performance standards are based on the “Essential Services of Public Health Services.” Environmental health service programs are also using performance standards to improve the quality and accountability of their programs and to enhance the science base of environmental public health practice. This session will explore the use of performance standards to improve environmental public health services.

Session Objective: 
At the end of this session, participants will be able to do the following:
1) Understand how performance standards can be used to improve the
    practice of environmental health.

Moderator:
CAPT Patrick O. Bohan, USPHS (Ret), RS, MS, MSEH; East Central
   University, Ada, Oklahoma

Presenters:
Arturo Aguirre, REHS, MA; Los Angeles County Department of Health
   Services
Paul Halverson, PhD, FACHE; Public Health Practice Program Office,
   Centers for Disease Control and Prevention
Ron Grimes, RS, DAAS, MPH; Jackson County Health Department,
   Jackson, Michigan
Faye Feldstein, MS; Center for Food Safety and Applied Nutrition, Food
   and Drug Administration

T2: Information Technologies for Responding to Environmental Disasters in the 21st Century
Room: WALTON – 2nd Floor

Timely emergency-management decision making demands accurate and timely data discovery, assemblage, analysis, interpretation, and dissemination of data about environmental disasters, including natural and technological disasters. Advanced information technologies provide a tool for emergency management and response operations through a decision support system for disaster/hazard preparedness. This session will address key issues regarding the support and enhancement of these technologies as applied to public health—namely, how to (1) identify state-of-the-art advanced disaster information techniques, (2) exchange information related to rapid assessment of infrastructure change and condition assessment methods, and (3) exchange information about advanced information technologies related to public health in emergencies.

Session Objectives:
At the end of this session, participants will be able to do the following:
1) List two or more advanced information technologies that can be
    applied for public health decision making after an environmental
    disaster.
2) Discuss issues related to developing and applying advanced
    information technologies in the public health sector.

Moderator:
Kimberley Schoaf, DrPH; UCLA Center for Public Health and Disasters

Presenters:
William Roper, PhD; George Washington University
Richard Olsen, PhD, PE; U.S. Army Engineer Research and Development
   Center
Denise Stephenson Hawk, PhD; The Stephenson Group
H.S. Lew, PhD; National Institute of Standards and Technology

T3: Communication Issues in a Radiological and Chemical Terrorism Event: An Update From the Pre-event Message Project
Room: HENRY – 2nd Floor

Lessons learned from recent experiences with anthrax and the World Trade Center events underscore the importance of effective communication during these kinds of incidents and the importance of preparing for potential future events. CDC/ATSDR, in collaboration with external partners, began immediately after September 11, 2001, to prepare for the possibility of a radiologic or chemical terrorist event. Significant progress has been made in audience research and materials development for public health preparedness for these possible incidents. Presenters will do the following:

• Describe CDC/ATSDR’s activities and communication role related to emergency preparedness and response in a radiological or chemical event.
   
• Describe some of the communication research that has been conducted among members of the public about their radiologic and chemical terrorism information needs.
   
• Discuss the role of hospitals and their communication preparedness for a radiologic or chemical terrorist event.

After the presentation, panel members will answer questions and discuss collaborative efforts in risk communication for emergency preparedness.

Session Objectives:
At the end of this session, participants will be able to do the following:
1) Describe and discuss CDC/ATSDR’s and other health agencies’ public
    health communication roles in a radiologic or chemical terrorist
    event.
2) Describe and discuss formative research on communication needs of
    various audiences prior to and during a radiologic or chemical
    terrorist event.

Moderator:
Timothy Church, Washington State Department of Health

Presenters:
Marsha Vanderford, PhD; Office of Communication, Centers for Disease
   Control and Prevention
Steven M. Becker, PhD; University of Alabama at Birmingham

T4: Community Environmental Health Assessments: The Domestic and International Applications of PACE-EH
Room: FORSYTHE – 2nd Floor

The Protocol for Assessing Community Excellence in Environmental Health (PACE-EH) is a useful tool to conduct community-based environmental public health assessments. NCEH/ATSDR provides on-site technical assistance to domestic and international partners regarding the use of PACE-EH, which promotes demand-based environmental public health solutions utilizing basic environmental health services. Although communities differ greatly across demographic, environmental, cultural, political, economic, ethnographic, and health status variables, similarities exist in the ways that domestic and international communities apply PACE-EH to identify, prioritize, and resolve broad-ranging environmental public health issues and concerns. This session will discuss similarities and differences in how domestic and international communities apply PACE-EH as well as the challenges involved in developing strategies.

Session Objectives:
At the end of this session, participants will be able to do the following:
1) Describe the similarities and differences in how domestic and
    international communities are using PACE EH to identify, prioritize,
    and resolve environmental health issues.
2) Recognize the challenges faced by domestic and international
    communities when working with their local communities to develop
    action plans and interventions to resolve their priority environmental
    health issues.

Moderator:
Carl Osaki, Washington State Department of Health

Presenters:
Lila Wickham, MS, RN; Multnomah County (OR) Health Department
Carlos A. Yunsan, Tennessee Department of Health
Virginia Baffigo, MD, PhD; CARE Peru

T5: Natural Toxicants in Food
Room: CLAYTON – 2nd Floor

Every day, Americans are exposed to unknown quantities of natural toxicants in the foods they eat. Recently, acrylamide was found in large amounts in potato chips, French fries, and crackers—foods that are consumed by a significant portion of the U.S. population. Although human exposure to acrylamide in occupational settings has been the subject of research activities, little is known about the exposure of the general population and the risks associated with food-related exposure. Molds and mycotoxins in human and animal foods can be associated with potentially serious consequences when high concentrations are inadvertently consumed. Aflatoxins are the most common type of mycotoxin found in food and feed. Although the content of aflatoxins in food and feed is regulated, exposure of the U.S. general population to aflatoxins has not been measured. This session will provide an overview of the various approaches used for exposure assessment regarding natural toxicants in food.

Session Objectives:
At the end of this session, participants will be able to do the following:
1) Understand the potential public health problems related to natural
    toxicants in food.
2) Identify the various approaches used for exposure assessment.

Moderator:
Christine Pfeiffer, PhD; National Center for Environmental
   Health/Agency for Toxic Substances and Disease Registry

Presenters:
Hubert Vesper, PhD; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry
Mary Trucksess, PhD; Food and Drug Administration
Rosemary Schleicher, PhD; National Center for Environmental
   Health/Agency for Toxic Substances and Disease Registry
Nadia Slimani, WHO International Agency for Research on Cancer,
   Lyon, France

T6: Media 101 for Environmental Health
NOTE: This session has moved to Thursday, 3:30 -5:00 pm
Room: JACKSON – 2nd Floor

In 1995, researchers at Duquesne University surveyed journalists, industry communicators, and the public to learn more about who these groups considered to be credible sources of information. Respondents ranked credibility as follows: government officials, 88%; environmental groups, 78%; and business and industry groups, 53%. This session will help environmental public health practitioners capitalize on their credibility by describing how the media operates and how practitioners can collaborate with members of the media to disseminate important environmental health messages. The session will include a presentation from the CDC/ATSDR media office as well as a panel discussion with state officials and journalists. The panel will review best practices for communicating information about a variety of environmental health topics.

Session Objectives:
At the end of this session, participants will be able to do the following:
1) Develop environmental health messages for various types of media
    (print, broadcast, Internet).
2) Discuss how the news media operates and what is considered
    newsworthy.

Moderator:
Kathy Skipper, MA, APR; National Center for Environmental Health/Agency for Toxic Substances and Disease Registry

Presenters:
Kathryn Harben, Office of Communication, Centers for Disease Control
   and Prevention
Martha Framsted, Nevada State Health Division
Jim Najima, Nevada Division of Environmental Protection
Maryn McKenna, MSJ; Atlanta Journal-Constitution
Ted Vigodsky, WABE-FM

T7: Primary Prevention of Lead Poisoning in Our Communities
Room: FULTON – 2nd Floor

The steady decline in the proportion of U.S. children with elevated blood lead levels between 1980 and 2000 is a true public health success. The most recent estimates from the 1999-2000 NHANES II indicate that approximately 434,000, or 2.2%, of U.S. children younger than 6 years of age had elevated blood lead levels (i.e., levels greater than or equal to 10 g/dL). However, this improvement has not been realized uniformly across communities, and areas remain where the risk for exposure is disproportionately high. To eliminate lead poisoning, we must focus efforts to prevent children from being exposed to lead in these highest-risk areas. CDC currently partners with 42 state and local governments to implement primary prevention activities. In this session, staff members from four programs will describe their current projects and how they help prevent childhood lead poisoning in some of the nation’s highest-risk communities. The following projects will be described:

• Philadelphia’s incorporation of lead dust testing in home visits to high-risk pregnant women and new mothers
   
• Tennessee’s prevention of industrial migration of lead using a targeted intervention program at a local battery plant
   
• Rhode Island’s Keep Your Baby Lead-Safe (KYBLS) project, which educates pregnant women about lead services and puts them in contact with resources to assist in the removal of lead hazards
   
• Maryland’s requirements for rental units to meet lead-safe standards at turnover and the creation of the state’s pre-1950 rental registry

Session Objectives:
At the end of this session, participants will be able to do the following:
1) Describe the concept of primary prevention in childhood lead
    poisoning.
2) Discuss primary prevention projects from three state/local programs.

Moderator:
Timothy Morta, National Center for Environmental Health/Agency for
   Toxic Substances and Disease Registry

Presenters:
Richard Tobin, Philadelphia Department of Public Health
Peggy O'Hara-Murdock, PhD; Middle Tennessee State University
Magaly Angeloni, Rhode Island Department of Health
Barbara Conrad, Maryland Department of the Environment

T8: NHANES and Beyond
Room: NEWTON – 2nd Floor

The National Health and Nutrition Examination Survey (NHANES) involves a statistical sampling of people in the United States who are 6 years of age and older. The population not sampled comprises toddlers, infants, and fetuses. The first session will bring together experts in the area of fetal and infant exposure assessment to discuss their recent research.

Session Objective:
At the end of this session, participants will be able to do the following:
1) Understand the issues related to fetal and infant exposure
    assessment.

Moderator:
Donald G. Patterson, Jr., PhD; National Center for Environmental
   Health/Agency for Toxic Substances and Disease Registry

Presenters:
Larry Needham, PhD; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry
Cynthia Bearer, MD, PhD; Rainbow Babies and Children’s Hospital, Case Western Reserve University
Judy LaKind, LaKind Associates

T9: Modeling and Measuring Environmental Health Promotion at the Community Level
Room: ROCKDALE – 2nd Floor

In this session, presenters describe why environmental health issues are “wicked” problems and provide a model that can help public health professionals and others in their efforts to develop health promotion approaches to address such problems. Presenters also will discuss indicators for measuring results.

Session Objectives:
At the end of this session, participants will be able to do the following:
1) Define three attributes of “wicked” problems.
2) Describe two ways in which health promotion strategies can be
    used to address “wicked” problems.

Moderator:
Elizabeth Howze, ScD, CHES; National Center for Environmental
   Health/Agency for Toxic Substances and Disease Registry

Presenters:
Michael Hatcher, DrPH, MPH, CHES; National Center for Environmental
   Health/Agency for Toxic Substances and Disease Registry
Terrie Sterling, PhD; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry
Janet Heitgerd, PhD; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry

T10: Chemicals in Commonly Used Products
Room: COBB – 2nd Floor

Some chemicals found in commonly used products, such as personal care products, pharmaceuticals, and medical instrumentation, are of concern to people in the field of environmental public health because of the great potential for human exposure and the demonstrated toxicity of some of these compounds in animals. For example, phthalates, which are industrial chemicals extensively used as additives and plasticizers, are known endocrine disruptors and can cause reproductive and developmental toxicities in rodents. Similarly, exposure during pregnancy to some perfluorochemicals, which is a group of widely used surfactants, results in maternal and developmental toxicity. However, little is known about the concentration of these chemicals in people, especially among vulnerable or at-risk populations, and whether a relation exists between exposure and disease. The purpose of the session is to better understand the prevalence of human exposure to chemicals used in consumer products and the use of exposure data for risk assessment.

Session Objectives:
At the end of this session, participants will be able to do the following:
1) Understand exposures to chemicals present in commonly used
    consumer products.
2) Understand the use of the exposure data for risk assessment.

Moderator:
Antonia Calafat, PhD; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry

Presenters:
Jürgen Angerer, PhD; Institute and Outpatient Clinic of Occupational,
   Social, and Environmental Medicine, Erlangen, Germany
George Lambert, MD; University of Medicine and Dentistry of New
   Jersey
Antonia Calafat, PhD; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry
Christian Daughton, PhD; U.S. Environmental Protection Agency
Andrea Pfahles-Hutchens, MS; U.S. Environmental Protection Agency

T11: The Pacific Emergency Health Initiative: Improving Emergency Preparedness in the Pacific Islands
Room: PAULDING – 2nd Floor

Environmental emergencies and disasters are frequent among developing nations. Pacific island nations, part of the geological “ring of fire,” now experience property losses of $1 billion each year as a result of these emergencies. In addition, events such as the bombing in Bali and the smaller attacks in the Philippines demonstrate these island nations’ vulnerability to acts of terrorism. Nearly all nations of the Pacific basin are geographically isolated and have very limited resources to provide emergency and disaster health services. CDC founded the Pacific Emergency Health Initiative (PEHI) in 2000 with the mission to strengthen the capacity for emergency health preparedness and response among Pacific island nations. PEHI has three objectives: to assess emergency preparedness among Pacific island health and medical systems; to facilitate emergency planning, preparedness, and response among Pacific health sectors; and to promote sustainable and indigenous emergency health education in Pacific island nations. Presenters in this session will discuss PEHI activities to date, including the establishment of the Palau Center for Emergency Health as a regional venue for hands-on public health and medical education.

Session Objectives:
At the end of this session, participants will be able to do the following:
1) Describe the unique emergency public health and medical challenges
    in the Pacific islands.
2) Describe the various types of assistance available to the Pacific
    island nations from PEHI.

Moderator:
Mark Keim, MD; National Center for Environmental Health/Agency for
   Toxic Substances and Disease Registry

Presenters:
Greg Dever, MD; Ministry of Health, Republic of Palau
Paul Giannone, MPH; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry
Bill Rich, AAS, CEM, EMT-P; National Center for Environmental
   Health/Agency for Toxic Substances and Disease Registry

T12: Emerging Issues in Assessing Human Exposure: Metals
Room: DeKALB – 2nd Floor

This session will discuss studies, emerging issues, and investigations of population exposures to various trace and toxic metals. Several recent exposure investigations have shown that certain groups of people have been exposed to trace and toxic metals and that the public health community has been unaware of the nature and extent of the exposure. These exposure investigations and the resulting implications to public health will be discussed. In addition, except for lead and cadmium, information about the “normal” levels of the population’s body burden to many toxic elements (metals) has not been available. In response to this information gap, laboratories have developed advanced methods for analyzing metals in blood, urine, bone, and other biological matrices. A reliable measurement of human biomarkers to assess preventable risk factors associated with adverse health outcomes or disabling conditions is a high priority for public health and for clinical laboratory medicine. This critical measurement process will be described by highlighting the current “state-of-the-art” and future laboratory methods of measuring these trace and toxic metals in people.

Session Objectives:
At the end of this session, participants will be able to do the following:
1) Describe some of the latest issues, studies, and investigations
    regarding the types and levels of metal exposures of various
    populations.
2) Describe some of the preanalytical issues and analytical
    technologies associated with the clinical measurement of trace and
    toxic metals.

Moderator:
Robert L. Jones, PhD; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry

Presenters:
Carol H. Rubin, DVM; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry
Kenneth G. Orloff, PhD, DABT; National Center for Environmental
   Health/Agency for Toxic Substances and Disease Registry
Patrick J. Parsons, PhD; New York State Department of Health
Robert L. Jones, PhD; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry

T13: Disease Clusters: Philosophy, Methodology, and Application
Room: DOUGLAS – 2nd Floor

This session will cover the subject of disease clusters. Presentations will include an overview of the field, including controversial and philosophical issues surrounding the study of disease clusters, a session on methodology used to detect and study clusters, and two specific examples of cluster investigations.

Session Objectives:
At the end of this session, participants will be able to do the following:
1) Discuss the science and methodology for disease cluster
    investigation and the complex issues involved.
2) Identify issues surrounding the science of disease clusters to
    provide a more coordinated and efficient state and federal response
    to disease cluster inquiries and investigations.

Moderator:
Beverly Kingsley, PhD, MPH; National Center for Environmental
   Health/Agency for Toxic Substances and Disease Registry

Presenters:
Dan Wartenberg, PhD; Environmental and Occupational Health
   Institute
Geoffrey Jacquez, MS, PhD; Biomedware
Jerry Fagliano, MPH, PhD; New Jersey Department of Health and Senior
   Services
Peter Langlois, PhD; Texas Department of Health

T14: Building State Public Health Laboratories’ Capacity to Respond: Biomonitoring and Chemical Terrorism
Room: JACKSON – 3rd Floor

During FY 2003, CDC programs that had been created to enhance states’ capacity to respond to terrorism threats and other emergencies were expanded to enhance the capacity of public health laboratories in 62 states and territories. FY 03 also marked the end of the 2-year planning phase of the CDC-supported biomonitoring program for state public health laboratories and the beginning of the implementation phase. Public health laboratory directors from four states that have received CDC funds for these programs will describe laboratory preparations, technology transfer activities, and future challenges and opportunities.

Session Objectives:
At the end of this session, participants will be able to do the following:
1) Understand the important role that state public health laboratories
    play in developing the nation’s capacity to respond to human
    exposure to toxic chemicals in the environment, to chemical
    terrorism, and to other chemical emergencies.
2) Understand CDC’s efforts to (1) transfer technology and train public
    health laboratory personnel in Level 2 and 3 laboratories regarding
    analytical procedures for determining human exposure to hazardous
    chemicals and (2) prepare Level 1 laboratories to participate in this
    process.

Moderator:
Dayton T. Miller, PhD; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry

Presenters:
Norman Crouch, PhD; Public Health Laboratory, Minnesota Department
   of Health
James L. Pearson, DrPH, BCLD; Division of Consolidated Laboratories,
   Commonwealth of Virginia
Richard Harris, PhD, HCLD (ABB); Wyoming Department of Health
Veronica C. Malmberg, MS, MT (ASCP); New Hampshire Office of
   Community and Public Health
Robert Kobelski, PhD; National Center for Environmental Health/Agency
   for Toxic Substances and Disease Registry