Division of Environmental Health Epidemiology James N. Logue, Dr.P.H., M.P.H.

1. Pennsylvania Department of Health Division of Environmental Health Epidemiology James N. Logue, Dr.P.H., M.P.H.

2. Environmental Health Priorities for PADOH • NPL Site Specific Public Health Assessment Activities • Occupational Health Program • Toxicology Program • Environmental Epidemiology and Medicine • Environmental Public Health Tracking

3. Key Strategic Planning Documents • Healthy People 2010 (30 Environmental Health Objectives) • Pew Environmental Health Commission Report • Pennsylvania 21st Century Environment Commission 1998 Report • PADOH SHIP 2000 Report • Institute of Medicine 1988 Report

4. Pew Environmental Health Commission Report • In 2000, stated that our existing environmental Health System is neither adequate nor well organized • Recommended a National Health Tracking Network that informs consumers, communities, public health practitioners, researchers, and policymakers on chronic diseases and Related Environmental hazards and population exposures.

5. PART A Begin Developing a Nationwide Environmental Public Health Tracking Network Develop Capacity in Environmental Health Within State and Local Health Departments PART B Develop or Enhance Exposure or Health Effect Surveillance Systems Conduct Projects to Assess the Utility of Linking and Reporting Health Effect Data for Guiding Appropriate Public Health Action or Practice Funding CDC Received $17.5 Million in 2002 and $28 Million in 2003 to:

6. Hazard Tracking Exposure Tracking Tracking Network Health TrackingOutcome Environmental Public Health Tracking The ongoing collection, integration, analysis, and interpretation of data about Environmental Hazards, Exposure to Environmental Hazards, Health effects potentially related to environmental hazards.

7. Initial Co-operative Agreements - 2002 17 State Health Departments:  California  Connecticut  Illinois  Maine  Massachusetts  Maryland  Missouri  Montana  Nevada  New Hampshire  New Mexico  New York  Oregon  Pennsylvania  Utah  Washington  Wisconsin 3 Local Health Departments  Houston, TX  New York City  Washington D.C. 3 Schools of Public Health (Centers of Excellence)  Tulane University  University of California, Berkley  Johns Hopkins University

8. State/Local Activities (2002 Grantees) • Funded at two levels – A & B • Require collaboration between State/local health and environmental agencies • Select Activities include: • Evaluate existing databases/prioritize needs • Develop/enhance surveillance systems (health, exposure, hazard) • Assess utility of Environmental Public Health Indicators • Participate in standards development workgroups • Data linkage/utilization/evaluation projects – Part B states only

9. The National Environmental Public Health Tracking Initial Program - 2002 RI NEW YORK CITY, NY NJ JOHNS HOPKINS UNIVERSITY DE UNIVERSITY OF CALIFORNIA, BERKELEY MD WASHINGTON, D.C. TULANE UNIVERSITY HOUSTON, TX Planning and Capacity Building Enhancement and Demonstration Project Centers of Excellence WA ME MT ND OR MN VT NH ID NY SD WI MA WY MI CT IA PA NE NV OH UT IN IL CO WV CA VA KS MO KY NC TN AZ OK NM AR SC MS AL GA TX LA FL AK

10. In 2003, the CDC funded 10 new and additionally funded states and localities to further support the tracking program These new members focus on data linkage projects using existing surveillance systems California* New Mexico* New Jersey New York* Oklahoma Wisconsin* City of New York* Florida Louisiana Massachusetts* New Program Announcement - 2003 * Indicates additional funding in 2003

11. State Data Linkage Demonstration Projects: Asthma RI NEW YORK CITY, NY NJ JOHNS HOPKINS UNIVERSITY DE UNIVERSITY OF CALIFORNIA, BERKELEY MD WASHINGTON, D.C. TULANE UNIVERSITY HOUSTON, TX Planning and Capacity Building Enhancement and Demonstration Project Centers of Excellence Asthma linked with school indoor air quality WA ME MT ND Low birth wt, preterm births, intrauterine growth retardation, childhood mortality, and childhood asthma admissions linked to air pollution (O3, SOX , NOX , PM2.5, PM10, CO) Asthma prevalence, low birth wt, and preterm birth linked with traffic exhaust / air monitoring data OR MN VT NH ID NY SD WI MA WY MI CT IA PA NE NV OH UT IN IL CO WV CA VA KS MO KY NC TN AZ OK NM AR SC MS AL GA TX LA FL AK

12. Pennsylvania’s Proposed Asthma Project • I.D. # of school districts with unusually high levels of students with self reported asthma diagnosed by physician • I.D. students with asthma from the targeted school districts • Examine indoor and ambient air pollution levels • I.D. other potential risk factors for asthma (school, home, other)

13. Asthma Proposed Project (cont.) • I.D. “markers” associated with asthma to be used for program evaluation (e.g., school absences, 911 calls, hospital admissions for asthma, E.D. visits related to asthma, etc.) • Determine if there appears to be a correlation between air pollution levels and disease activity • I.D. potential recommended strategies for intervening to help reduce the threat of asthma or improve the quality of life for those who have asthma

14. Asthma Proposed Project (cont.) • Conduct periodic program evaluations • Educate physicians, medical personnel, parents, and students about asthma and disease intervention methods

15. TABLE 1Student Asthma Diagnoses Rates (%) for Selected School Districts by School Year

16. Challenges and Opportunities Ahead Success will be the result of: • Well coordinated surveillance efforts • Utilizing effective networking approaches • Utilizing strong science • Collaboration and innovation with other partners • Effectively communicating realistic expectations • Necessary and effective follow up and evaluation

17. For Additional Information Visit: The PADOH’s website at: www.health.state.pa.us or The CDC’s tracking program website at: www.cdc.gov/nceh/tracking/program.htm