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Meet Elizabeth (Libby) H. Howze
Dr. Howze moved to Atlanta
in 1994 to serve as Chief of the Health Interventions and Translation
Branch in the National Center for Chronic Disease Prevention and Health
Promotion at the Centers for Disease Control and Prevention (CDC). Her
branch was instrumental in helping redirect public health research and
practice in nutrition and physical activity from a focus on individual
behavior change to a public health ecologic framework that emphasized
policy and environmental change. As branch chief—and later as the
Associate Director for Health Promotion in the Division of Nutrition
and Physical Activity at CDC—she provided leadership in the development,
release, and dissemination of the first Surgeon General's report on
physical activity and health. Dr. Howze also directed the nutrition
and physical activity communications team, one of the first social marketing
initiatives at CDC. About her work as a division
director at ATSDR, Dr. Howze says, "I've spent most of my public
health career working on the prevention and control of chronic diseases.
Coming to work in environmental health promotion at ATSDR presents a
whole new set of challenges for me. First, how can we most effectively
assist communities that have been impacted by hazardous chemicals? And
second, what public health actions can be taken to prevent similar harm
from occurring to other communities? The growing science base linking
environmental exposures to chronic diseases makes the work that ATSDR
does all the more important. I'm excited to be part of it."
Childhood
Lead Poisoning in Missouri and Kansas
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For more information on the Jasper County study, contact Scott Clardy, Section
Chief |
Galena, Kansas, is in the southeast corner of Cherokee County, Kansas. The Galena Superfund site is one of six former smelter subsites in Cherokee County. In the Tri-State area of Kansas, Missouri, and Oklahoma, mining and smelting operations for lead ore recovery began in 1876 and ended in 1979. Mining and smelting for zinc ore recovery began in the 1890s and ended in the 1960s.
In July 1990, the Kansas Department of Health and Environment conducted a human exposure study of lead and urine cadmium in children between 6 months and 6 years of age living near the Galena, Kansas, Mine Tailings Superfund site (2). The study concluded that children younger than 6 years had higher blood lead levels than did a control group of same-aged children. Lead levels in six (10.5%) of 57 children in Galena exceeded the Centers for Disease Control and Prevention lead guideline of 10 µg/dL (3). No children in the control community had elevated blood lead levels (n=128).
Since the initial health study, EPA has completed residential cleanups at 664 properties in Galena, where more than 1,500 properties were tested.
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For more information on the Cherokee County study, contact Maria Albert, Manager,
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Near the end of the soil remediation activities, ATSDR entered into grants with the Missouri Department of Health and Senior Services and Kansas Department of Health and Environment to conduct a follow-up health study in each state. Each study is an EPA initiative and fully funded by EPA. The goal of the follow-up health studies is to
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Follow-up study activities include
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Missouri Department of Health and Senior Services study participants included
Study activities in Missouri include
The Kansas Department of Health and Environment study included
analysis of
In February 2002, the Missouri Department of Health and Senior Services released a draft final report for public comment. The Kansas Department of Health and Environment will release its draft final report for public comment later in the year.—Scott Clardy; Maria Albert; and Lakeisha Sykes, MPH
1. Agency for Toxic Substances and Disease Registry. Jasper County, Missouri, Superfund site lead and cadmium exposure study. Atlanta: US Department of Health and Human Services; 1995.
2. Agency for Toxic Substances and Disease Registry. Lead and cadmium exposure study, Galena, Kansas. Atlanta: US Department of Health and Human Services; 1996.
3. Centers
for Disease Control and Prevention. Screening young children for lead
poisoning: guidance for state and local public health officials. Atlanta:
US Department of Health and Human Services; 1997.
ATSDR
had to play detective when it undertook the Camp Lejeune survey on birth
outcomes in children who were exposed in the womb to trichloroethylene
(TCE) and tetrachloroethylene (PCE). ATSDR’s challenge was to find and
survey an estimated 16,500 children who might have been conceived or
carried in utero during 1968–1985 at Camp Lejeune in Jacksonville, North
Carolina, while their mothers lived in on-base housing at U.S. Marine
Corps (USMC) Base Camp Lejeune. Birth certificates were available for
12,493 of these children, but no locating information (such as social
security numbers [SSNs]) was listed on the birth certificates.
TCE and PCE contamination was found in the wells used at the on-base housing areas at Camp Lejeune. The sources of these contaminants were improper chemical disposal at an on-base motor pool area and an off-base dry-cleaning business. The contamination was discovered during routine tap water sampling, as required for compliance with the Safe Drinking Water Act. No drinking water standards existed for TCE and PCE until 1991 (see box). Early exposure to these contaminants in drinking water has been associated with hearing loss, delays in speech development, and impaired fetal development.
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TCE and PCE are solvents that were used as degreasers and as dry cleaning agents. TCE and PCE levels were 1,400 parts per billion (ppb) and 215 ppb, respectively, at the tap. The maximum contaminant level (MCL) (passed in 1991) for both TCE and PCE is 5 ppb. MCLs are standards used to define levels above which water is unsafe for drinking. |
In medical files at the Camp Lejeune Naval Hospital, we found contact information for almost one-third of the 12,493 children for whom we had birth certificates. Additional information was found by reviewing old birth announcements from files of the local newspaper (the Jacksonville Daily News). In addition, the DOD privacy officer agreed that the USMC could try to match names from the 12,493 birth certificates with the Defense Manpower Data Center (DMDC). A USMC staff person was assigned to find databases within the USMC system that could help ATSDR. If a database was found, USMC personnel searched it for ATSDR to see if it contained current addresses, telephone numbers, or SSN information for those persons who had not yet completed the telephone survey. Only exact matches were released to ATSDR. Much information was obtained through this process, and it has been extremely helpful.
The data collection phase
of the survey ended on January 26, 2002; 12,598 surveys were completed.
A summary report will be available in fall 2002. The report will give
the rates of birth defects and childhood cancers in children who participated
in the project. If the rates in children conceived or carried at Camp
Lejeune are elevated compared with the national rates for these same
conditions, further study will attempt to determine potential factors
that might have attributed to these increased rates.—Marie
L. Socha, DrPH, MS, MSPH
[Table of Contents]
In 1998, the Developmental Disabilities Work Group of the President’s Task Force on Environmental Health Risks and Safety Risks to Children recommended the commission of a longitudinal cohort study of environmental impacts on children. The purpose of the study is to identify subtle, but important, effects of low-level environmental exposures, as well as other biological and social factors on children’s health. In addition, the study will become a valuable resource to answer other questions of scientific interest.
Under the auspices of the task force, several federal agencies, including ATSDR, the National Institute of Child Health and Human Development, the Environmental Protection Agency, the National Institute of Environmental Health Sciences, and the National Center for Environmental Health of the Centers for Disease Control and Prevention have begun work to plan and implement this proposed study. Planning groups of federal scientists and other experts will define specific study hypotheses, study design, technology applications, and ethical guidelines over the next year. Methodologic development and pilot studies are planned for fiscal year 2001–2003. The study is planned to begin in 2004.
The April 2002 study assembly
meeting reports will soon be available on the study site (www.nationalchildrensstudy.gov).
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For information about
related research, refer to the Children’s Environmental Health
and Safety Inventory of Research (CHEHSIR) (oaspub.epa.gov/chehsir/chehsir.page). |
Web Site Resources |
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www.ahcpr.gov/research/chilres1.htm
The Agency for Health Care Policy and Research (AHCPR) Research on Children’s
Health highlights the key findings of the agency in the area of children’s
health.
www.atsdr.cdc.gov/child/ochchildhlth.html
Home page of ATSDR’s Office of Children’s Health.
www.childstats.gov
The Federal Interagency Forum on Child and Family Statistics provides
statistics in areas such as children’s health.
www.nlm.nih.gov/medlineplus/childrenshealth.html
Medline Plus Children’s Health home page provides an overview of diseases,
prevention, and research.
www.nichd.nih.gov
The National Institute of Child Health and Human Development provides
information concerning children’s health.
www.aap.org
Home page of the American Academy of Pediatrics.
www.childrennow.org/links/links-health.html
Children Now features a list of links on children’s health.
www.cfw.tufts.edu
Tufts University Child and Family Webguide features sections on physical
and mental health, typical development, education and learning, and
more.
yosemite.epa.gov/ochp/ochpweb.nsf/homepage
The EPA Office of Children’s Health Protection is a gateway to information
about environmental threats to children.
www.epa.gov/iaq/schools/tools4s2.html
Information on EPA’s Indoor Air Quality Tools for Schools Kit.
http://www.health.state.mn.us/divs/eh/children/conf2001/directory.htm
The Children’s Environmental Health Resource Directory is sponsored
by the Minnesota Department of Health, Environmental Health Division.
www.niehs.nih.gov/dert/programs/translat/children/children.htm
The Centers for Children’s Environmental Health and Disease Prevention
Research promote translation of basic research findings into applied
intervention and prevention methods.
www.childenvironment.org
The Center for Children’s Health and the Environment evaluates the link
between exposure to contaminants and childhood illness.
www.childwatch.uio.no
The Childwatch International Research Network is involved in research
on children’s rights, protection, and well-being.
www.cehn.org/cehn/Aboutceh.html
The Children’s Environmental Health Network is a resource on children’s
environmental health.
www.checnet.org
The Children’s Health Environmental Coalition educates the public about
environmental chemicals that can affect children’s health.
www.isde.org/inches.html
Inches (the International Research and Information Network on Children’s
Health, Environment and Safety) promotes the protection of children
against environmental hazards.
www.iceh.org
The mission of the Institute for Children’s Environmental Health is
to mitigate children’s exposure to toxicants. The organization sponsors
several initiatives.
www.kidsforsavingearth.org
Kids for Saving Earth provides free environmental education curricula
for all ages.
www.cehi.org
The Children’s Environmental Health Institute is dedicated to improving
children’s environmental health through education, research, and policy.
www.cepis.ops-oms.org/enwww/salunino/infonoex.html
Children’s Health and the Environment is a collection of facts on the
topic of children’s health and the environment from the World Health
Organization.
www.ocefoundation.org
The mission of Our Children’s Earth Foundation is to protect children
through the enforcement of the Clean Air Act.
www.partnersforchildren.org
The Partnership for Children’s Health and the Environment is an international
coalition of entities whose mission is to protect children from harmful
environmental exposures.
www.psr.org/home.cfm?id=childrens_health
The Physicians for Social Responsibility home page on children’s environmental
health. This organization represents 20,000 physicians, nurses, and
other health care professionals who are concerned about environmental
health and other issues.
www.preventingharm.org
Preventing Harm is a nonprofit organization and resource center focusing
on children’s environmental health.
Following is information on two recent children’s environmental health publications.
Creating
Safe Learning Zones: Child Proofing Our Communities
Campaign, c/o Center for Health, Environment and Justice, PO Box
6806, Falls Church, VA 22040 (telephone: 703-237-2249; Web: www.childproofing.org;
e-mail: childproofing@chej.org).
This publication is a followup
to the March 2001 Child Proofing Our Communities Campaign publication,
Poisoned Schools: Invisible Threats, Visible Actions. Creating Safe
Learning Zones: Invisible Threats, Visible Actions includes model
school siting legislation to help local communities promote laws and
policies that protect children’s health. The report also outlines action
steps that parents can take to ensure that their children are not sent
to schools that pose unnecessary health risks. The report is available
at childproofing.org/cslzindex.html.
The Creating Safe Learning
Zones: The ABCs of Healthy Schools primer was also recently published
on the campaign’s Web site (www.childproofing.org).
Raising
Healthy Children in a Toxic World: Phillip J. Landrigan, Herbert L. Needleman, and Mary Landrigan
Paperback, 152pp. ISBN: 087596947X. Published by St. Martin’s Press, Inc., February 2002.
This publication discusses
many environmental dangers that parents and their children face and
provides strategies for avoiding those dangers. Topics include allergens,
asbestos, contaminated water, heavy metals, herbicides, household chemicals,
pesticides, phthalates, pressure-treated wood, radon, solvents, and
unsafe foods.
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This page last updated on
October 24, 2003
Contact Name: Wilma López/ WLópez@cdc.gov
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U.S.
Department of Health and Human Services
Elizabeth
(Libby) H. Howze, ScD, CHES, is the new Director of the Division of Toxicology and Environmental Medicine at ATSDR in Atlanta, Georgia. Dr. Howze
worked in family planning in the Peace Corps in Sri Lanka during 1967-1969.
She graduated from the Johns Hopkins University School of Hygiene and
Public Health in 1985 with a doctorate in public health education.
The
Oronogo-Duenweg Mining Belt site is in Jasper County in southwestern
Missouri. The site is part of the Tri-State Mining District, which covers
an area of approximately 2,500 square miles in southwestern Missouri,
southeastern Kansas, and northeastern Oklahoma. Mining, milling, and
smelting of lead and zinc ore began in 1850 and continued in the district
until the 1970s.