INVENTORY
OF
ENVIRONMENTAL
PUBLIC
HEALTH
BIOMONITORING
PROGRAMS
AND
HEALTH
SURVEILLANCE
DATABASES
FOR
THE
MIDATLANTIC
REGION
Overview
To
improve
understanding
of
the
linkages
between
human
health
and
environmental
condition
in
the
Mid­
Atlantic,
the
U.
S.
Environmental
Protection
Agency
(
EPA)
is
working
with
federal,
state,
local,
and
academic
partners
to
produce
an
interactive,
spatial
inventory
of
public
health
biomonitoring
programs
and
health
surveillance
databases
for
the
region.
Data
identified
by
the
inventory
will
contribute
to
the
Mid­
Atlantic
Integrated
Assessment
(
MAIA)
experimental
research
and
monitoring
effort
that
links
human
health
and
environmental
condition
and
will
build
upon
the
success
of
the
MAIA
regional­
scale
geographic
assessment
of
ecological
condition.
The
effort
will
combine
many
scientific
disciplines
including
ecology,
genetics,
chemistry,
geology,
hydrology,
economics,
sociology,
psychology,
political
science,
statistics,
informatics,
GIS,
and
health
science
(
e.
g.,
public
health,
medical
&
veterinary
science,
pharmacology,
toxicology,
etc.)
in
an
effort
to
study
the
effects
of
the
changed
environment
upon
humans.
A
key
component
will
be
the
development
of
multi­
metric
indices
for
human
body
systems
as
a
way
to
assess
the
cumulative
effects
of
multiple
stressors
on
human
health.

Organizations
within
the
Mid­
Atlantic
region
have
considerable
knowledge,
expertise,
and
information
to
bring
to
this
effort.
Several
large
efforts
are
already
underway
to
collect
information
from
hospitals,
pharmacies,
veterinarians,
etc.,
as
part
of
Homeland
Defense
preparedness.
An
example
is
DOD's
Electronic
Surveillance
System
for
the
Early
Notification
of
Community­
based
Epidemics
(
ESSENCE),
which
is
operational
in
the
DC
area.
Since
significant
variability
exists
in
reporting
among
providers
and
clinics,
similar
ICD­
9­
CM
codes
are
grouped
together
in
seven
syndromes
that
best
represent
presenting
signs,
symptoms,
and
diagnoses.

In
addition,
CDC
and
ATSDR
maintain
many
existing
tracking
systems
(
e.
g.,
vital
statistics,
health
surveys,
asthma
tracking,
cancer
and
birth
defects
registries,
blood
lead
monitoring,
biomonitoring,
and
food
borne
and
waterborne
disease
tracking).
The
information
being
gathered
could
provide
some
of
what
is
needed
to
assess
environmental
health,
while
the
environmental
and
socio­
economic
information
already
collected
in
the
mid­
Atlantic
during
the
past
30
years
can
further
inform
the
effort.

MAIA
proposes
to
use
existing
surveillance
programs
and
emerging
networks
as
the
foundation
for
the
project.
A
first
step
is
the
development
of
an
interactive,
spatial
Inventory
of
Environmental
Health
Biomonitoring
Programs
and
Health
Surveillance
Databases
for
the
Mid­
Atlantic
Region.
For
each
program,
the
inventory
will
include
lists
of
measurements
and
design
and
administrative
information.
This
database
will
allow
partners
to
search
for
sources
of
relevant
data
for
a
given
use.

The
inventory
will
be
used
to
identify
the
programs
that
will
become
core
components
of
a
Mid­
Atlantic
Environmental
Public
Health
Tracking
Network.
A
gap
analysis
will
be
conducted
to
identify
additional
monitoring
needs,
and
the
partners
will
develop
a
strategy
for
meeting
those
needs.
The
assessment
team
will
then
develop
and
document
existing
data,
analytical
and
visualization
tools,
and
conduct
a
baseline
assessment
of
environmental
health.

The
inventory
will
also
be
used
by
the
partners
to
design
more
integrated
health
and
environmental
monitoring
and
research
activities.
This
new
Inventory
will
complement
the
existing
Mid­
Atlantic
Inventory
of
Environmental
Monitoring
Programs
(
www.
epa.
gov/
monitor)
(
EPA
ICR
#
1819.01).

Concept
For
each
included
program,
the
inventory
will
display
a
map
of
sampling
locations,
a
detailed
list
of
variables
measured,
and
design
and
administrative
information.
In
addition,
users
will
be
able
to
query
the
inventory's
database
to
construct
customized
maps
of
programs
that
satisfy
userdefined
constraints.
(
For
example,
"
Display
all
programs
that
collect
data
on
respiratory
system
disease
in
adults
related
to
particulate
matter.")
The
data
in
the
inventory
will
be
available
electronically
and
on
the
Internet
for
use
by
a
variety
of
resource
managers,
regulators,
the
scientific
community,
and
the
informed
public.
It
will
allow
the
user
to
identify
the
location,
purpose,
agency/
institution
participation,
parameter
characteristics
(
type,
frequency,
format),
and
data
disposition
for
each
inventoried
program.
Data
confidentiality
(
when
required)
will
be
maintained.

Populating
the
Inventory
The
EPA
has
identified
federal,
state,
local,
and
private
programs
that
collect
significant
human
health
data
in
the
area.
Information
about
each
program
will
be
collected
in
a
questionnaire
during
an
interview
of
program
staff
by
trained
project
members
in
EPA
or
partner
federal
agencies,
or
by
trained
consultants.

Information
in
the
Inventory
The
inventory
will
contain
information
on
program
design,
program
administration,
and
specific
meta­
data
on
parameters
that
are
collected
on
the
various
body
systems
(
e.
g.,
circulatory,
respiratory,
endocrine,
integumentary,
musculoskeletal,
nervous,
reproductive,
digestive,
urinary,
and
immune),
as
well
as
demographics,
stressors,
exposure
routes,
and
infectious
and
parasitic
diseases.
It
was
developed
in
consultation
with
scientists
from
multiple
agencies
and
resource
backgrounds.
The
survey
will
be
distributed
in
paper
form
to
monitoring
program
managers
and
voluntary
response
will
be
made
with
the
assistance,
in
person
or
by
telephone,
of
EPA
representatives.

The
questionnaire
was
designed
to
be
as
short
as
possible,
yet
convey
sufficient
detail
on
data
and
sampling
methodology
for
a
user
to
determine
if
any
included
programs
would
help
to
fulfill
analysis
or
assessment
needs.

Project
Leads
Patricia
Bradley,
ORD/
MAIA:
(
410)
305­
2744
Marsha
Marsh,
ORD/
NCEA:
(
919)
541­
2542
