Human Health Effects Research Program
Research Strategy
The following strategy has been implemented in support of the research program's goals. This strategy is built upon the five traditional elements of disease prevention:
- Identification of patterns of morbidity and mortality (through use of surveillance systems, exposure registries, and reports from state/local health agencies).
- Evaluation of causal factors accountable for the observed pattern of morbidity or mortality (through epidemiologic investigations and experimental research).
- Control of the factors found or thought to be accountable for the observed morbidity or mortality (through health advisories, regulatory actions, and medical interventions).
- Dissemination of information about the identification, evaluation, and control of the observed pattern of morbidity/mortality (through local advisories, publications, state programs, and local, state, and national media).
- Infrastructure to support the elements of disease prevention - identification, evaluation, control, and dissemination (through institutional mechanisms that involve staffing, budgets, and organizational arrangements).
In order to identify human populations who may be at special risk of adverse health effects, particularly from consumption of sport fish from the Great Lakes, ATSDR has funded research to better characterize exposure, pathways, associated body burdens, and potential human health effects from exposure to persistent toxic substances in the Great Lakes basin with special emphasis on at-risk populations. ATSDR has worked with state and local health agencies in the Great Lakes Basin to obtain any surveillance data, reports of morbidity, and other information that might help identify populations at health risk.
Identified human populations thought to be at risk of adverse health effects will lead to evaluation of health status in select populations and toxicological studies where indicated. Adverse health effects would lead to control actions that would include communicating health advice from ATSDR to state/local agencies, possible establishment of surveillance or registries of high risk populations, and advice to regulatory agencies for their consideration. ATSDR would draw upon its Division of Health Education and Promotion to coordinate the dissemination of results from its research program that pertain to identifying at- risk populations in the Great Lakes basin and actions that might prevent any adverse health effects. These activities include physician education, assistance to state and local health departments, and any necessary preventive programs to protect human health.
Also in support of this research program, the agency has relied on advice from the agency's Board of Scientific Counselors, through its Workgroup on Great Lakes Human Health Effects Research.
This strategy provides an overall framework for: (1)
coordination and implementation of needed health research;
(2) utilization of findings from this program and other
relevant efforts; and (3) development of integrated
approaches to interdict exposures and mitigate toxicity
throughout the basin area [25]. This strategy has been
endorsed by ATSDR's Board of Scientific Counselors and the
Council of Great Lakes Research Managers, and adopted by the
International Joint Commission (IJC) as a framework for the
study of human health and other ecosystem effects in the
Great Lakes basin.
In addition, to strengthen and enhance the findings and
comparability across the health studies, ATSDR has initiated
several activities. These activities include harmonizing
questionnaires, analytical protocols, human health end
points, and contaminants tested, and establishing a quality
assurance and quality control program and tissue bank to
archive samples for future study. These activities will
allow ATSDR to (1) enhance exposure assessment in the Great
Lakes basin and (2) determine the potential for adverse
human health effects from exposure to Great Lakes
contaminants [26].
As an outgrowth of this research and other relevant human health effects findings, ATSDR will coordinate with appropriate federal state, and local agencies; universities; and other organizations in the development and implementation of preventative programs to protect human health. Coordination with federal agencies will include the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the Indian Health Service (IHS), as well as the Environmental Protection Agency (EPA). Additionally, ATSDR will also continue to work closely with other organizations that have significant programs relevant to the Great Lakes basin, including the IJC, the Great Lakes Health Effects Program of Canada, and the Great Lakes Protection Fund.
