Outcomes of Interest in Massachusetts

1. Environmental Public Health Tracking ProgramAdministered byNational Centers for Environmental HealthU.S. Centers for Disease Control and PreventionSuzanne K. Condon, Assistant CommissionerPrincipal Investigator

2. National GoalTo develop a standards-based environmental public health tracking network that allows direct electronic data reporting and linkage of health effect exposure and hazard data, which can operate with other public health systems

3. 2001 Pew Environmental Health Commission Report, “America’s Environmental Health Gap: Why the Country Needs a Nationwide Health Tracking Network” Environmental health programs across the country lack the necessary financial resources/infrastructure to adequately respond to increasing public concerns over disease prevalence and the role of the environment

4. Massachusetts one of seven state health departments in the country to receive funding to implement environmental public health tracking systemsInitial year of funding for approximately $680,000; total three-year funding anticipated to be approximately $2.4 millionThirteen other state or local health departments received planning grants (New Hampshire, Connecticut and Maine are among them).

5. Outcomes of Interest in Massachusetts • Pediatric Asthma • Systemic Lupus Erythematosus • Developmental Effects

6. Potential Environmental Exposures • Indoor Air Quality in Schools (MDPH 1999 study) • Exposure Opportunities to sources of petroleum distillates (e.g., state hazardous waste sites) • Areas of PCB Contamination (Jacobsen and Jacobson 1996)

7. Proposed Approach: Pediatric Asthma • Initial year will include 186 communities in Enhanced School Health Network; eventually will include entire state • Relies on reporting of pediatric asthma by school health nurses

8. Proposed Approach: Pediatric Asthma (cont.) • This reporting has been shown to be highly reliable and complete, based on MDPH experience with Merrimack Valley study • Health data will be linked with existing and to-be-collected indoor air quality data from schools 

9. Proposed Approach: Lupus • Focus on Boston • Initial case ascertainment through hospital discharge/billing databases

10. Proposed Approach: Lupus (cont.) • Case information will be linked with environmental exposures of interest (e.g., petroleum distillates) • Will work with MDEP to link with existing and most appropriate environmental databases

11. Proposed Approach: Developmental Effects • Initial efforts will focus on Housatonic River area of Massachusetts, but will expand to Southeastern Massachusetts • Track developmental effects among 3-10 year olds through existing databases (e.g., Department of Education Individual Education Program, MDPH Early Intervention Program

12. Proposed Approach: Developmental Effects (cont.) • Health data will be linked with environmental (PCB) data from BEHA GIS system • Because one hypothesized mechanism of action of PCBs for developmental effects is its ability to depress thyroid hormone levels, health data is also proposed to be linked with existing newborn screening data on thyroid hormone levels

13. Questions ???