Success Stories - Targeting Prevention

Heat Wave Preparedness

What is the problem?

During the California 2006 heat wave, there were 140 confirmed deaths and an additional 515 suspected deaths due to extreme heat. An estimated $133 million in health-related costs was attributed to the heat wave, along with an estimated $500 million in agriculture-related costs from the loss of livestock. Heat waves have and will continue to impact all regions of California, including urban, rural, inland, and coastal areas. In California, heat waves are expected to become longer and more frequent over time.

What did Tracking do?

The California Environmental Health Tracking Program worked with the Bay Area National Weather Service (NWS) regional office to conduct a study to determine if heat alerts accurately predicted times when people suffered the most heat illness. NWS monitors temperature and issues heat alerts. The heat alerts serve as triggers for cities and counties to take preventative action, such as opening cooling centers where the public can gather for life-saving relief from the heat. The California Tracking Program showed that heat-related emergency room visits peaked immediately following heat alerts for the San Jose area and subsided when the heat alerts were discontinued. Due to budget cuts, the City of San Jose wanted scientific evidence from NWS to show there was a need for cooling centers during heat waves. Without this proof, decision-makers would not approve the opening of cooling centers as part of the city's heat alert response plan for the upcoming summer.

Improved public health

NWS presented the California Tracking Program study findings to City of San Jose decision-makers. Based on this evidence, the city decided to allow cooling centers to open as part of the city's heat alert response. The California Tracking Program is partnering with NWS to conduct similar studies for other regions in California, including Los Angeles. This information will help cities to make decisions about heat wave preparedness policies and help NWS refine its heat alert system for each region.

Connecticut - Improving evaluation of asthma programs

What is the problem?

Asthma is an ongoing concern for many Connecticut residents, especially those living in urban areas. Tracking the rates of stays in the hospital because of asthma is key to assessing the success of public health interventions.

What did Tracking do?

The Connecticut Tracking Program developed a part of the state tracking network just for asthma. This section includes data from the state asthma program and from hospitals across the state. Users can view real-time rates for asthma-related hospital stays by ethnicity, gender, race, and county.

Improved public health

Thanks to the Connecticut Tracking Program, complete, user-friendly asthma data for the state are available in one place for the first time. Other health department programs in Connecticut now have access to asthma data that can help them more readily evaluate their asthma prevention and control activities in less time.

Florida - Consuming fish safely: Mercury biomonitoring project

What is the problem?

Mercury is a toxin that occurs in the environment naturally and as a result of industrial pollution. Methylmercury is a form of mercury found in some fish and shellfish. It poses a risk to people who consume certain types of fish and shellfish. The greatest risk is to women of childbearing age and to children, who should not eat certain types of fish. Mercury can damage the nervous system of young children and developing fetuses.

Human exposure to mercury through fish consumption is a growing concern in the United States. Areas with high mercury emissions from coal-fired power plants and that have populations who frequently consume fish are of most concern. To help people eat the proper amount and species, they need accurate information about how much and what types of fish to consume.

What did Tracking do?

Researchers evaluated fish eating patterns among women of child-bearing age in Duval and Martin Counties, their research also included mercury biomonitoring. Participants completed a survey about their fish eating habits, knowledge of fish consumption advisories, pregnancy status, demographic and socio-economic information, and mercury exposure history. And each participant provided a scalp hair sample for mercury analysis.

Results showed that women of child-bearing age in Duval and Martin Counties consume more fish than their counterparts in other areas of the United States and that their hair-mercury levels are higher than the participants of the study who do not consume fish. Because of the low local awareness of fish advisories, increased education is needed about the advisories and about mercury exposure among at-risk populations in Duval and Martin Counties.

Improved public health

The Florida Tracking Program created the Fish for Your Health Wallet Card. It contains information about what types and amounts of fish to eat. It encourages women to enjoy the health benefits of certain kinds of fish but also avoid unsafe amounts of mercury. The card lists:

• Species of fish by different categories of mercury content, and
• Suggested amounts of fish to eat each week.

The Florida Tracking Program distributes the wallet cards to county health departments, state fish markets and grocery stores, and to the Florida Medical Association (FMA). The FMA sends the wallet cards to local branches and to physicians' offices.

Kansas - Mapping childhood lead poisoning data

What is the problem?

Lead is a heavy metal toxin that is commonly found in our environment. Lead affects the health of many, especially children. The most common cause of childhood lead poisoning is the deterioration of lead-based paint surfaces in homes. Nearly 70% of homes in Kansas are at risk due to the use of lead-based paints. Blood lead levels (BLLs) as low as 5 micrograms per deciliter (ug/dL) are associated with harmful effects on children's learning and behavior. In Kansas, a child is considered poisoned with a BLL of 10 ug/dL. Hundreds of children are poisoned by lead in Kansas each year. However, many children in the state are not screened for lead.

What did Tracking do?

The Kansas Tracking Program will partner with KDHE's Healthy Homes Program to evaluate data from the childhood blood lead program. Through mapping, the Kansas Tracking Program will be able to illustrate the areas of the state where BLLs are high and a large number of older homes are located.

Improved public health

Using the evaluation, the Kansas Tracking Program will be able to define objectively the scope of both childhood blood lead screening and childhood blood lead poisoning. This will provide valuable information to public health professionals to conduct targeted health outreach. The goal is to increase the number of children that are screened for lead in their blood and decrease the number of children with blood lead poisoning.

Kansas - Partnering with Kansas Radon Program

What is the problem?

Radon is the leading cause of lung cancer in non-smokers and the second leading cause of lung cancer overall. It is estimated that as many as 200 cases of lung cancer per year may be related to prolonged radon exposure in Kansans. Radon typically moves from the ground under and around a home through cracks and other holes in the foundation. The Kansas Radon Program's database of tests has more than 47,000 measurements, and 40% of them are at or above the U.S. Environmental Protection Agency's action level.

What did Tracking do?

The Kansas Tracking Program will assist the Kansas Radon Program to analyze data and discover trends that indicate increased risk to public health. The results of this analysis will be made available to all citizens through the Kansas Tracking Network.

Improved public health

This information will increase public awareness of radon. It will also allow public health officials and the public to make informed decisions and take action to prevent exposure and reduce the risks associated with elevated radon levels.

Massachusetts - Collaborating with federal agencies to improve public health

What is the problem?

The U.S. Environmental Protection Agency (USEPA) asked the Massachusetts Tracking Program to evaluate lead levels in surface soil at the former Agawam Sportsman Club site. EPA wanted to find out whether the amount of lead in the soil posed a risk to young children or to others who used the area. High amounts of lead in surface soil can pose serious health concerns if exposures occur, especially to young children.

What did Tracking do?

The Massachusetts Tracking Program evaluated surface soil sampling results for the site. The tracking program also looked at available data on blood lead levels (BLLs) in children who lived or had lived near the site.

Lead was detected in the soil in amounts higher than EPA screening levels. But, the actual BLLs among the tested children were low. The tracking program also found that the number of cases of high BLLs in the area of the former sportsmen's club was similar to other parts of the town.

Improved public health

Though BLLs among children living near the site were not as high as expected, the EPA took action to reduce possible contact with the contaminated soil. Specifically, the EPA removed soil where needed and installed soil-erosion control devices next to a nearby stream.

Pennsylvania - Asthma school project(2004-2005 school year)

What is the problem?

Analysis showed that the Bradford Area and Oley Valley school districts had the highest prevalence of reported asthma for six school years between 1997 and 2003.

What did Tracking do?

School nurses tracked asthma cases at all 501 public school districts in Pennsylvania. The project then tracked all students with asthma in the two districts that had the highest prevalence of asthma cases. The project also evaluated environmental factors at the schools but no unusual patterns or links to the schools were identified.

Improved public health

Pennsylvania's Tracking Program uses information from this school-based asthma surveillance project to target prevention strategies. They provided prevention strategies and educational materials on asthma and asthma triggers to the public, schools and communities. People can use these materials to reduce exposure to potential environmental risks and triggers and increase their knowledge and awareness regarding asthma.