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The environment plays an important role in human development and health. Researchers have identified associations between exposures to some environmental hazards and specific diseases, such as exposure to asbestos and lung cancer. Other interactions between environmental exposures and health effects are suspected but need further research, such as the association between exposure to disinfectant by-products and bladder cancer.
Surveillance systems that capture data on public health effects and monitoring systems that capture environmental data currently exist. They are, however, separate systems, often developed by different agencies and for different purposes, making it difficult to track environmental hazards and investigate possible associated health effects. The environmental monitoring and health/exposure surveillance systems that exist currently are generally not compatible with each other because of differences in the purposes of the systems. There is a lack of common standards in how data are collected, including where data are collected, frequency of collection, characteristics collected, and data formats. Therefore, linking environmental and health systems can be very complex and time-consuming.
The issue of environmental public health tracking was identified in a 2001 Pew Environmental Health Commission report called “America's Environmental Health Gap: Why the Country Needs a Nationwide Health Tracking Network” . In this report, the Commission stated that the existing environmental health system was inadequate and fragmented, and they recommended a “Nationwide Health Tracking Network for disease and exposures.”
Surveys conducted by the Pew Commission in the 50 states and selected local jurisdictions found that many of the public health departments have little capacity for environmental public health tracking. As a result, fundamental information about community health status and environmental exposures is often not available for disease prevention, policy, and scientific purposes. Congress responded in 2002 by appropriating funding for CDC to begin developing and implementing a nationwide environmental public health tracking program and to develop environmental health capacity in state and local health departments. CDC has issued solicitations for two rounds of cooperative agreements with state, university, and local partners to begin developing the Environmental Public Health Tracking Network (the Network). (http://www.cdc.gov/nceh/tracking/). This focuses on both noninfectious conditions with long latency (chronic diseases) and noninfectious conditions with short latency (toxic effects, such as acute poisoning) that may be related to environmental exposures.
Environmental public health issues exist nationally and locally. In some cases, states are responsible for public health, but in other cases, the responsibility is shared between federal and state agencies. Some environmental hazards are specific to local or state areas, but other environmental hazards have no boundaries and are regional or national. Therefore, the need for coordination and data sharing is essential. Developing a national Network together with state efforts will improve awareness, communication, and standards.
The EPHT Program has been established to address the problems outlined above. The EPHT Network will support the purposes of the EPHT Program. This Network will make data and tools available to support activities of the EPHT Program and other public health and environmental health programs.
The Environmental Public Health Tracking Program has three purposes:
- Provide information to initiate public health actions, both immediate or long term, as warranted
- Conduct planning and evaluation (e.g., estimate the magnitude of the problem, track trends, identify high risk groups and modifiable risk factors, and evaluate the effectiveness of interventions) and
- Establish a basis for etiologic studies
The EPHT Program will facilitate the integration of data on environmental hazards, environmental exposures, and health effects to protect and improve public health. The EPHT Network will support data integration by both owners and users. Integrated data will provide public health agencies with information that can be used to plan, apply, and evaluate actions that prevent and control environmentally related diseases. The Program will provide the flexibility to address national, regional, state, and local environmental public health needs.
The EPHT Network will be a distributed, web-based network that provides access to environmental and health data collected by a wide variety of agencies. It will be comprised of individual state networks and a national network, will comply with PHIN standards, and will be able to exchange data with the EPA Exchange Network, where applicable.
The scope of the EPHT Network is characterized by the following set of principles developed as part of the Standards and Network Development Workgroup efforts:
- The EPHT Network provides access to and support of both centralized and de-centralized data stores and repositories
- The EPHT Network supports data exchanges and data linkages within states, across states and regions, and nationally
- The EPHT Network enables the discovery and access to environmental data, health data, and linked environmental-health data
- The EPHT Network provides access to centralized and decentralized tools (e.g., methods, software, and algorithms to link data).