NCEH in
Partnership With Alaska
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 diseases and deaths that result from interactions
between people and their environment.
NCEH and partners throughout Alaska collaborate on a
variety of environmental health projects throughout the state. In
fiscal years 2000–2003, NCEH awarded more than $3
million in direct funds and services to Alaska for various
projects. These projects include activities related to arctic
health, breast cancer, and public health inspections of cruise
ships. In addition, Alaska 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 Alaska.
Asthma
- Statewide Asthma Awareness
Campaign—In fiscal year 2003, NCEH funded the Asthma and
Allergy Foundation of America’s Alaska Chapter to conduct a
statewide asthma-awareness campaign for families and health-care
providers.
- Asthma Surveillance
Enhancement and Asthma Coalition—In fiscal year 2003, NCEH
funded the American Lung Association of Alaska to enhance
surveillance, build a statewide asthma coalition, and raise
public awareness about asthma.
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Environmental Public Health
Studies Projects
- Arctic Health Cooperative
Agreement—NCEH is funding a cooperative agreement with the
Alaska Department of Health and Social Services to work
with the Alaska Department of Education and Early Development
to create curriculum materials that address environmental health
issues related to contaminants in traditional foods and with
Frontier GeoSciences, Inc., to analyze human hair for trace
metals. Frontier will analyze hair samples for four trace
metals: total selenium, total cadmium, total mercury, and
methylmercury. Funding began in fiscal year 2000 and runs
through fiscal year 2004.
- Evaluating the Relation
Between Breast Cancer and Exposure to Environmental
Organochlorines Among Alaska Native Females—This ongoing
hospital-based study assessed breast cancer risk among Alaska
Native women exposed to chemicals (e.g., pesticides) through
their diet. The ultimate goal of the study is to enhance the
primary prevention of breast cancer by evaluating the
environmental risk factors for this disease. Subjects were women
who came to the Alaska Native Medical Center for breast
biopsy. Researchers collected urine, serum (blood), and tissue
samples and obtained blood samples from the Arctic
Investigations Serum Bank. Using these samples, researchers will
be able to model exposure over time.
Enrollment and sample
collection for this study are complete. Biologic samples are
awaiting NCEH analysis. Researchers have collected and begun to
analyze data from interviews. Funding began in fiscal year 1998.
- Exposure to Environmental
Pollutants Among Alaska Native Mothers and Infants—NCEH is
measuring levels of persistent organic pollutants, persistent
pesticides, and heavy metals in the pregnant women and their
newborn infants and investigating associations of individual
contaminants with pregnancy outcomes as well as growth and
development outcomes in the child’s first year of life. NCEH has
collected urine, whole blood, and serum from the mothers and
cord blood from the infants.
The study is in its fourth year
and has enrolled more than 200 women and 90 infants living in
Anchorage and other sites in Alaska.
Results of the ongoing study
will be provided to Alaska Native communities to help them
create acceptable strategies for reducing exposure to these
chemicals while maintaining their traditional diet. When the
infants are 1 year of age, researchers will collect infant
dietary surveys and medical records.
- Using Isotope Ratios to
Study Whether Lead Shot Is a Source of Lead Exposure Among
Adults in Bethel, Alaska—Researchers from NCEH and the
Alaska Native Tribal Health Consortium (ANTHC) hypothesize
that lead shot used by the native community in Bethel
when hunting for food is contaminating the captured food, and
subsequently the humans eating the food, with lead.
A recent study that examined blood lead levels in Arctic
Canadians found that the participants’ lead-isotope pattern did
not match the lead-isotope pattern in the region’s gasoline but
did match the lead-isotope pattern in lead shot from Mexico. The
lead shot used in Bethel also originates in Mexico.
Preliminary results from the ongoing Bethel study reveal that
maternal blood lead levels are higher in women from Bethel than
in women from Barrow, where steel shot is used.
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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
Alaska.
Funding
- Antiterrorism Funding to
Increase State Chemical Laboratory Capacity—In fiscal year
2003, CDC provided more than $780,000 to Alaska to assist
the state in expanding its 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. NCEH has begun to fund laboratory
development and the purchase of state-of-the-art equipment in
Alaska’s state public health laboratory to develop a network of
chemical laboratories and transfer technology to measure
chemical agents.
- Biomonitoring Planning
Grant—In fiscal years 2001 and 2002, NCEH awarded grants to
Alaska to develop a plan for implementing a biomonitoring
program for the state. The state could use the plan to make
decisions about which environmental chemicals within its borders
were of health concern and could plan for measuring levels of
those chemicals in the Alaska population.
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Studies
- Exposure to Polychlorinated
Biphenyls (PCBs) Among Residents of Unalakleet—In October
2003, at the request of the Alaska Division of Public Health,
NCEH analyzed 25 serum samples of Unalakleet residents
who were thought to have been exposed to PCBs from the former
U.S. Air Force North River Radio Relay site. This request was in
direct response to community concerns about possible exposure to
PCBs, and all activities were conducted under the medical and
public health authorities of the Alaska Division of Public
Health. Results, which were reported within 2 weeks, showed no
elevated PCB levels in the residents tested. These findings
helped public health officials quell residents’ fears about
exposure to PCBs.
- Risk Factors Associated
with Respiratory Syncytial Virus (RSV) Infection Among Alaska
Native Infants and Children―In this study, conducted in
collaboration with CDC’s National Center for Infectious
Diseases, NCEH measured cotinine levels in about 200 children as
an index of exposure to environmental tobacco smoke (ETS).
Cotinine is a metabolite of nicotine, and a biologic indicator,
or marker, of exposure to ETS and has been considered a risk
factor for RSV. Results of the study, which were published in
the journal Pediatrics in 2003, showed no positive association
between the presence of smokers in the children’s households and
children’s serum cotinine levels and wheezing, chronic
bronchitis, or cough. The percentage of households with smokers
in this study (45%) was similar to that found in a national
survey, in which approximately 44% of children 4–11 years of age
were reportedly subject to smoke exposure in the home. Children
exposed to household cigarette smoke in this study may have had
more intense exposure than did children in the national survey,
although exposure levels were similar for both case- and
control-children and for wheezing and nonwheezing children.
- Alaska Mothers-to-be and
Smokeless Tobacco―In collaboration with the Office on
Smoking and Health at CDC’s National Center for Chronic Disease
Prevention and Health Promotion, NCEH is planning to examine
levels of addictive, toxic, and carcinogenic compounds in
smokeless tobacco used by pregnant women in Alaska;
biomarkers of exposure; and pregnancy outcomes for these women.
The study protocol is in development.
- Smoking Cessation Among
Alaska Native Women―This proposed study is a planned,
intensive, smoking-cessation effort to be undertaken as part of
the Smoke-Free Families initiative to stop smoking during and
beyond pregnancy. The study will evaluate approximately 500
women who will be counseled at their first prenatal visit and
again at the 6th and 8th months of pregnancy. NCEH will measure
levels of cotinine in study participants. Measurement of
biomarkers such as cotinine is essential to accurately assess
the results of smoking-cessation programs. These data also will
provide new information about the extent of exposure in this
population. A final project proposal is in development.
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Services
- Helping State Public Health
Laboratories Respond to Chemical Terrorism—NCEH is working
with Alaska’s public health laboratory to prepare state
laboratory scientists to measure chemical terrorism agents or
their metabolites in people’s blood or urine. NCEH is
transferring analytical methods for measuring chemical terrorism
agents (including cyanide-based compounds and other chemicals)
to Alaska. Additionally, NCEH has instituted a
proficiency-testing program to determine the compatibility of
analytical results from Alaska with those of NCEH.
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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. Following is an
example of such an activity that NCEH conducted or supported in
Alaska.
- Public Health Inspections
of Cruise Ships—NCEH established the model Vessel Sanitation
Program in 1975 to combine cruise ship industry cooperation with
CDC’s ability to aggressively protect the health of travelers.
The program assists the industry in developing and implementing
comprehensive sanitation programs to minimize risks for
gastrointestinal diseases. Every vessel that has a foreign
itinerary and carries 13 or more passengers is subject to two
unannounced inspections each year. In 2003, the Vessel
Sanitation Program conducted 34 inspections of cruise vessels
with stops in Alaska. Since the program’s inception, rates and
outbreaks of diarrheal diseases among passengers have continued
to decrease because of environmental sanitation inspections.
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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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