California Tracking              No. 3  Fall 2003

The Newsletter of the California Environmental Health Tracking Program

IN THIS ISSUE:

Feature Article

Draft Report of the SB702 Expert Working Group

Related News

Cal/EPA Environmental Justice Recommendations

National Activities and Updates

FY 2004 grants from the Centers for Disease Control and Prevention

Trust for America's Health's 2003 Report Card on State Cancer Tracking

California Activities and Updates

CEHTP's New Demonstration Linkage Project

California Cancer Registry Receives an A

Medicine and the Environment Conference

Environmental Public Health Tracking Sessions at the APHA annual meeting

Senate Bill 702 DRAFT REPORT

SB702 Expert Working Group on Environmental Health Surveillance seeks stakeholder input on their draft report to the legislature

Background:  In October 2001, Governor Gray Davis signed California Senate Bill 702 (Escutia), making California the first state in the nation to begin planning a statewide Environmental Health Surveillance System.  This proposed system would track chronic diseases and environmental hazards and exposures in order to (1) facilitate the examination of the relationship between diseases and the environment and (2) establish ongoing surveillance of environmental exposures and diseases.  SB702 also established an Expert Working Group charged with recommending various approaches and costs to the legislature for developing an Environmental Health Surveillance System.  We expect the final report to be available in February 2004.

What was the Intent of the Legislature?  The Legislature requested that the Expert Working Group develop a blue-print for a system designed to perform ongoing surveillance (tracking) of environmental hazards/exposures and diseases affecting Californians.   The Legislature requested that the Expert Working Group focus on the prevalence and determinants of diseases such as asthma, cancer, birth defects, learning disabilities, and neurological disorders such as Parkinson's and Alzheimer's.

What is the Problem?  The environment plays a critical role in initiating and/or exacerbating disease.  With double digit increases in health care costs, environmentally-related chronic diseases are taking a fiscal and human toll on Californians.  For example, the estimated cost of only nine environmentally-related diseases is $10 billion per year, or $288 per person.  An estimated 3.9 million adults and children have had asthma in their lives.  Alarmingly, some of these illnesses are on the rise: from 1984 to 2003, asthma prevalence increased 76% in the State. 

Why Track?  Effective public health and environmental policies begin with accurate information about exposures and disease.  The benefits of targeted environmental policies have been shown to greatly exceed their cost.  An effective surveillance system that reduces only 1% of the cost of environmentally-related diseases would save the State $100 million annually.  The estimated total annual net benefits of Federal environmental polices between 1992 and 2002 range from $110 to $188 billion.  The fundamental objective of environmental health tracking is to coordinate and enhance existing information systems in order to reduce the crippling burden of disease in California.

What Information Would Tracking Provide?  An Environmental Health Tracking System would:

 Document exposures to environmental pollutants and help monitor ‘hotspots' in California;

 Track disease trends over time and geography to document health trends;

 Enable better linkage between exposure and disease in order to generate new hypotheses about possible connections; 

 Provide the scientific basis for evaluating and developing public health and environmental protection policies; and

 Facilitate the publics' right-to-know about environmental health issues.

What is in the Report?  The document details the Expert Working Group's purpose and scope, the need for and goals of environmental health tracking in California, and the current knowledge about environmentally-related diseases and their costs.  It also describes the diseases, environmental hazards, and exposures that should be tracked in California; community needs with regards to tracking; ethical, legal and policy issues; and the Expert Working Group's priority recommendations.

What are the Specific Recommendations? 

 An Inter-Agency CDHS/Cal-EPA Office of Environmental Health Tracking (OEHT) should be established by the CDHS and Cal-EPA. The OEHT would be responsible for implementing the Expert Working Group's recommendations (see the full report for a detailed list of proposed functions) in a phased-in approach as funding becomes available.

 Restore and maintain key existing registries tracking birth defects, cancer, and lead poisoning.

 Explore working with health care providers to develop a Parkinson's and Alzheimer's registry.  This public-private partnership could provide a cost-effective mechanism to gather important information about the devastating diseases.

 Coordinate and integrate data from state agencies in a uniform way and develop a web-enabled interface which would allow local residents to view multiple hazards in their neighborhoods.

 Collect diet, health and exposure information for a sample of Californians similar to the National Health and Nutrition Examination Survey.

 Investigate the feasibility and cost of establishing an employer-based reporting system for occupational history.

 Improve insurer submissions of Doctor's First Reports (DFRs) and provide outreach and education for health care practitioners about work-related illness.

What Can You Do?  The Expert Working Group encourages your input on the draft report.  The report will inform, guide, and influence the direction of environmental health surveillance efforts in California, including future policies and planning efforts.  It is crucial that we hear from a broad range of organizations and agencies which may affect, be affected by, or have an interest in environmental health tracking. To that end, the Expert Working Group is soliciting comment from stakeholders on this draft report.

The Expert Working Group is particularly interested in specific input on the following:

 Comments specific to the key findings and recommendations.

 Any technical or factual points that need to be addressed.

 Relevance of the findings and recommendations to the specific agency or organization.

 Comments in the form of an organizational/departmental consensus statement in relation to issues or areas of organizational expertise, focus, mission, etc. are encouraged.

 Please cite specific page numbers or chapters where appropriate.

 In order to be considered, written comments must be sent by November 14th, 2003.  Submission via mail or fax should be in addition to, not in lieu of, electronic submission (email):

SB702 Comments

CDHS-EHIB

850 Marina Bay Parkway, Building P, 3rd Floor

Richmond, CA  94804

FAX: (510) 620-3720

EMAIL: comments@catracking.com

Related News

Recommendations of the Cal/EPA Advisory Committee on Environmental Justice

The California Environmental Protection Agency (Cal/EPA) Advisory Committee on Environmental Justice has announced the finalization of the Environmental Justice Recommendations Report to the Interagency Working Group on Environmental Justice document.

On September 30th, 2003, the Advisory Committee revised and finalized the Recommendations document which covers specific areas in regards to Cal/EPA's legislative mandate under Senate Bill 89 and is intended to provide a set of comprehensive recommendations to establish and implement an effective environmental justice program at Cal/EPA.  More importantly, the report reflects the collective judgment of the Committee about the steps needed to make environmental justice a reality for all Californians.  It should be noted that in formulating these recommendations, the Committee sought, received, and considered extensive public and stakeholder input.

To view the final Recommendations document or to learn more about Cal/EPA's Environmental Justice Program, visit: http://www.calepa.ca.gov/envjustice/

National Activities & Updates

New Round of Grants for Environmental Health Tracking from the Centers for Disease Control and Prevention (CDC)

The purpose of these grants is to support the development of the National Environmental Public Health Tracking (Surveillance) Network, including expanding efforts to track chronic diseases such as cancer, asthma, birth defects, and Parkinson's, which combined are responsible for seven in ten deaths in the U.S.  These new grants, totaling nearly $4.2 million, are another step forward toward allowing some states to better track chronic diseases and environmental exposures, including chemicals, toxins, and other agents, that may be linked to them.  The 2003 CDC grants were awarded to: California (read about the California project below), City of New York, Florida, Louisiana, Massachusetts, New Jersey, New Mexico, New York, Oklahoma, and Wisconsin.  The grantees are charged with demonstrating and evaluating methods for linking data from ongoing, existing health effects surveillance systems with data from existing surveillance/monitoring systems for human exposure and environmental hazards.  Grantees must also demonstrate efforts to improve existing surveillance and monitoring systems by enhancing epidemiologic, analytic, and technological capacity at the local, state, and regional level.

Trust for America's Health (TFAH) Report: Improving Cancer Tracking Today Saves Lives Tomorrow: Do States Make the Grade?  2003 Report Card on State Cancer Tracking

This TFAH report evaluates state health agencies efforts to track, control and prevent cancer, and awards grades on a state-by-state basis.  According to the report findings, most states perform very well at maintaining high quality data about cancer rates; however, cancer control and prevention could be greatly enhanced if increased efforts were made to systematically and routinely connect cancer tracking information and other sources of health information.  The report concludes that states are missing key, important opportunities to reduce cancer rates.  Additionally, the survey revealed a gap in the ability of states to answer the public's questions about disparities in cancer rates among different ethnic groups and communities.  The report offers specific recommendations for how cancer tracking could be improved to increase prevention efforts and reduce the burden of cancer on families, communities and the nation.

California Activities & Updates

The California Environmental Health Tracking Program Receives Funding for New Demonstration Linkage Project

On September 15th, CDC awarded CEHTP funding for a 3-year demonstration linkage project to link perinatal exposures to airborne toxics and pesticides, blood lead levels, and health outcomes in pregnancy and early childhood.  Airborne toxics will include pesticides and criteria air pollutants.  Health outcomes will include birth outcomes (gestational age, birthweight), post-neonatal outcomes (SIDS), and neurodevelopmental outcomes (Autism Spectrum Disorder, mental retardation).  The geographic scope of this project is the Central Valley and South Coastal regions of California.

Project collaborators include the California Air Resources Board, the California Childhood Lead Poisoning Prevention Branch, the California Center of Excellence for Autism and Developmental Disabilities Research and Epidemiology (CADDRE), and the University of California Center for Environmental Public Health Tracking.

California Cancer Registry Receives an A Grade

Trust for America's Health gave California high marks for maintaining high quality cancer data and for having one of the nation's best cancer registry programs.  They recognized California as one of the leading states at using cancer tracking data for prevention efforts.  California's cancer registry program has also received a Gold rating from the North American Association of Central Cancer Registries (NAACCR).  Read more about TFAH's assessment of the California Caner Registry here: http://healthyamericans.org/state/cancergrade/display.php?StateID=CA.

Visit the California Cancer Registry website:  http://www.ccrcal.org/

Medicine and the Environment Conference: A Clinical, Scientific and Public Health Update

Saturday, November 15, 2003, 8:30 a.m. - 5:30 p.m.   Cole Hall, University of California, San Francisco

This conference is jointly sponsored by The Collaborative on Health and the Environment (CHE), the Center for Occupational and Environmental Health of the University of California, Physicians for Social Responsibility, and the San Francisco Medical Society.  Leading scientists, clinicians, and advocates will review new concepts in toxicology and environmental science, clinical presentations and treatment, prevention, and policy issues.  Topics include: scientific updates on diseases linked to environmental toxicants; new concepts in dose, exposure, and mixtures; developmental issues and children as a special risk group; biomonitoring and health tracking; advocacy by scientists and patients; new legislation and policy; and more.  Learn more about the conference here: http://www.cheforhealth.org/events/nov1503.html.  View the conference agenda here: http://www.cheforhealth.org/events/nov1503agenda.html.

Environmental Public Health Tracking Sessions at the American Public Health Association annual meeting in San Francisco November 15-19

The University of California Center for Environmental Public Health Tracking has compiled a list of poster/oral sessions and lectures, from the APHA schedule, related to Environmental Health Tracking.  To view the list, including dates, times, format, topic, and presenters, go to: http://ehtracking.berkeley.edu/WhatsNew.htm.  For more information about APHA's 131^st Annual Meeting and Exposition, go to: http://apha.org/meetings/.

Disclaimer: Links to non-CEHTP resources found at this site are provided solely as a service. These links do not constitute an endorsement of these resources and none should be inferred. CEHTP is not responsible for the content of the individual organization Web pages or documents found at these links.