Infrastructure Enhancement and Data Linkage
Demonstration Project
| Grantee: | The Commonwealth of Massachusetts Department of Public Health Bureau of Environmental Health Assessment |
|---|---|
| Contact: | Suzanne K. Condon, MSM |
| Telephone: | 617-624-5757 |
| E-mail: | suzanne.condon@state.ma.us |
| Address: | MA Department of Public Health 250 Washington Street Boston, MA 02108-4619 |
| Web site: | http://www.mass.gov/dph/beha/beha.htm [external link] |
| Funded Since: | September 30, 2002 |
| Funded Program: | National Environmental Public Health Tracking Program, Part B |
Program Description:
The Massachusetts Department of Public Health, Bureau of Environmental Health Assessment (MDPH/BEHA), has been funded to conduct three pilot demonstration projects under this cooperative agreement:
- Pediatric asthma surveillance to be linked with a database on indoor
air quality (IAQ) data in schools
- Developmental disability surveillance to be linked with
polychlorinated biphenyl compound (PCB) environmental exposures and with
biomarkers from a newborn screening database
- Systemic lupus erythematosus (SLE) surveillance to be linked with electronic environmental databases for specific pollutants of interest (e.g., petroleum distillates).
MDPH/BEHA has identified these three environmental public health tracking (surveillance) efforts as priorities in Massachusetts based on the following criteria: (1) they are already conducting some surveillance for each health outcome; (2) each health outcome involves different types of environmental exposure pathways; (3) tracking these health outcomes will address data gaps, as well as high levels of community concerns in the Commonwealth; (4) each pilot represents an opportunity to enhance existing infrastructure through uniquely different reporting/ascertainment methods; (5) each pilot is compatible with the program announcement requirements for electronic reporting; and (6) each health outcome is plausibly associated with environmental exposure opportunities to be linked.
The selected health effects, exposure, and hazard data selected for the pilot demonstration projects are consistent with those identified as priority areas in recent national forums (e.g., Pew Environmental Health Commission; CDC’s environmental public health indicators). MDPH/BEHA proposes to build a database for these tracking (surveillance) efforts that will electronically communicate with the MDPH National Electronic Disease Surveillance System, enhancing electronic reporting to CDC and other partners under this program announcement.
For the pediatric asthma surveillance, MDPH/BEHA will expand an initial database containing school health records for six Merrimack Valley communities to include 186 of the state’s communities. This equates to 1,390 public schools and 321 private and charter schools covering a total of 803,109 students. IAQ information is available for 130 schools. During Year 1, MDPH/BEHA will assess IAQ at an additional 40 schools that include grades K-8, with the goal of achieving statewide tracking of pediatric asthma and school IAQ by the end of year 3.
Data from the Massachusetts Department of Education will be used to ascertain developmental disabilities in children aged 3-10 years in the Housatonic River area of western Massachusetts. These data will be linked to thyroid hormone levels from newborn screening data and data on PCB contamination in the Housatonic River area. Annual prevalence rates of selected developmental disabilities and basic characteristics of the population will be obtained. The pilot project will include a component to evaluate and verify case ascertainment. Extensive environmental data exist for the Housatonic River area and document PCB contamination in soil, ambient air, groundwater, river sediment, and fish. The best and most feasible ways of linking these data with developmental disability data will be explored. Examples of linkage may be based on residence according to gradients of ambient air concentrations of PCBs or on residential proximity to the Housatonic River.
Electronic hospital discharge and billing databases have proven to be complete sources of initial case ascertainment for SLE in South Boston. An initial database of cases from the five teaching hospitals will be expanded to include other Boston hospitals. SLE cases will be confirmed through medical record reviews to confirm the presence of American College of Rheumatology criteria for SLE. Linkage of the identified case information will be to electronic environmental database(s) with the goal of linkage to suspected environmental etiologies including petroleum distillates, silica dust, and organic solvents. During years 2 and 3, tracking efforts can be expanded beyond Boston based on the pilot demonstration results.
In addition to the pilot projects, MDPH/BEHA will:
- Enhance electronic reporting capabilities for sharing data across
tracking systems, within confidentiality and security restrictions
- Standardize reporting of target health outcomes and develop standard
data systems for sharing information
- Increase the number of partnerships with medical community and
academic institutions for health outcomes targeted for the pilot
projects
- Verify validity and completeness of data sources for developmental
disability outcomes of interest
- Conduct file searches to evaluate quality of readily available information from electronic Massachusetts Department of Environmental Protection-regulated facility and site databases for linking with SLE cases.
Data Linkage Demonstration Project
| Grantee: | The Commonwealth of Massachusetts Massachusetts Department of Public Health Bureau of Environmental Health Assessment |
|---|---|
| Contact: | Suzanne K. Condon, MSM |
| Telephone: | 617-624-5757 |
| E-mail: | suzanne.condon@state.ma.us |
| Address: | Massachusetts Department of Public Health 250 Washington Street Boston, MA 02188-4619 |
| Funded Since: | September 15, 2003 |
| Funded Program: | Environmental and Health Effect Tracking; Program Announcement #3074 |
Program Description:
The Massachusetts Department of Public Health, Bureau of Environmental Health Assessment (MDPH/BEHA) will conduct three demonstration linkage projects in coordination with CDC as part of the development of the National Environmental Public Health Tracking (EPHT) Network.
The overall purpose of this project is to demonstrate and evaluate methods for linking data from ongoing, existing health effects surveillance systems in Massachusetts with hazard and exposure data from existing surveillance/monitoring systems. Specifically, the Massachusetts program will implement the following three components:
- Blood lead level data from the Childhood Blood Lead Prevention
Program's surveillance system will be linked with environmental data on
ambient air contaminants, lead smelters, and drinking water distribution
systems
- Childhood cancer incidence data from the Massachusetts Cancer
Registry (MCR) will be linked with drinking water quality and pesticide
use databases
- Birth defects data from the State Birth Defects Registry and low birth weight data from the Registry of Vital Records and Statistics will be linked with drinking water quality data.
Methods, tools, and best practices developed through the project will be used to advance the development of an environmental public health tracking (surveillance) network at the state, local, and national level.
For the blood lead level surveillance, MDPH/BEHA will use geographic information system tools to geocode addresses of children with blood lead level data for 1995 forward. The geocoded blood lead level data will be linked with environmental databases, such as monitoring data for ambient air pollutants, industry profiles, and drinking water systems. The initial effort will focus on linkage between blood lead level data and environmental data in high-risk communities, determined through a mathematical algorithm. Approximately 86,000 children aged 0-4 years reside in 21 high-risk communities in Massachusetts.
Activities for surveillance of childhood cancer incidence include geocoding statewide cancer incidence data for the most recent years initially, then historical data for 1982-1986. This geocoding work will facilitate linkage of childhood cancer incidence data for all years of MCR data with environmental databases. The current version of the Standardized Incidence Ratio (SIR) calculator will be updated continuously as new data become available. (The SIR calculator computes census-tract-level SIRs on the basis of on user-defined settings.) In addition, a protocol for statewide evaluation of linkage between childhood cancer and environmental databases will be developed.
Information from the Massachusetts birth defects registry will be geocoded to enable linkage with environmental databases. Geocoding addresses information from all births in the state starting in 1999 will allow development of a calculator similar to the SIR calculator. Geocoding will include birth weight information for subsequent linkage of low birth weight data with environmental databases. MDPH/BEHA will develop a protocol for evaluating linkage between birth defects and low birth weight data with environmental databases. Drinking water quality databases will be evaluated for the feasibility of linkage.
