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The assessment of exposure through direct measurement of environmental chemicals in human specimens, such as blood or urine.


Clusters of health events (clusters)

An unusual aggregation, real or perceived, of health events that are grouped together in time and space and that are reported to a health agency. See Guidelines for Investigating Clusters of Healthy Events (MMWR July 27, 1990/Vol.29/No. RR-11)

Collaborative relationships

CDC’s goal is to develop a National Environmental Public Health Tracking system that integrates data about environmental hazards and exposures with data about adverse health effects that are possibly linked to the environment. This system will allow federal, state, and local agencies, and others to collaborate and ultimately monitor and distribute information about environmental hazards and health effects trends; advance research on possible linkages between environmental hazards and health effects; and develop, implement, and evaluate regulatory and public health actions to prevent or control environment-related health effects. CDC’s National Environmental Public Health Tracking Network initiative is an important priority for CDC because of the opportunity it provides to address some of the most challenging problems facing local, state, and national public health leaders. From the outset, this activity has involved substantial collaboration between CDC and its public health and environmental partnerships. Thirty organizations, including federal agencies, state and local public health and environment agencies, non-governmental organizations, and academic institutions have provided recommendations to CDC and ATSDR on development of the National Environmental Public Health Tracking Network.


Data and information technology standards

A set of standards and guidelines for data representation and code values that includes specifications for representing concepts as well as standard code lists for coded elements.

Data linkage

For the purpose of CDC’s National Environmental Public Health Tracking initiative, data linkage refers to projects that will link health effect data with exposure and/or hazard data as part of ongoing surveillance activities and use this linked data in guiding public health policy and practice. Also for this purpose, there are two types of data linkage. One is record linkage, which is a method for assembling the information contained in two or more records—e.g., in different sets of medical charts and in vital records, such as birth and death certificates—and a procedure to ensure that the same individual is counted only once. This procedure incorporates a unique identifying system, such as a personal identification number. Record linkage makes it possible to relate significant health events that are remote from one another in time and place or to bring together records of different individuals, e.g., members of a family. The resulting information is generally stored and retrieved by computer, which can be programmed to tabulate and analyze the data. The second type is geographic record linkage, which is a method for assembling the information at a geographic unit level rather than an individual level—e.g., in different sets of environmental protection data—and a procedure to ensure that the same geographic unit is counted only once. Geographic record linkage is a type of ecologic correlation where the units studied are populations rather than individuals. Correlations found in this manner may not hold true for the individual members of these populations.


Eligible applicants

Applicants eligible for this program announcement are health departments of states or their bona fide agents, including the District of Columbia, the Virgin Islands, the Commonwealth of the Northern Mariana Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau. In consultation with States, assistance may be provided to the local health departments of Chicago, Illinois, Philadelphia, Pennsylvania, Los Angeles County, California, Houston, Texas, and New York City, New York. Due to limited resources, competition is limited to the five largest incorporated, metropolitan areas in the United States. Also, it is limited to only the listed applicants to accommodate legislative appropriations language, which specifies capacity development of environmental health at state and local health departments.

Environmental hazard

An environmental hazard is an agent or factor in the environment that may adversely affect human health. People can be exposed to physical, chemical, or biological agents from various environmental sources through air, water, soil, and food. For this program, environmental hazards include biological toxins, but do not include infectious agents (e.g. E-coli in drinking water is not included).

Environmental hazard data

There are two types of environmental hazard data: (1) data that is generated from information pertaining to a site or facility (i.e., Toxic Release Inventory data; National Emission Inventory data, etc.) and (2) data that is generated from measurements of contaminates in the air, water, soil, or sediment (i.e., air monitoring data, Safe Drinking Water Information System data, etc.) .

Environmental Protection Agency (EPA)

Founded in 1970, EPA's mission is to protect human health and to safeguard the natural environment—air, water, and land—upon which life depends. EPA provides leadership in the nation's environmental science, research, education, and assessment efforts. EPA works closely with other federal agencies, state and local governments, and Indian tribes to develop and enforce regulations under existing environmental laws. EPA is responsible for researching and setting national standards for a variety of environmental programs and delegates to states and tribes responsible for issuing permits and monitoring and enforcing compliance. Where national standards are not met, EPA can issue sanctions and take other steps to assist the states and tribes in reaching the desired levels of environmental quality. The agency also works with industries and all levels of government in a wide variety of voluntary pollution prevention programs and energy conservation efforts. EPA is an active partner in CDC’s National Environmental Public Health Tracking Network initiative through the Memorandum of Understanding with the Department of Health and Human Services.

Environmental public health

The health of the human population as it relates to the environment.

Environmental public health surveillance

Environmental public health surveillance is public health surveillance (see definition) of health effects integrated with surveillance of environmental exposures and hazards. Efforts in environmental public health surveillance and this integration provide a strategic opportunity to link environmental and health data on a local, state, and national level, thereby better equipping the public health community to identify problems and effective solutions to reduce the burden of environment-related health effects in the U.S. (See the definition for "National Environmental Public Health Tracking (surveillance) initiative.")

Environmental Public Health Tracking (surveillance) initiative

The Congressionally-mandated national initiative that will establish a network that will enable the ongoing collection, integration, analysis, and interpretation of data about the following factors: (1) environmental hazards, (2) exposure to environmental hazards, and (3) health effects potentially related to exposure to environmental hazards. In fiscal year 2002, Congress provided CDC with funding to begin developing the nationwide environmental public health tracking network and to develop capacity in environmental health within state and local health departments. Health effects that are to be included are birth defects, developmental disabilities, neurological/immunologic diseases, cancer, chronic respiratory disease and other non-infectious health effects that may be related to exposure to chemicals, physical agents, biomechanical stressors, or biologic toxins in the environment. Visit for more information.


The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems.


A process that attempts to determine as systematically and objectively as possible the relevance, effectiveness, and impact of activities in the light of their objectives. Several varieties of evaluation can be distinguished, e.g., evaluation of structure, process, and outcome.

Executive Order 12372 (E.O 12372)

Executive Order 12372, "Intergovernmental Review of Federal Programs," was issued on July 14, 1982 and amended on April 8, 1983. This executive order is applied to federal grant processes. It is intended to foster an intergovernmental partnership and a strengthened federalism by relying on state processes and on state, area-wide, regional and local coordination for review of proposed federal financial assistance and direct federal development.

Existing health surveillance system

State-wide or regional health effect registries or surveillance/monitoring existing systems that contain data of sufficient completeness, timeliness, and quality to allow reporting of valid estimates of health effect prevalence, incidence, or mortality for a population. This information should be readily available to health department staff for analysis and dissemination of information to guide public health action. Birth defects registries should include populations with at least 35,000 live births per year. Cancer registry surveillance systems should be limited to those registries who have obtained certification from the North American Association of Central Cancer Registries (NAACCR).


Proximity and/or contact with a source of a disease agent in such a manner that effective transmission of the agent or harmful effects of the agent may occur.

Exposure data

Measures of contaminants in a human body.



A basic conceptual structure (as of ideas).


Geographic Information Systems (GIS)

Software technology that enables the integration of multiple sources of data and displaying data in time and space. GIS technology is expected to be a primary tool employed in the nationwide environmental public health tracking network.



A factor that may adversely affect health.

Health effects

Chronic or acute health conditions that affect the well-being of an individual or community. Health effects are measured in terms of illness and death.

Healthy People 2010

A Department of Health and Human Services sponsored national activity to reduce illness and death, and improve quality of life. For more information, visit the Internet site [external link]



The number of new events—e.g., new cases of a disease in a defined population—within a specified period of time.

Infectious Agent

A living microorganism that enters, invades, or inhabits another organism, causing infection, health effects, and/or contamination.

In public health, the method or background for current and future efforts to improve the information systems that support essential public health functions.

Taking actions in public health so as to reduce adverse health effects, regulatory, and prevention strategies.


Letter of Collaboration (LOC)

A document that provides proposed collaborations/partnerships with relevant organizations and agencies within the state/local/tribal government (if applicable) and provides evidence that these organizations/agencies are willing to support and be actively involved in carrying out the project.

Letter of Intent (LOI)

A document submitted by the grantee that declares the level of interest in the announcement of the organization at all levels and their plan to apply for funding under the program announcement.

Linkage project

For the purpose of CDC’s National Environmental Public Health Tracking initiative, a linkage project demonstrates: (a) an approach for linking (on an individual or ecologic level) existing health effect surveillance data with exposure and/or hazard data as part of an ongoing surveillance activities; (b) a sustainable effort to build capacity; and (c) the utility of this linked data in guiding public health policy and practice.


Measurable outcome

A measurable outcome is an objective or goal that can be quantified to determine completion and effectiveness. Measurable outcomes that are selected in the design phase of a project must also be aligned with set performance goals for the overall program. A measurable outcome can be, for example, the change(s) expected as a direct result of the program's implementation or expected data that will demonstrate the activities and implementation of a program.

Measure of effectiveness

A standard quantifiable measure to demonstrate how program goals and objectives have been met.

Memorandum of Understanding (MOU)

An agreement of cooperation between organizations defining the roles and responsibilities of each organization in relation to the other or others with respects to an issue over which the organizations have concurrent jurisdiction. CDC (through the Department of Health and Human Services (HHS)) has entered into a Memorandum of Understanding with the Environmental Protection Agency (EPA). This MOU will facilitate a working relationship between the agencies to better understand the linkages between environmental hazards, ensuing human exposure, and potential health outcome. This will allow for more informed environmental and public health policies/decisions and improved ability to assess the efficacy of such policies and decisions. As a cornerstone of this collaborative commitment, EPA and CDC will take advantage of ongoing, cross-institutional initiatives to develop and link environmental health information sources, namely the EPA National Environmental Information Exchange Network (NEIEN) and CDC’s National Environmental Public Health Tracking Network (EPHT Network). At project completion, the linkage of these two systems will utilize and enhance information technology tools to advance the analysis and dissemination of information obtained to various audiences. This joint effort between EPA and CDC/HHS also has the potential to increase environmental and health infrastructure and capacity at the local, state, and national level by coordinating and integrating electronic reporting of hazard, exposure, and health data. For more information, visit


National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)

CDC’s National Center for Chronic Disease Prevention and Health Promotion is at the forefront of the nation's efforts to prevent and control chronic health effects. CDC's framework for preventing and controlling chronic health effects is supported by surveillance, which involves collecting data to better understand the extent of risk behaviors, to monitor the progress of prevention efforts, and to help public health professionals and legislators make more timely and effective decisions. NCCDPHP is an active partner in CDC’s National Environmental Public Health Tracking initiative.

National Center for Environmental Health (NCEH)

The National Center for Environmental Health investigates and increases knowledge about the relation between human health and the environment and to use this knowledge to develop national public health programs and policies for preventing health effects. CDC’s Public Health Tracking Network is housed within CDC’s National Center for Environmental Health. NCEH coordinates with other CDC centers, institutes, and offices and the Agency for Toxic Substances and Disease Registry to pool resources and expertise on cross-cutting issues concerning National Environmental Public Health Tracking and surveillance systems.

National Center on Birth Defects and Developmental Disability (NCBDDD)

CDC’s National Center on Birth Defects and Developmental Disabilities seeks to promote optimal fetal, infant, and child development; prevent birth defects and childhood developmental disabilities; and enhance the quality of life and prevent secondary conditions among children, adolescents, and adults who are living with a disability. NCBDDD is an active partner in CDC’s National Environmental Public Health Tracking initiative.

National Electronic Disease Surveillance System (NEDSS)

Developed by CDC, it is an electronic information system architecture for use in the states that can automatically gather health data from a variety of sources on a real time basis, assist in the ongoing analysis of trends and detection of emerging public health problems, and facilitate monitoring of community health. Initially designed to be used for communicable disease surveillance, it can be applied to National Environmental Public Health Tracking activities. NEDSS now falls under CDC’s larger Public Health Information Network (PHIN).

National Environmental Information Exchange Network (NEIEN)

Managed by the Environmental Protection Agency (EPA), the National Environmental Information Exchange Network is a new nationwide initiative with the states to build locally and nationally accessible, cohesive, and coherent environmental information systems. The goals of this program are to improve the quality of data, provide agencies and the public ready access to these data, and increase the ability of state agencies and EPA to employ this information to protect public health and the environment. EPA also maintains a number of vital databases that can be critical elements of a nationwide environmental public heath tracking network, notably its Toxic Release Inventory (TRI).

Non-infectious agents

Non-living or abiotic force or substance capable of producing adverse health effects.


Persistent chemicals

Chemical substances that persist in the environment, bioaccumulate through the food web, and pose a risk of causing adverse effects to human health and the environment.

Pew Environmental Health Commission

In May 1999, the Pew Charitable Trusts launched a blue-ribbon commission charged with proposing recommendations to bolster America's ability to track and prevent health problems linked to environmental conditions. In January 2001, this panel—the Pew Environmental Health Commission—which included leaders from the public policy, health industry, government, academic and nonprofit communities, released a report calling for a nationwide health effects monitoring and tracking network. reports/ trackingcompanion.pdf [PDF]


The number of events, e.g., instances of a given health effect or other condition, in a given population at a designated time.

Public Health Information Network (PHIN)

CDC’s new electronic information network system that supports monitoring of the public’s health. PHIN will detect health problems, analyze accumulated data, create useful information, communicate alerts as needed, and inform appropriate responses. The overall vision for the PHIN is to be the information network that integrates public health partners across the nation. PHIN will have dual functionality by providing a foundation for routine public health activities and by enhancing bioterrorism detection and response. PHIN will be a live, secure, Internet-based network for exchanging comparable critical health information between all levels of public health (local, state, and federal) and other critical information systems. CDC’s National Environmental Public Health Tracking Network and National Electronic Disease Surveillance System (NEDSS) fall under this larger CDC effort that is the PHIN. Visit

Public health surveillance

The ongoing, systematic collection, analysis, and interpretation of outcome-specific data used to plan, implement, and evaluate public health practice.



Something that serves as a basis for comparison; a technical specification or written report drawn up by experts based on the consolidated results of scientific study, technology, and experience; aimed at optimum benefits; and approved by a recognized and representative body.

State Single Point of Contact (SPOC)

As established through E.O. 12372, states have designated an entity to coordinate and review proposed federal financial assistance. An official list of those entities (and a link to those states that have a home page for their designated entity) can be found at