Infrastructure Enhancement and Data Linkage
Demonstration Project
| Grantee: | Wisconsin Department of Health and Family Services, Division of
Public Health, Bureau of Environmental Health |
|---|---|
| Contact: | Mark Werner, PhD |
| Telephone: | 608-266-7480 |
| E-mail: | wernema@dhfs.state.wi.us |
| Address: | 1 West Wilson Street Room 150 Madison, WI 53701-2659 |
| Web site: | http://dhfs.wisconsin.gov/eh/ [external link] |
| Funded Since: | September 30, 2002 |
| Funded Program: | National Environmental Public Health Tracking Program, Part B |
Program Description:
The Wisconsin Environmental Public Health Tracking Collaborative (WEPHTC) will streamline and centralize access to existing environmental, agricultural, and health data systems specific to Wisconsin creating a user-friendly Wisconsin Environmental Public Health Tracking System. Its foundation is the already close working relationships between the Wisconsin Department of Health and Family Services (DHFS), the Wisconsin Department of Natural Resources (DNR), and the Wisconsin Department of Agriculture, Trade, and Consumer Protection (DATCP). These agencies have established relationships with local health departments, the University of Wisconsin, and the State Laboratory of Hygiene.
The WEPHTC has the following goals:
- Establish a comprehensive, Web-based environmental public health
tracking system that integrates environmental and health information
- Build a tracking system based on national data standards and case
definitions
- Facilitate use of the tracking system to address community and individual concerns as well as priority research questions identified by the Centers of Excellence.
The WEPHTC will initiate two pilot projects in Year 1. The first project will be the childhood cancer follow-back, and a pilot for three environmental indicators (carbon monoxide poisoning, methyl mercury exposure, and pesticide poisonings). For the childhood cancer follow-back project, information from the state tumor registry will be linked with environmental data, including, at a minimum, drinking water quality, ambient air quality, residential and regional pesticide use, traffic density near the home, and radiation exposures such as radon, x-ray, and electromagnetic fields.
Carbon monoxide (CO) and pesticide poisonings are two of three environmental indicators that will be linked with depressed cholinesterase activity, pesticide residue in blood and urine, pesticide measurements in water, and reported incidents of overspray and drift. Onsite investigations for carbon monoxide will be conducted by public health officials. Regional representatives of the Department of Agriculture, Trade and Consumer Protection are responsible for investigating pesticide exposure cases. The WEPHTC will search hospital discharge data and mortality records for an association with CO or pesticide exposure. An automated reporting system will be developed to facilitate reporting by coroners, healthcare providers, local public health agencies, poison centers, and clinical laboratories to aid in the development of a carbon monoxide and pesticide poisoning surveillance effort.
In addition to establishing a carbon monoxide/pesticide surveillance system, WEPHTC will also link fish consumption data from a BRFS model. This module will begin January 2004. Hair samples from 1,000 men over the age of 35 and participating in the Behavioral Risk Factor Survey (BRFS) will be analyzed for methyl mercury content. Men will be selected randomly to provide an assessment of methyl mercury exposure among the general population of adult males. Men who consume sport-caught or commercially sold fish more than four (4) times a month will be over-sampled to improve Wisconsin’s assessment among this potentially high exposure cohort. All data collected as part of the BRFS will follow the same protocol of confidentiality. The hair sampling portion of the study will be conducted as a pilot. These pilot projects will demonstrate the feasibility of linked environmental health data systems deployed on Wisconsin’s Health Alert Network.
At the completion of Year 2 of the project, the WEPHTC will prepare an annual tracking report based on statistical analyses of the surveillance data, including categorizing cases by age, sex, rural or urban location, environmental exposure data, and other variables. County or regional incident rates will be calculated. Standardized reports will be developed and implemented in SAS Internet, which will allow automated report generation and statistical display from the live surveillance database.
Data Linkage Demonstration Project
| Grantee: | Wisconsin Department of Health and Family Services, Division of
Public Health, Bureau of Environmental Health |
|---|---|
| Contact: | Marni Bekkedal, PhD |
| Telephone: | 608-267-3811 |
| E-mail: | bekkemy@dhfs.state.wi.us |
| Address: | 1 West Wilson Street Room 150 Madison, WI 53701-2659 |
| Funded Since: | September 15, 2003 |
| Funded Program: | Environmental and Health Effect Tracking; Program Announcement #3074 |
Program Description:
The Wisconsin Department of Health and Family Services and the Wisconsin Department of Natural Resources (WDNR) will establish a program to develop and implement an electronic tracking system for sentinel diseases believed to have environmental risk factors. The overall purpose of this project is to demonstrate and evaluate methods for linking data from existing health effects surveillance systems in Wisconsin with data from existing environmental monitoring systems.
The Wisconsin tracking program will be coordinated with the Centers for Disease Control and Prevention (CDC) to ensure compatibility with the developing National Environmental Public Health Tracking (EPHT) Program. Methods, tools, and best practices developed through the project will be used to advance the development of the EPHT Network at the state, local, and national levels.
The Wisconsin program addresses asthma and other respiratory diseases, multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS). The asthma tracking system will be used to evaluate interventions and regulatory actions. Asthma and other respiratory conditions will be tracked with respect to pollutants, demographic, and other data using geographic information systems. Because fixed monitor sites in Wisconsin are limited, air dispersion modeling systems will be used while more advanced methodologies are evaluated. Atmospheric and vegetation data also will be included.
The MS/ALS system will be used to suggest shared risk factors. Linking geocoded cases of these diseases (mortality and hospital discharges) with environmental exposure databases will allow detection of unrecognized clusters and may identify environmental parameters. Education and training programs will be developed to ensure use of the developed system. Five regional seminars are planned.
Data from WDNR databases will be used to track human exposure to substances in ambient air. Staff expertise in air modeling will be used to supplement regional and neighborhood exposure estimates. The Wisconsin Department of Health and Family Services currently has eight existing data systems that have been inventoried for tracking purposes. The WDNR has four major data-collection programs for air, private water, surface water, and fish tissue.
The University of Wisconsin, Division of Information Technology (UW-DoIT), will provide the information technology resources to design, install, operate, maintain, and modify the Wisconsin Health Alert Network/National Electronic Disease Surveillance System (NEDSS) integrated environmental health tracking program area modules (PAMs) for asthma and neurologic disease. UW-DoIT also will develop additional NEDSS elements for these PAMs on data visualization, reporting, security, messaging with clinical data systems, and user training.
