Interview With Dr. Stephanie Ostrowski
ATSDR Terrorism Response Activities Coordinator

Dr. Stephanie Ostrowski is the Terrorism Response Activities Coordinator and the lead for ATSDR’s Terrorism Response program, which operates out of the agency’s Office of the Assistant Administrator. Dr. Ostrowski recently spoke to Diane Drew about her role in ATSDR’s Terrorism Response program.

DIANE M. DREW (DMD): Dr. Ostrowski, how did you get involved in this program?

DR. STEPHANIE OSTROWSKI (SO): I began my professional career in veterinary medicine. After earning a Masters in Preventive Veterinary Medicine, however, I became interested in epidemiology, disease prevention, and the study of diseases in populations. This interest led me to apply for the Centers for Disease Control and Prevention (CDC) Epidemic Intelligence Service, known as the EIS program. As a part of the training, I was matched with an EIS position at CDC’s National Center for Environmental Health (NCEH). While at NCEH, I met and worked with Dr. Henry Falk, who was also my division director at NCEH at that time.

I always wanted to be involved in larger public health issues—ones that have national implications—so when I had the opportunity, I accepted a position with ATSDR's Division of Health Assessment and Consultation from 1991 to 1993. In 1999, I came back to ATSDR and worked in the Emergency Response Section of the Division of Toxicology. When the September 11, 2001, events occurred, I was detailed to the CDC emergency operations center. Not long after that, anthrax was identified as the cause of death for a Florida man and soon anthrax was also found at other locations. As a result of the mounting pressures of responding to these events, Dr. Falk realized that he needed someone to coordinate ATSDR’s involvement in emergency response. In October 2001, I began what was intended to be a temporary assignment for me, serving as the agency’s coordinator. However, by January 2002, I was officially named the ATSDR Terrorism Response Activities Coordinator.

DMD: That’s an interesting career path. Would you tell me more about what the Terrorism Response program covers?

SO: The biggest part of my job these days is what I call “consequence management.” We respond to events as they rush at us, determine what is needed, and figure out how ATSDR can help. This includes things like advising the U.S. Postal Service and its contractors on building cleanup, and serving on building anthrax clearance committees to assess whether buildings like the Capitol Hill offices are safe for reentry. A principal focus of CDC’s occupational-environmental team, of which ATSDR is a member, has been the many issues that came up in relation to anthrax; but now we’re also looking at other chemical and environmental issues in relation to emergency preparedness.

I also represent ATSDR on the National Coordinating Committee, an ad hoc committee of the National Response Team consisting of representatives from 16 federal agencies and departments. We worked on anthrax and other issues in developing a management guide for the Department of Homeland Security. The guide will focus on various aspects of determining the adequacy of cleanup of biological and chemical contamination of buildings and environmental surfaces.

At Dr. Falk’s direction, we performed an intensive internal review process to determine ATSDR’s preparedness for dealing with catastrophic chemical terrorism events. We identified gaps and developed recommendations for addressing areas of concern.

ATSDR staff members have been involved in providing support to the FBI [Federal Bureau of Investigation] in the second phase of the investigation into the AMI building (the Florida location associated with the first death resulting from anthrax), another activity coordinated by our program.

DMD: What is your vision for this program? For example, what are the priorities and future plans for the program?

SO: Because of the critical nature of terrorism preparedness and the level of funding being provided to states for planning and preparedness, I believe our program will continue to play an important role in the federal government’s efforts and will continue to receive strong support. It’s also clear that ATSDR, with our very specialized knowledge and unique staff, will continue to be important in working toward greater readiness. We expect to involve more people in training and preparedness activities. ATSDR will continue to serve an important support role along with other responders but would not be the lead HHS [U.S. Department of Health and Human Services] agency unless an event involved a chemical catastrophe.

DMD: Dr. Ostrowski, thanks so much for telling us about the Terrorism Response program.
—DIANE M. DREW, RN, MPA

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Toxicological Profiles Now on CD-ROM

ATSDR’s new ToxProfiles 2002 CD-ROM is now available. ToxProfiles 2002 includes 159 Toxicological Profiles and five new Interaction Profiles covering more than 250 hazardous substances. The Toxicological Profiles include information on health effects from exposure to specific hazardous substances as well as other toxicologic and epidemiologic information. Each profile is peer-reviewed and includes an easy-to-read public health information section in nontechnical language.

The Toxicological Profiles also are accessible on the ATSDR Web site at www.atsdr.cdc.gov.

To order a free copy of the CD-ROM, contact the ATSDR Information Center toll-free at 1-888-42-ATSDR (1-888-422-8737) or e-mail requests to atsdric@cdc.gov.

Fifteen CSEMs Are Now Available

Fifteen Case Studies in Environmental Medicine (CSEMs) are now available on ATSDR’s CSEM Web site (www.atsdr.cdc.gov/HEC/CSEM). Three of these CSEMs are new to the site:

• Arsenic Toxicity

• Asbestos Toxicity

• Benzene Toxicity

• Chromium Toxicity

• Disease Clusters: An Overview (new)

• Environmental Triggers of Asthma (new)

• Lead Toxicity

• Nitrate/Nitrite Toxicity

• Pediatric Environmental Health (new)

• Polychlorinated Biphenyl (PCB) Toxicity

• Radon Toxicity

• Stoddard Solvent Toxicity

• Taking an Exposure History

• Toluene Toxicity

• Trichloroethylene (TCE) Toxicity.

The case studies are self-instructional monographs designed to increase the primary care provider’s knowledge of hazardous substances in the environment and to aid in the evaluation of potentially exposed patients. Continuing medical education (CME) credits, continuing nursing education (CNE) units, continuing education units (CEU), and continuing health education specialist (CHES) credits are available.

The online evaluation and posttest for CSEM continuing education credits are now offered through CDC’s Morbidity and Mortality Weekly Report (MMWR) Continuing Education Web site. Link to ATSDR’s Continuing Education Program page at www.cdc.gov/atsdr/index.html.

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About 50% of the 250 workers in this preliminary study had persistent World Trade Center (WTC)-related pulmonary; ear, nose, and throat (ENT); and/or mental health symptoms 10 months to 1 year after the New York terrorist attacks in 2001. These results indicate the need for medical treatment and a long-term monitoring program.

Data were analyzed on a random sample of 250 WTC program participants from the first 500 WTC responders to participate. More than 3,500 WTC responders have been screened as part of the 1-year World Trade Center Worker and Volunteer Medical Screening Program, which ends in July 2003.

Screening Program

The World Trade Center Worker and Volunteer Medical Screening Program is a federal medical screening program to evaluate health problems and hazardous exposures of worker and volunteer emergency responders in New York. The program offers free, confidential medical screening examinations nationwide for exposed workers and volunteers in post-September 11 efforts in the rescue, recovery, and cleanup work at Ground Zero and the Staten Island landfill. This work exposed workers and volunteers to environmental hazards and placed them at risk for resultant health problems.

Worker Study Findings

Major findings of the preliminary analysis of 250 screening program participants include the following:

• 78% reported at least one WTC-related pulmonary symptom that first developed or worsened as a result of their WTC-related efforts; 46% still experienced at least one pulmonary symptom in the month before the screening examination.

• 88% reported at least one WTC-related ear, nose, or throat (ENT) symptom; 52% still experienced at least one ENT symptom in the month before the screening examination.

• 52% reported mental health symptoms requiring further mental health evaluation.

• 73% had either ENT symptoms or abnormal physical examination findings or both.

• 57% had either pulmonary symptoms or an abnormal pulmonary function test or both.

Only about one-third of the sample participants had received any prior medical care for their symptoms and conditions before participating in the screening program, emphasizing the critical need for medical screening. To date, federal funding has been received to support a total of 9,000 medical screening examinations. This translates to one screening each for 9,000 of the estimated 40,000-plus responders who participated in post-September 11, 2001, efforts at Ground Zero.

Further follow-up of affected workers is also needed to monitor the chronic nature and severity of these health problems and to ensure that proper treatment is received.

Workers and volunteers interested in getting more information or registering for the program are asked to call the toll-free WTC medical screening hotline at 1-888-702-0630.

For more information about the WTC worker program and links to the preliminary study results, go to www.wtcexams.org/ .

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Nursing Roundtable Report Available

Environmental health nursing is being revitalized and strengthened. The recommendations outlined in the Nursing and Environmental Health Roundtable report can help to better coordinate environmental health nursing research, education, and translation to advances in practice. If implemented, these recommendations will establish a strong foundation for environmental health nursing.

The report is organized around three themes from the multiagency August 2002 roundtable in Research Triangle Park, North Carolina: research, education, and translation to practice. The report highlights the current state of the science and incorporates recommendations made during the roundtable. The report also includes a list of suggested reading materials.

 

Download a copy of the roundtable report at www.niehs.nih.gov/translat/nurse-rt.htm.

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Health Statistics Resource Available

Health, United States, 2002, is now available. Health, United States is an annual report on national trends in health statistics. The 2002 report includes a highlights section, chartbook on trends in the health of Americans, and 147 trend tables.

The 2002 report and previous editions are available online from www.cdc.gov/nchs/hus.htm.

Join the Health, United States electronic mailing list for notices on updates to the online files (www.cdc.gov/nchs/products/pubs/pubd/hus/huslistserv.htm).

Web Site Survey

Help improve ATSDR’s Web site by taking our online customer satisfaction survey at www.atsdr.cdc.gov. The link to the survey is at the bottom of the page.

Thank you for your input!

Grand Rounds in Environmental Medicine

Grand Rounds in Environmental Medicine, published by the Environmental Health Perspectives journal, is now available. Grand Rounds in Environmental Medicine is a collection of 38 concise case studies of clinical presentations resulting from exposures to common environmental agents.

To order a copy, go to ehp.niehs.nih.gov/docs/admin/EMtoc.html and follow the online order link.

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Homeland Defense Journal

The Homeland Defense Journal is an electronic publication launched in January 2002. The mission of the journal is “to create a forum for the useful flow of information between the private and public sectors that will positively influence and hasten the development of solutions to homeland security requirements.” Volume 1, issue 23, includes articles on the December 2002 Gilmore Commission report that recommended the creation of a National Counter Terrorism Center to operate as an independent intelligence agency. The commission recommended that this center coordinate information about potential terrorist attacks in the United States and that it should report directly to the president.

The Homeland Defense Journal is free and is available from www.homelanddefensejournal.com/. The journal also lists conferences and workshops as well as homeland defense business opportunities and recent awards.

The Homeland Defense Grants Report and Grants Database are also available by subscription through the journal. The Grants Database includes more than 160 grants from federal, state, private, and regional agencies to support state and local governments as they prepare, plan, and outfit for homeland security and defense. The Grants Report includes points of contact for the grants initiative in state and local governments.

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Human Exposure to Environmental Chemicals

The Centers for Disease Control and Prevention's Second National Report on Human Exposure to Environmental Chemicals is now available. The report is the second in a series of publications that provide an ongoing assessment of the exposure of the U.S. population to environmental chemicals using biomonitoring. Biomonitoring is the assessment of human exposure to chemicals by measuring the chemicals or their metabolites in human specimens such as blood or urine.

This report is an important research tool that provides current information about the U.S. population’s exposure to 116 environmental chemicals. It is the most extensive assessment ever of the population’s environmental exposures. Having better information on environmental exposures means that problems can be better identified and prevented.

The report is available from www.cdc.gov/exposurereport.

ENA Starts New Journal

Disaster Management & Response is the new journal of the Emergency Nurses Association (ENA). ENA’s former journal, the International Journal of Trauma Nursing, ceased publication with the July 2002 issue. Link to the journal at www.ena.org/publications/dmr/.

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This page last updated on October 24, 2003
Contact Name: Wilma López/ mailto:WLopez@cdc.gov