Children and the Environment

· Pediatric Environmental Health Specialty Units Established. As part of its ongoing cooperative agreement with the Agency for Toxic Substances and Disease Registry (ATSDR), the Association of Occupational and Environmental Clinics (AOEC) has established two pilot pediatric environmental health specialty units. ATSDR, AOEC, and these pilot units will focus on increasing communication and collaboration among pediatric clinics and AOEC clinics at the two following locations:

• Harborview Medical Center at the University of Washington. This unit will be a collaboration between the University of Washington's Occupational and Environmental Program and Department of Environmental Health, School of Public Health and Community Medicine; Harborview Medical Center; the Washington Poison Center; and Children's Hospital and Regional Medical Center.
• Occupational and Environmental Health Center at Cambridge Hospital. Collaborators in this unit are the Occupational and Environmental Health Center; the Pediatric Environmental Health Center at Children's Hospital in Boston; the Center for Occupational and Environmental Medicine of the Massachusetts Respiratory Hospital; and the Occupational and Environmental Medicine Program at Harvard School of Public Health.

In addition to increasing communication and collaboration among the partners, staff of the pilot units will instruct local health care providers about environmental health and the special concerns of and medical interventions that might be needed by various pediatric age groups. The educational activities are expected to encompass not only physiological concerns but also the psychological effects of living near hazardous waste sites. The educational activities will include methods of communicating risk to both parents and children in an appropriate manner.

As an ongoing part of its cooperative agreement with ATSDR, AOEC acts as an environmental medicine clinical referral resource for health care providers. The pediatric environmental health specialty pilot units will serve as referral locations for both site-specific questions and regional pediatric environmental health concerns.

For more information about these pilot pediatric units, contact AOEC headquarters at (202)347-4976 or Vivian Rush, MD, MPH, ATSDR Technical Project Officer, at (404) 639- 5080.

In 1998, through other partners, a third pediatric environmental health specialty pilot unit will be formed at Mt. Sinai Medical Center with similar goals and activities. For more information on this unit, contact Stanley Gordon, DDS, ATSDR Technical Project Officer, at (404) 639-6218.

· New Case Study on Children Under Review. ATSDR, in partnership with the American College of Occupational and Environmental Medicine, has developed a new monograph in the Case Studies in Environmental Medicine series—Case Studies in Environmental Medicine: Evaluation of Children Exposed to Environmental Hazards. The case study (1) describes how and why children differ from adults in their susceptibility to environmental hazards; (2) demonstrates how to incorporate environmental medicine in the evaluation of well and sick children; and (3) includes resource information for additional assistance. It is currently undergoing extensive peer review and will be available through ATSDR this summer.

· Federal Task Force Identifies National Priorities for Children. President Clinton has established the Task Force on Environmental Health Risks and Safety Risks to Children. The task force is cochaired by US Department of Health and Human Services Secretary Donna Shalala and US Environmental Protection Agency (EPA) Administrator Carol Browner and includes more than a dozen other Cabinet officers. The task force is charged with making strategic recommendations to the President, reporting research data and other information, and establishing a government-wide database to enhance the effectiveness and coordination of government programs that respond to key environmental health and safety risks to children. Senior representatives from the participating departments and agencies have identified four priority childhood health problems for the task force: (1) asthma, (2) unintentional injuries, (3) cancer, and (4) developmental disorders, including birth defects. The task force has created workgroups to address issues of program implementation, data needs, and research. The program implementation workgroup is cochaired by Dr. Barry L. Johnson, ATSDR Assistant Administrator, and Mr. Jerry Clifford, EPA-VI Regional Administrator. The data needs and research workgroup is cochaired by Dr. Kenneth Olden, Director, National Institute of Environmental Health Sciences, and Dr. William Farland, Director, EPA's National Center for Environmental Assessment.

From the States

CTDPH Offers Risk Assessment Training Course for Local Departments of Health

Kenny Foscue, MPH, Connecticut Department of Public Health

Local departments of health (LDHs) often need to respond to the public health implications of hazardous waste sites in their areas. Some have gained extensive experience through their involvement with Superfund National Priorities List (NPL) sites; however, few LDH personnel have received adequate training in toxic substances and hazardous waste issues.

With the growing importance of brownfields (abandoned or idle industrial and commercial facility sites where redevelopment is complicated by contamination), there is a need for public health officials on the local level to be more effective players in this issue. There are many more brownfields (possibly thousands) than NPL sites; therefore the brownfields program may have the greater impact on LDHs. LDHs need to be able to facilitate a public health response and ensure community involvement and participation at these sites.

To address this need, the Connecticut Department of Public Health (CTDPH) has developed an on-going training initiative to upgrade LDHs' ability to respond specifically to brownfields and generally to other hazardous waste and toxic substance issues.

CTDPH developed a four-module training course: Risk Assessment and Toxicology, Environmental Epidemiology, Risk Management and Communication, and Indoor Air Quality. The first three are considered key skill areas for evaluating and responding to hazardous waste issues. The Indoor Air Quality module was developed because indoor air quality has and continues to be a major environmental health issue and a primary focus of citizen inquiries and LDHs.

The course is designed for health directors, sanitarians, and public health nurses, and is funded as part of CTDPH's cooperative agreement with the Agency for Toxic Substances and Disease Registry (ATSDR) to address public health issues at hazardous waste sites. CTDPH has conducted the training with four LDHs. Participants who complete the course receive certificates.

The training course has several important goals: capacity building, enabling LDHs to have a role in the brownfields process, and partnership building. Primarily, it is a capacity building effort to enable LDHs to respond to all types of toxic hazard and hazardous waste issues by providing training and experience in the course's key areas. Rather than develop "experts," the course seeks to provide a working knowledge of these areas for an oversight role.

A more immediate goal is to empower LDHs through technical capabilities and knowledge of resources to insert themselves into the brownfields process. At this time, brownfield site development is driven primarily by economic interests with little or no emphasis on public health issues. By obtaining background and skills, LDHs will be able to represent public health issues and community concerns at the table with environmental and economic development representatives. The final goal is to develop stronger relationships between the state health department and local health agencies to build an ongoing team approach to toxic hazard issues.

In developing the technical content, CTDPH utilized a number of highly qualified staff with training experience: a toxicologist, an environmental epidemiologist, a health educator, and other staff. The course is designed to be presented in 4 half-day workshops over a 4-week period. CTDPH decided against a 1- or 2-day conference to accommodate LDH schedules and to allow time for participants to do the background reading required for the course.

To the extent possible, CTDPH uses an interactive approach with questions and answers and videos and exercises, rather than straight lecture. Program presenters use case studies of actual Connecticut situations to illuminate the concepts and skills (e.g., a case study involving hydrogen sulfide exposure at a municipal landfill is presented in the risk assessment module).

In addition to providing basic skills and concepts, the course provides substantial information on background resources—where to go for help. Participants and their respective health departments receive several toxic hazard-related reference sources and manuals. Over the course of the training, division staff provide briefings on department policies and resources in occupational health, the ATSDR Health Assessment Program, the division's Geographic Information System (GIS) capabilities and groundwater program, and other topics. Besides providing useful information, these briefings establish a relationship between LDH personnel and our division.

Perhaps the most exciting and useful parts of the course are the "hands-on" projects required of participants. Participants choose a topic and develop a written document in an effort to put course knowledge and skills into practice. The project can be a small risk assessment of a site (preferably a brownfield) or a communication tool for the public. Participants are to obtain and review environmental and other site data, analyze the data, and provide conclusions and recommendations for public health actions. Some of the projects include an assessment of the public health implications of a large urban demolition project, a risk assessment of a gas-fired power plant, and assessments of specific brownfields. LDHs working on brownfields have actually begun "inserting" themselves into the brownfields process in their cities in the course of their research, which is a major goal of the course.

The LDH participants from the first two sessions have provided positive evaluations with useful ideas for improvement. Although initially very labor intensive for course planners, the course has already proven successful with several positive outcomes. CTDPH has developed stronger relations with four LDHs, which now have better trained staffs. Both CTDPH and these LDHs have learned more about the brownfields program and how to ensure a public health presence. Another goal of the training is to encourage local health departments to utilize CTDPH's resources and work with CTDPH on toxic hazard problems. Since the training, CTDPH has seen an increase in such activity with these departments.

CTDPH is planning to offer the course on a semiannual basis. For more information, contact Brian Toal, MSPH, or Kenny Foscue, MPH, at CTDPH, EEOH, MS# 11CHA, PO Box 340308, Hartford, CT 06134; telephone (860) 509-7742; fax (860) 509-7785; e-mail (Foscue) fosc100w@cdc.gov.

Environmental and Public Health Internet Resources

ATSDR Science Corner is a gateway to environmental health information and resources. It is a simple and user-friendly guide to search the World Wide Web for environmental health information. The primary focus is to find and share global information resources on the linkage between human exposure to hazardous chemicals and adverse human health effects.

This site lists ATSDR's minimal risk levels (MRLs) for hazardous substances. An MRL is an estimate of the daily human exposure to a hazardous substance that is likely to be without appreciable risk of adverse noncancer health effects over a specified duration of exposure.

Combined Health Information Database (CHID)
http://chid.nih.gov

CHID is a federally produced bibliographic database of health information, education, and promotion resources. Current information producers include the Centers for Disease Control and Prevention, National Institutes of Health, Office of Disease Prevention and Health Promotion, and the Health Resources and Services Administration. The database contains descriptions of health education and promotion programs underway at the state and local levels. It provides bibliographic citations and abstracts of journal articles, books, reports, pamphlets, audiovisuals, and other health resources. It also provides program contacts and source and availability information so that users can follow up directly. CHID is updated in January, April, July, and October. If you would like to share your program efforts through the database with other health professionals, contact the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) at NCCDPHP/TIESB, 4770 Buford Highway, NE, MS K13, Atlanta, GA 30341- 3724 or call (770) 488-5080.

Environmental Health Policy Committee
http://web.health.gov/environment

The Environmental Health Policy Committee (EHPC) of the US Department of Health and Human Services (DHHS) promotes the exchange of environmental health information and provides review, advice, and consensus facilitation where necessary on environmental health research, exposure assessments, risk assessments, and risk management procedures for DHHS. The site contains EHPC reports, publications, and policy statements; meeting and training information; and a search engine linked to environmental databases.

National Environmental Publications Information
http://www.epa.gov/ncepihom/index.htm

More than 6,000 US Environmental Protection Agency (EPA) publications are available for searching, viewing, and printing through this site. Links are available to Technical Information Packages (TIPS); environmental terms; and the publications catalog of EPA's National Center for Environmental Publications and Information.

Medicine & Public Health: The Power of Collaboration
http://www.cacsh.org/mph.html

This monograph is the result of an 18-month study that included focus groups, key informant interviews, and an analysis of more than 400 cases of medicine and public health collaboration around the country. It is a tool that health professionals can use to improve health and enhance their own effectiveness and economic stability. The monograph is part of the Medicine and Public Health Initiative (http://www.sph.uth.tmc.edu/mph/index.html) of the American Medical Association and the American Public Health Association for bridging the gap between the medicine and public health sectors.

Announcements

A Spanish version of ATSDR's A Primer on Health Risk Communication Principles and Practices is now available by contacting Diana Cronin at ATSDR, 1600 Clifton Rd, NE, MS E29, Atlanta, GA 30333; telephone (404) 498-0313; fax (404) 488-4178; e-mail dmc9@cdc.gov or calling (800) 447-1544. The English version is available at /HEC/primer.html.

This conference is sponsored by the Hunter College Center for Occupational and Environmental Health; the New York City Departments of Health, Environmental Protection, and City Planning; and the Pratt Institute Graduate Center for Planning and the Environment. The conference will explore academic, professional, government, and community development links between public health and urban planning disciplines. Abstracts are invited from investigators, practitioners, and community members. Abstracts should explore, analyze, and critique the connection—or lack thereof —between urban planning and public health. For a list of suggested topic areas and abstract guidelines, contact Sarah Perl, MPH, at Hunter COEH, Conference Abstracts, 425 E. 25th St, Box 621, New York, NY 10010; telephone (212) 481-8790; e-mail dkass@hunter.cuny.edu.

Sixteenth International Neurotoxicology Conference: Pesticides and Susceptible Populations: Who Is At Risk and When?; September 13-16, 1998; Little Rock, AR. Abstract deadline is August 1, 1998.

Topics to be addressed include genetic predisposition/individual sensitivity, economic justice, risk assessment and regulatory issues, priority research needs, and various populations at risk (e.g., fetus, infant, child, elderly). For more information, contact Joan Cranmer, Department of Pediatrics, University of Arkansas for Medical Sciences, 1120 Marshall, Rm 304, Little Rock, AR 72202; telephone (501) 320-2986; fax (501) 320-4978; e-mail cranmerjoanm@exchange.uams.edu.

1998 Geographic Information Systems (GIS) in Public Health Conference; August 18-20, 1998; Pre-conference workshops, August 17, 1998; San Diego, CA.

ATSDR and partners are sponsoring this conference to highlight innovative applications of GIS and spatial analysis techniques for the protection of public health and the environment. Meeting tracks include implementation and operations, disease surveillance, environmental health protection, and social/demographic analyses. The meeting will include an exposition of state-of-the-art equipment, software, and books to support spatial analysis. Two workshops will be offered the day before the conference begins. They will provide an introduction to the use of GIS in the health sciences and an opportunity to learn more about using spatial techniques to analyze health data. For more information, contact GIS in Public Health Conference, Visions USA, Inc, 57 Forsyth Street, NW, Atlanta, GA 30303; telephone (404) 880-0002; fax (404) 880- 0404; e-mail visions@internetmci.com; or Internet /GIS/conference/.

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COURSES

11th Annual Summer Institute in Environmental Health Sciences; June 1-12, 1998; Baltimore, MD. Ten full or four short courses in environmental health will be offered for academic credit or continuing education units. This is the first year that two certificate programs—Environmental Health and Occupational Health—are also offered. Each certificate is comprised of five full courses taken for academic credit. Cost: Depends upon course and credit choices.

For course and certificate program descriptions and registration information, contact Kay Castleberry at (410) 955-2212 or e-mail to summerEHS@jhsph.edu; Internet http://www.jhsph.edu/.

North Carolina Occupational Safety and Health Educational Resource Center

Environmental Site Assessments; May 27-29, 1998. This course is designed to assist participants in conducting a Phase I and Phase II site investigation according to the newly published American Society for Testing and Materials (ASTM) standard. The entire assessment process and selected case studies will be presented. Cost: $475.

For more information, contact the North Carolina Occupational Safety and Health Educational Resource Center, University of North Carolina at 109 Conner Drive, Suite 1101, Chapel Hill, NC 27514; telephone (919) 962-2101; fax (919) 966-7579; Internet http://www.sph.unc.edu/osherc/CALENDAR/calendar.htm.

National Environmental Health Association (NEHA)

Risk Communication Workshops. The workshops provide participants with tools for effective risk communication and community involvement, emphasizing the application of these tools in Superfund-related settings. Cost: nominal to no fee (varies by location).

• Date: May 13
  Place: Charleston,WV
  Contact: Cindy Persley, (304) 347-1253

• Date: August 5
  Place: Charlotte, NC
  Contact: John Barry, (704) 336-5500

• Date: September 10
  Place: Seattle, WA
  Contact: Carl Osaki, (206) 296-4806

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CALENDAR

May

· May 3-6, 1998. National Conference on Environmental Decision Making; Knoxville, TN. Contact: University of Tennessee Dept of Conferences, ATTN: NCEDR Conference, PO Box 2648, Knoxville, TN 37901-2648; telephone (423) 974-0250; fax (423) 974-0264; e-mail utconferences@gateway.ce.utk.edu; Internet http://www.ncedr.org/conference/.

· May 27-29, 1998. Partnerships for Networked Consumer Health Information Conference: "Bringing Knowledge to the Point of Use"; Philadelphia, Pennsylvania. Contact: Watch for details at http://odphp.osophs.dhhs.gov/confrnce/.

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June

· June 14-19, 1998. Air & Waste Management Association (A&WMA) 91st Annual Meeting and Exposition; San Diego, CA. Contact: A&WMA, One Gateway Center, Third Floor, Pittsburgh, PA 15222; telephone (412) 232-3444; fax (412) 232-3450; Internet http://www.awma.org/.

· June 21-16, 1998. XVI World Conference on Health Promotion and Health Education: "New Horizons in Health: From Vision to Practice"; San Juan, Puerto Rico. Contact: Secretariat, XVI World Conference on Health Promotion and Health Education, PO Box 365067, San Juan, Puerto Rico 00936-5067; telephone (787) 274-0582; fax (787) 754-6621; e-mail hir_arroyo@rcmaca.upr.clu.edu.

· June 27-July 1, 1998. National Environmental Health Association 62nd Annual Educational Conference and Exhibition; Las Vegas, NV. Contact: NEHA, Meetings Department, 720 S. Colorado Blvd., Ste 970, S. Tower, Denver, CO 80246-1925; telephone (303) 756-9090; fax (303) 691-9490. A registration form may be obtained through fax-on-demand by calling (303) 756-9090, selecting option #5, and requesting document #208.

· June 28-July 1, 1998. 1998 National Media Education Conference: A Paradigm for Public Health; Colorado Springs, CO. Contact: PME Conference Office, 2121 South Oneida St, Suite 325, Denver, CO 80224-2552; telephone (303) 756-8380; fax (303) 759-8861; Internet http://www.ConferenceOffice.com/NMEC.

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July

· July 12-15, 1998. Third International Conference on Arsenic Exposure and Health Effects; San Diego, CA. Contact: Willard R. Chappell, PhD, Campus Box 136, University of Colorado, PO Box 173364, Denver, CO 80217-3364; telephone (303)556-4520; fax (303)556-4292; e-mail as98@carbon.cudenver.edu; Internet http://www.cudenver.edu.

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August

· August 11-13, 1998; International Conference on Children's Health and Environment; Amsterdam. Contact: Conference Secretariat ICCHE '98, c/o VVAA conference Service, PO Box 8153, 3503 RD, Utrecht, The Netherlands; telephone + 31 30 247 44 50; fax + 31 30 247 46 47; e-mail congres@vvaa.nl; Internet http://web.inter.NL.net/users/nvmm/.

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This page last updated on October 28, 2003
Contact Name: Wilma López/ WLópez@cdc.gov