed). You should receive your gift card within three weeks of your visit to a collection centre.

If you find it difficult to go to a collection centre, please let your ABS Interviewer know, or call 1800 225 437 to discuss other options such as a home visit. You will not receive a gift card if you receive a home visit.

Sonic Pathology Australia

You can give blood and urine samples at any Sonic Pathology Australia collection Centre.

It is important to attend a Sonic Pathology Australia collection centre so that all participants’ samples are collected and analysed in the same way. You can find a participating collection centre most convenient to you, or call Sonic Pathology Australia on 1800 577 500.

Note that some Sonic Pathology Australia collection centres run under a different name, for example some collection centres in Sydney may operate as Douglass Hanly Moir, or as Clinpath Pathology services in South Australia.

Please find below a list of collection centres by state:

New South Wales

• Capital Pathology
• Douglass Hanly Moir Pathology
• Southern IML Pathology
• Sullivan Nicolaides Pathology.

Tasmania

• Hobart Pathology
• Launceston Pathology
• North West Pathology.

Australian Capital Territory

• Capital Pathology.

Victoria

• Melbourne Pathology.

Queensland & Northern Territory

• Sullivan Nicolaides Pathology.

South Australia & Western Australia

• Clinpath Pathology.

If you find it difficult to go to a collection centre please let your ABS Interviewer know, or call 1800 225 437 to discuss other options such as a home visit. You will not receive a gift card if you receive a home visit.

Health Services

Health Services provide a culturally appropriate alternative to mainstream medical services for Aboriginal and Torres Strait Islander peoples. People who take part in NATSIHMS may have the choice to attend a local participating Health Service for the collection of bloods and urine samples. Please note a list of participating health services in non-remote areas will be added soon.

If you live in remote locations arrangements may be made with local Health Services for the collection of samples.

No, Sonic Pathology Australia don’t require you to make an appointment to provide blood and urine samples. The opening hours of your nearest participating collection centre are available to you by visiting www.soniccommercialpath.com.au/our-locations, so that you can determine a time to attend that suits you. Some collection centres are open early, which may best suit those people fasting overnight.

Please contact the Heath Service you are looking to visit to find out if you require an appointment and for opening hours.

You can choose to give both blood and urine samples, blood samples only, or a urine sample only if you are 12 years or over. Children aged 5-11 can only give urine samples. Children aged 4 and under will not be asked to take part in sample collection.

If you agree, a copy of your results will be provided to you within three weeks of attending a collection centre. You can also choose whether to have a copy sent to your doctor.

There is a possibility that your sample(s) results may reveal a medical condition that you were unaware of. If you have agreed, we will provide the test results to your regular doctor. If you have not agreed to your regular doctor being notified and test results find an incidental significant health risk, a representative from Sonic Pathology Australia will be in contact and advise you to urgently seek medical attention.

It is important to remember that this study is not intended to diagnose or treat any health problems you may have and should not replace visits to a doctor or other health professional. If you wish to discuss your test results, please consult your doctor or health professional.

No, participants will not be paid to take part in the survey. Once they have attended a collection centre to provide samples, they will receive a reimbursement in the form of a $75 gift card to help with any costs associated with visiting a collection centre, like childcare or travel expenses (no receipts are needed). The gift card should be received within three weeks of their visit to a collection centre.

Gift cards will be emailed or posted to you, depending on the contact details you provided to the ABS Interviewer at the time of your interview.

Call 1800 225 437 to speak with an ABS staff member who will arrange for a referral form to be sent to you.

Once you have received your form, fill in the parts specified for the participant. You can then visit a participating collection centre to give your samples. You can find a participating collection centre most convenient to you, or call Sonic Pathology Australia on 1800 577 500. Remember to take your referral form with you to the collection centre.

In more remote areas, please contact your interviewer if you have lost your form and would like to take part.

All gift cards will be posted and addressed to the participant, unless you chose to get the gift card by email. It may take up to three weeks after attending the collection centre to receive your gift card. If you haven’t received it within three weeks of providing your samples, please call 1800 225 437 to speak with an ABS staff member.

If you have a child who has taken part, or you are a child who has taken part, your gift card will be posted and addressed to the child.

Participants can withdraw from the survey at any time. Withdrawing will not affect your ability to take part in future studies. If you, or a child in your care, decide to withdraw, please call the ABS on 1800 225 437 to speak with an ABS staff member.

Your samples will be destroyed after 7 days as per Sonic Pathology Australia’s standard procedures. All other data that has not been de-identified will also be removed.

For help or more information about the survey please call us on 1800 225 437 during business hours. For help outside these hours, please leave a message with your contact details and we will return your call as soon as possible.

The survey involves collecting blood and/or urine samples from people aged 12 years and above. Children aged 5-11 years will only be asked to give a urine sample. Participation is entirely voluntary – you or the child can say yes or no to taking part.

The child can give their samples at any participating collection centre. It will take about 10-20 minutes and there is no cost to you or the child.

Sonic

For a list of the closest collection centres please:

• Visit: www.soniccommercialpath.com.au/our-locations
• Call Sonic: 1800 577 500.
• Otherwise speak to your Interviewer or call the ABS on 1800 225 437.

When the child arrives, a trained health professional will:

• Check the details on the referral form
• Ask if they have any health conditions
• Take a small sample of blood from their arm near their elbow (for people aged over 12 years only)
• Ask for a small urine sample.

Health Services

Health Services provide a culturally appropriate alternative to mainstream medical services for Aboriginal and Torres Strait Islander peoples. People who participate in NATSIHMS may have the choice to attend a local participating Health Service for the collection of bloods and urine samples. Please note a list of participating health services in non-remote areas will be added soon.

If you live in remote locations arrangements may be made with local Health Services for the collection of samples.

If the child is 12 years and over, they can give both blood and urine samples, blood samples only, or a urine sample only. If they are aged 5-11, they can only give urine samples. Children aged 4 and under will not be asked to take part in the collection.

If you agree, a copy of the child in your care’s results will be provided within three weeks of attending a collection centre. You can also choose whether to have a copy sent to their doctor.

There is a possibility that their sample results may reveal a medical condition that you or they were unaware of. If you have agreed, we will provide the test results to their regular doctor. If you have not agreed to their regular doctor being notified and test results find an incidental significant health risk, a representative from Sonic Pathology Australia will be in contact and will advise you to urgently seek medical attention for the child.

It is important to remember that this study is not intended to diagnose or treat any health problems they may have and should not replace visits to a doctor or other health professional. If you wish to discuss their test results, please consult their doctor or health professional.

You can choose if you want to take part. Please ask your parent/carer to fill in the guardian consent and referral forms. We will also ask you to complete a form asking for your consent.

Giving samples only takes a few minutes.

• Blood – a special nurse will use a small needle to collect some blood in a tube from your arm near your elbow. This is only if you are over 12 years old.
• Urine – the nurse will provide you with a special container to collect some urine when you go to the toilet. The nurse will explain how to do this.

By donating a small amount of your blood and/or urine we can see how healthy you are. Your samples will be sent away to be tested; from this we’ll be able to get a picture of your health. We can learn, for example, about your vitamin levels and how well your kidneys work. The results can also be used to help all Australians live healthier lives.

If you are 12 years and over, you can choose to give both blood and urine samples, blood samples only, or a urine sample only. If you are aged 5-11, you can only give urine samples. Children aged 4 and under will not be asked to take part in the collection.

Please discuss your participation with your parent/carer.

If you and your parent/carer agree, a copy of your results will be provided to you within three weeks of attending a collection centre. You and your parent/carer can also choose whether to have a copy sent to your regular doctor.

Please discuss your participation with your parent/carer.