National Center for Environmental Assessment (NCEA)
http://www.epa.gov/ncea/

The NCEA web site of the U.S. Environmental Protection Agency (EPA) features ecological risk assessment documents, scientific support for conducting risk assessments, and access to tools used in understanding risk in the environmental arena. Risk assessments are currently available for dioxin, lead, ozone, particulate matter, polychlorinated biphenyls, and environmental tobacco smoke. Guidelines are available for carcinogen, reproductive toxicity, and ecological risk assessments. The site also provides access to the Integrated Risk Information System (IRIS) Web Prototype. EPA is testing and working to improve this World Wide Web presentation of IRIS, a database of human health effects that may result from exposure to various substances found in the environment.

RiskWorld
http://www.riskworld.com/

RiskWorld is a World Wide Web (WWW) publication covering risk assessment and risk management. It is published by Tec-Com Inc., a publishing company specializing in technical communications primarily for energy or risk-focused organizations. RiskWorld contains news articles, announcements, government reports, paper abstracts, WWW site profiles, risk software, job information, and more.

EPA Superfund WWW Site
http://www.epa.gov/superfund

The U.S. Environmental Protection Agency (EPA) has revamped its Superfund (National Priorities List hazardous waste site) World Wide Web site so that it is more user-friendly and useful to EPA's various audiences. The "Welcome" file contains information on the site's new organization, which includes a new "Superfund for Kids" section.

Crescent Community-based Research Listserv

The University of Massachusetts Extension, the Loka Institute, and the Community Research Network have created the Crescent group mailing list to address the growing need for community-based researchers worldwide to share experiences, research methods, and resource management and fundraising information. To subscribe, send an e-mail message to majordomo@reeusda.gov containing the message "subscribe crescent." Crescent grew out of an initiative known as the Community Research Network (CRN). For more information about CRN, go to http://amherst.edu/~loka/ or e-mail the Loka Institute at mailto:loka@amherst.edu

Environment97 Conference To Be Held on Internet Only

The Environment97 conference will be held entirely and exclusively on the Internet at http://www.environment97.org/, November 3-14, 1997. The conference will include approximately 150 technical and general papers, discussion groups for each keynote paper, downloadable images of environmental bad practices, life cycle assessment comparing an Internet conference with a real conference, and a participant chat room. Papers cover global issues, environmental philosophy, toolkits, and techniques. Registration at the site is necessary for full access. The site contains frames, but a text-only and a non-frames version of the site will be available for the conference.

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Commentary

The U.S. Department of Health and Human Services and partners held the "1997 Partnerships for Networked Consumer Health Information Conference" in Washington, DC, April 14-16. The following is an editorial concerning some of the conference's key issues.

Many factors are influencing and changing how ATSDR and other health agencies, organizations, and individuals will promote health in the future. One of the most influential factors is rapid change in information delivery technologies.

Health professionals have good reason to be excited and concerned. The entire culture of communications--and therefore health promotion--is changing. No matter whether you are an early adopter or are coming along kicking and screaming into the Computer-based Information Age, you need to be aware of how networked, computer-based consumer health information systems are among the forces driving unprecedented changes in health care and health professions.

Once these changes in information delivery take place on a broader scale, health professionals will not be able to rely on the same systems, partners, or procedures for getting out health information or promoting health. Health care is moving into the home and toward more interactive communication, and multimedia computers and other new technologies are allowing this to happen at a faster rate than before.

"I believe that networked information systems will transform the face of health care," said Molly J. Coye, MD, MPH, vice president of strategic development, Health Desk Corporation, at the 1997 Partnerships for Networked Consumer Health Information Conference in Washington, DC, April 14-16. "They will help accelerate the transformation of health systems, assist in the creation of new types of health systems, and assist in the creation of new types of health professionals. Doing so will generate powerful new consumer and patient knowledge, expectations, and capabilities."

These cultural changes will not be easy, nor will they go smoothly. It is essential that health professionals do their best to make themselves aware of the coming changes and participate in the debate whenever possible.

What these new systems are doing is bringing the ideal of health promotion--the process of enabling people to increase control over and to improve their health--closer to reality. They are tapping into a resource that has always been there--individuals' informal networks for health information (friends, family, community--any source of day-to-day, personal interactions)--and connecting them with the health care establishment.

The words key to this change are "computer-based," "networked," and "consumer," and they are turning the traditional health care infrastructure and hierarchy upside down, said a number of conference speakers. Traditionally, physicians and other health professionals have been the providers of information and health care, and members of the public have been consumers of that care or information. With the growth of networked, computer-based consumer health information systems, the role of individuals in their own health care will increase, and the roles of health professionals will shift more toward facilitators or partners, away from being "authorities" who hold and dispense health knowledge, according to a number of conference speakers.

Furthermore, health professionals need to realize that noncentralized forms of communication such as the Internet are allowing nontraditional and alternative voices for health information to be heard on the same par as professional, traditional health information sources. Messages from these two groups are competing more and more for attention and credibility.

With interactive communication, everyone will be a consumer and provider of health information. This cultural change is already evident on the Internet where individuals participating in online self-help groups have become teachers and providers of health information. Samantha Scolamiero, who started a brain tumor discussion list (http://www.mit.edu:8001/people/samajane/BRAINTMR.html) on the Internet after developing brain cancer, is one of those teachers--not only of herself, other patients, and their families, but health care professionals as well.

"The brain tumor list is creating an awareness among physicians as to the specific physical, emotional, and spiritual needs of patients," Scolamiero said at the conference. "The patients are even helping those doctors who are willing to learn."

Tom Ferguson, MD, senior associate, The Center for Clinical Computing, Harvard School of Public Health, agrees.

"The conversations self-helpers conduct within these communities constitute a new and important medium which may be more effective in providing the information and connections they need than any other medium developed to date, including pamphlets, books, articles, multimedia CDs, videotapes, databases, and most Web pages," Ferguson said at the conference. "Within these groups, a great deal of technical medical information is exchanged. But there is a second level too: practical skills and management techniques. There is a third layer as well: participation in these online communities helps ease feelings of isolation and discouragement."

Self-helpers seeking health information online often view materials simply converted for loading onto the Internet as "shovelware," Ferguson said. This reaction indicates that computer-based information seekers expect and desire interactivity or information personalized to their situations.

The future is not only here in online self-help groups, it is already here in other technologies being researched and developed in many laboratories. For example, conference participants spoke about the development and testing of electronic "house call" systems for monitoring the health of homebound patients, such as the elderly or disabled. These systems will lower the cost of care and provide the patient with more access, participation, social contact, and accountability in their own health care. It is not inconceivable that these systems would be extended to the larger population via a future technology developed for sending a variety of information into the home. Various public health messages could be individually tailored and delivered piggy-backed onto this system.

As if rapid changes in communications and the health care industry are not problematic enough, forces other than the health community are spearheading the changes.

"We are in a power shift, and the health care system will be developed from the outside," said Charles L. Jacobson, MD, executive vice president, Premier, at the conference. "What will the future look like? It will be interesting to see."

Changes in health care and health communications are being driven by forces outside of the health professions--economics (public and industry pressure for more cost-effective and better health care services); the changing communications infrastructure, which is mostly in the hands of private companies developing and owning the new technologies; and the market forces related to the struggle for power over the future communications infrastructure by the telecommunications and computer giants and their competitors (i.e., who will own and control the information delivery infrastructure).

So what are health professionals supposed to do now about these coming changes? The Internet and computer technology will not look the same as they do now, even several years down the road. Our current televisions are about to become items of nostalgia. No one knows how information will be delivered to the home, even within the next 5 years, and who will control the infrastructure, but what health professionals need to keep an eye on is how the culture of communication is changing with these technologies, prepare themselves for the changes, and be ready to adapt their work to it.

The exciting thing about these changes is that health professionals can piggyback their messages and services into the new delivery systems and learn from the billions of dollars worth of research organizations are putting into developing and testing the new technologies. The Internet, for instance, is its own best critic. No longer do consumers have to rely on sales materials to make a decision about a product--the online community will tell you exactly what it thinks of a product and how well it works. Beta versions of software are released free as an open invitation for users to fix the bugs and influence the kind of product they want to work how they want it to. Never before has business worked this way.

Members of the health care community are already evaluating these new technologies and their applications to health fields. Health professionals should seek out this research information as a base for making decisions about use of new technologies. They should also build evaluation into their own plans for development of networked consumer-based information. Evaluation of networked consumer-based information by the target audience(s) during development is essential to success of the product and message(s).

In addition to cultural changes in communication, health professionals need to educate themselves and be aware of the changes these technologies will bring about regarding legal (mainly privacy and ownership) and equity (access) issues. Legal issues about who owns health information and who has access to specific individual and public health information will increase. Until there is universal access and use of new technologies, new technologies should never be the sole means of information distribution. They should be looked upon as supplemental means of distribution unless the entire intended audience has access and the skills and motivation to use the new technology.

Reed Tuckson, MD, president, Charles Drew University of Medicine and Science, eloquently summed up at the conference the resulting challenge for equity: "It seems to me our challenge--the challenge of committed health professionals and of committed health-concerned professionals who are learning to master the new tools of this field and who are influencing the design of new systems--is to discover the opportunities and the pitfalls that lie ahead, such as that the interconnected issues of health, social justice, and fairness are responsibly addressed."

Start now. You'll find many conference transcripts and audience discussions online at http://odphp.osophs.dhhs.gov/confrnce/partnr97/. This conference site is an example of how health communications are being changed and benefitting from networked, computer-based systems. Conference transcripts were placed on the Internet within weeks of the conference, allowing health professionals all over the world to learn about and use this new information in their own practices now, rather than waiting 2 to 3 years for print proceedings to be published--too late to be useful because communications by then would have changed so much that much of the information would be moot. In addition, participants could also receive transcripts directly by e-mail within days. This herculean effort by the forward-looking conference sponsors is to be applauded. The conference also showed how networked, computer-based communication systems are helping meet the health promotion goal of helping people to help themselves.

Georgia Moore
Managing Editor

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ANNOUNCEMENTS

ATSDR's Toxicological Profiles Available on CD-ROM

The Toxicological Profiles produced by the Agency for Toxic Substances and Disease Registry (ATSDR) are now available on CD-ROM through CRC Press. The CD-ROM contains 110 of ATSDR's Toxicological Profiles of hazardous substances, chemicals, and compounds. Each profile includes an examination, summary, and interpretation of available toxicologic and epidemiologic data on the hazardous substance. The CD-ROM costs $225 within the United States, $270 outside; it is also available on a free, 30-day trial basis. Visit the CRC web site (http://www.crcpress.com/PRODS/L1154.HTM) for full details or contact CRC Press Inc., Attn Customer Service, 2000 Corporate Blvd., NW, Boca Raton, FL 33431; telephone (800) 272-7737; fax (800) 374-3401.

Call for Presentations

PREVENTION 98: Translating Science into Action, April 2-5, 1998, San Francisco, California. Deadline for submission of presentation abstracts is September 8, 1997.

PREVENTION is the annual meeting of the Association of Teachers of Preventive Medicine and the American College of Preventive Medicine. The focus of PREVENTION 98 is preventive medicine expertise and exploring ways that this expertise can be translated into ethical, effective, and evidence-based action and policy. For more information or an abstract form, contact PREVENTION 98, 1660 L St., NW, #206, Washington, DC 20036, telephone (202) 466-2569; fax (202) 466-2662, e-mail prevention@acpm.org; Internet http://www.acpm.org.

Call for Abstracts

XVI World Conference on Health Promotion and Health Education, June 21-26, 1998, San Juan, Puerto Rico. Deadline for submission of abstracts is October 31, 1997.

For a complete registration and abstract packet, contact XVI World Conference on Health Promotion and Health Education, PO Box 365067, San Juan, Puerto Rico 00936-5067; telephone (787) 274-0582; fax (787) 754-662; e-mail hir_arroyo@rcmaca.upr.clu.edu.

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COURSES

Harvard School of Public Health

Leadership and Management Skills Essential for Health and Safety Professionals; November 17-19, 1997; Boston, Massachusetts. Content includes management theory and application, managing people and motivation, listening skills, conflict resolution, time management and utilization, regulatory affairs management, program management and negotiation and ethics. Cost: $745. For more information, contact Harvard School of Public Health, Center for Continuing Professional Education, 677 Huntington Ave, LL-23, Dept B, Boston, MA 02115-6096; telephone (617) 432-1171; fax (617) 432-1969; e-mail contedu@sph.harvard.edu; Internet http://www.hsph.harvard.edu/ccpe/.

Wright State University

12-Week Distance Learning Environmental Courses; Next Cycle Starting January 12, 1997. Wright State University is offering courses in hydrologic and environmental science, policy, and engineering through its Interactive Remote Instructional System (IRIS). IRIS was initially developed in conjunction with the U.S. Department of Agriculture, Natural Resource Conservation Service and with the support of the U.S. Environmental Protection Agency. Courses are self-taught through textbooks, lesson modules, workbooks, and in some cases, software. Tutors are available and participants can also communicate with "classmates" via electronic discussion groups on the Internet. A computer is necessary for some courses, but not for others; course prices vary. Courses offered are ground water hydrology; ground water flow modeling using MODFLOW; aquifer test analysis/well hydraulics; soil and ground water contamination; soil remediation; and environmental geophysics. Register within 4 weeks before a course starts to avoid a late processing fee. For more information and course descriptions, contact Wright State University, Center for Ground Water Management, 3640 Colonel Glenn Hwy, 056 Library, Dayton, OH 45435-0001; telephone (937) 775-3648; fax (937) 775-3649; e-mail IRIS@wright.edu; Internet http://geology.wright.edu/.

Midwest Center for Occupational Health and Safety

Safety and Health Training: Practical Strategies; October 14, 1997; St. Paul, Minnesota. This course provides tools for making workplace safety and health training more effective. It includes an overview of adult learning and alternatives to straight lecture. Cost: $195. For more information, contact the center at 640 Jackson St, St. Paul, MN 55101; telephone (612) 221-3992; Internet http://www1.umn.edu/mcohs/.

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CALENDAR

October

October 23-25, 1997. "Minimizing Toxic Chemicals Risk Through Dialogue, Commitment and Concerted Action: Collective Responsibility of Governments, Industry and Public" (a workshop of the Chemical Institute of Canada); Burlington, Ontario, Canada. Contact: BK Afghan, PhD, Environment Canada, NWRI, PO Box 5050, Burlington, Ontario, L7R 4A6; telephone (905) 336-4661; fax (905) 336-4972; e-mail aff.afghan@cciw.ca.

October 26-29, 1997. Fifteenth International Neurotoxicology Conference: "Manganese: Are There Effects from Long-Term, Low-Level Exposures?"; Little Rock, Arkansas. Abstract deadline: September 15, 1997. Contact: Joan Cranmer, Dept. of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, 1120 Marshall, Room 304, Little Rock, AR 72202; telephone (501) 320-2986; fax (501) 320-4978; e-mail cranmerjoanm@exchange.uams.edu.

October 28-30, 1997. GIS/LIS 1997 Annual Conference and Exposition (including GIS and Health Presentations); Cincinnati, Ohio. Contact: Denise Calvert, American Congress on Surveying and Mapping, 5410 Grosvenor Lane, Suite 100, Bethesda, MD 20814-21122; telephone (301) 493-0200; fax (301) 493-8245; e-mail deniseacsm@mindspring.com.

November

November 9-13, 1997. American Public Health Association (APHA) 125th Annual Meeting: "Communicating Public Health;" Indianapolis, Indiana. Contact: APHA, 1015 15th St., NW, Washington, DC 20005-2605; telephone (202) 789-5602; fax (202) 789-5661; e-mail comments@ahpa.org; Internet http://www.apha.org/

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This page last updated on October 24, 2003
Contact Name: Wilma López/ WLópez@cdc.gov