NCEH in
Partnership With Nevada
The National Center for Environmental Health (NCEH) is part of the
Centers for Disease Control and Prevention (CDC). NCEH’s work
focuses on three program areas: identifying environmental hazards,
measuring exposure to environmental chemicals, and preventing
health effects from environmental hazards. NCEH has approximately
450 employees and a budget for 2004 of approximately $189 million;
its mission is to promote health and quality of life by preventing
or controlling those diseases or deaths that result from
interactions between people and their environment.
NCEH and partners throughout Nevada collaborate on a
variety of environmental health projects throughout the state. In
fiscal years 2000–2004, NCEH awarded more than $1.8
million in direct funds and services to Nevada for various
projects. These projects include activities related to
environmental public health tracking, mercury exposure among
schoolchildren, and a cancer cluster investigation. In addition,
Nevada benefits from national-level prevention and response
activities conducted by NCEH or NCEH-funded partners.
Identifying Environmental Hazards
NCEH identifies, investigates, and tracks environmental hazards
and their effects on people’s health. Following are examples of
such activities that NCEH has conducted or supported in Nevada.
Environmental Public Health
Tracking (EPHT) Project
- Planning and
Capacity-Building for the EPHT Network—NCEH is funding a
cooperative agreement with the Nevada State Health Division.
This project’s four major goals are to
1. identify and increase the
capacities of the public health; surveillance; and reporting
infrastructures at the state, local, and tribal levels;
2. improve the public’s understanding of the relation between
exposure to environmental hazards and chronic diseases and
conditions;
3. facilitate the integration of an environmental public health
surveillance system with Nevada’s National Electronic Disease
Surveillance System, the U.S. Environmental Protection Agency’s
National Environmental Information Exchange Network, and the
surveillance system being established under the Health Resources
and Services Administration’s hospital bioterrorism preparedness
initiative; and
4. cultivate partnerships that will facilitate implementation of
a national EPHT system.
During 2003, the cooperative
agreement yielded a comprehensive inventory of environmental
hazards, chemical inventories, and noninfectious-disease
surveillance systems. Nevada also launched a statewide campaign
to educate the public and policy makers about the relation
between human exposure to environmental hazards and chronic
diseases and conditions.
Nevada proposes to establish a partnership with a local
community to implement the Protocol for Assessing Community
Excellence in Environmental Health, which would provide a
real-time evaluation tool against which to compare the developed
surveillance system’s ability to appropriately identify,
classify, report, track, and respond to incidents of human
exposure to environmental public health hazards. Funding began
in fiscal year 2003 and continues through fiscal year 2005.
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Environmental Public Health
Studies Projects
- Cross-Sectional Exposure
Assessment of Environmental Contaminants in Churchill County—In
2001, a statistically significant increase was reported in the
number of acute lymphocytic leukemia (ALL) and acute myelocytic
leukemia (AML) cases diagnosed in Churchill County
children—15 children by the end of 2001. The Nevada State
Health Division asked NCEH to evaluate risk factors for or
etiologic exposures linked to this cluster of ALL and AML cases
and to design and conduct a cross-sectional exposure assessment
of selective contaminants using environmental and biologic
specimens collected from case-families and from a reference
(control) population.
During 2001 and 2002, NCEH conducted a cross-sectional exposure
study of environmental contaminants in the region. NCEH opened a
field clinic in Fallon to collect biologic samples and
worked with the Nevada Division of Environmental Protection
to collect the environmental samples. Specimens were
collected from approximately 200 people, including case-children
and their families and control-children and their families. NCEH
analyzed blood samples for four metals (lead, mercury, cadmium,
and selenium); 13 persistent pesticides; 15 volatile organic
compounds; 38 polybrominated hydrocarbons; and genetic and
microbial markers. Urine specimens were analyzed for 43
nonpersistent pesticides and 26 metals, including seven species
of arsenic.
Levels of most chemicals in urine and blood samples from
Churchill County study participants were not elevated compared
with national estimates. Levels of arsenic and tungsten were
elevated in Churchill County participants’ urine but were not
higher in case-children than in control-children and families.
Levels of some nonpersistent pesticides in Churchill County
participants’ urine samples were slightly elevated, but the
levels did not differ between case- and control- children or
families. Levels of DDE (a breakdown product of the pesticide
DDT) were elevated in blood samples of Churchill County
participants but the levels did not differ between case- and
control-children or their families.
Exposure to arsenic exceeded health-based reference levels in
34% of the Churchill County study population. Exposure levels
were not higher among case-children or families than among
control-children or families.
In February 2003, NCEH reported that elevations of some
chemicals were identified but that these elevations did not
explain the incidence of childhood leukemia in the county.
Information about the tungsten study is in the Studies section
of this fact sheet.
- Mercury Exposure Among
Children at a Nevada Middle School—In January 2004, NCEH
assisted the Nevada State Health Division in assessing
exposure of children, faculty, and staff at a middle school in
Gardnerville after a student brought a large amount of
liquid mercury to the school. NCEH administered questionnaires
and obtained urine samples from 200 (23%) of 854 students and 80
staff who responded to announcements offering free testing after
the mercury spill. NCEH then compared participants’
urine-mercury and creatinine levels with those documented in the
National Health and Nutrition Examination Survey.
No significant association was found between participants’
urine-mercury levels and self-reported exposure to elemental
mercury at the school. Only children who reported touching
mercury on a previous occasion had significantly higher
creatinine-corrected urine mercury levels than did participants
who denied ever touching mercury. These results suggest that
transient exposures to mercury, such as when children find and
play with its elemental form, are associated with negligible
absorption.
Only the boy who brought the mercury to school had an elevated
mercury level. This level was slightly above levels in the
general population. Health officials used this information to
determine that no one else needed testing for mercury, and no
one required medical treatment as a result of exposure.
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Measuring Exposure to
Environmental Chemicals
NCEH measures environmental
chemicals in people to determine how to protect people and improve
their health. Following are examples of such activities that NCEH
has conducted or supported in Nevada.
Funding
- Antiterrorism Funding to
Increase Capacity of State Chemical Laboratories—In fiscal
year 2003, CDC provided more than $663,000 to Nevada to
assist in expanding chemical laboratory capacity to prepare and
respond to chemical terrorism incidents and other chemical
emergencies. This program expansion will allow for full
participation of chemical-terrorism response laboratories in the
Laboratory Response Network.
Studies
- Exposure to Tungsten in
Three Nevada Cities—NCEH assisted the Nevada State Health
Division in conducting a cross-sectional assessment of human
exposure to tungsten in Yerington, Lovelock, and
Pahrump. The purpose of the study was to determine
whether the elevated levels of tungsten found in human urine
samples collected as part of a childhood leukemia investigation
in Churchill County were unique to the county. The three
communities were chosen because their hydrogeology and history
of tungsten mining were similar to those of Churchill County.
Results of this study suggested that Churchill County’s tungsten
exposure is not unique. Results were sent to study participants
and released to the participating communities.
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Services
- Blood Lead Laboratory
Reference System (BLLRS)—In Nevada, three
laboratories participate in NCEH’s standardization program to
improve the overall quality of laboratory measurements of blood
lead levels. This program assists laboratories nationwide in
evaluating their performance on these critical laboratory tests.
NCEH provides BLLRS materials to the laboratories four times a
year without charge.
- Newborn Screening Quality
Assurance Program―NCEH provided proficiency-testing services
and dried blood-spot quality-control materials to monitor and
help ensure the quality of newborn screening program operations
in Nevada. The importance of accurate screening tests for
genetic metabolic diseases cannot be overestimated. Testing of
blood spots collected from newborns is mandated by law in almost
every state to promote early intervention that can prevent
mental retardation, severe illness, and premature death.
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Preventing Health Effects from
Environmental Hazards
NCEH promotes safe environmental
public health practices to minimize exposure to environmental
hazards and prevent adverse health effects. Childhood lead
poisoning prevention is an example of such activities. NCEH has
not recently conducted or supported any such activities in
Nevada.
Resources
NCEH develops materials that
public health professionals, medical-care providers, emergency
responders, decision makers, and the public can use to identify
and track hazards in the environment that threaten human health
and to prevent or mitigate exposure to those hazards. NCEH’s
resources cover a range of environmental public health issues,
including air pollution and respiratory health (e.g., asthma,
carbon monoxide poisoning, and mold exposure), biomonitoring to
determine whether and how much of selected chemicals in the
environment get into people, childhood lead poisoning, emergency
preparedness for and response to chemicals and radiation,
environmental health services, environmental public health
tracking, international emergency and refugee health, laboratory
sciences as applied to environmental health, radiation studies,
safe disposal of chemical weapons, specific health studies, vessel
sanitation, and veterans’ health.
For more information about NCEH programs, activities, and
publications and other resources, contact the NCEH Health Line
toll-free at 1-888-232-6789, e-mail NCEHinfo@cdc.gov, or visit the
NCEH Web site at
www.cdc.gov/nceh.
May 2004
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