NCEH in
Partnership With Alabama
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 in Alabama collaborate on a variety of
environmental health projects throughout the state. In fiscal
years 2000–2004, NCEH awarded more than $1.3 million in direct
funds and services to Alabama for various projects. These projects
include activities related to asthma intervention, measuring folic
acid levels in healthy adults, and chemical demilitarization. In
addition, Alabama 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 is an example of
such activities that NCEH conducted or supported in Alabama.
-
Inner-City Asthma Intervention—NCEH is funding the School
of Medicine at the University of Alabama at Birmingham to
provide inner-city families with asthma education and
individualized asthma-control plans. The Inner-City Asthma
Intervention program is based on the National Cooperative
Inner-City Asthma Study (NCICAS), a multifaceted, multimodal
intervention to address a range of problems that affect children
who have asthma, and their families. NCICAS demonstrated that an
individually tailored intervention carried out by masters-level
social workers trained in asthma management can reduce asthma
symptoms among children in the inner city. This program targets
children 6 to 12 years of age of low socioeconomic status who live
in urban areas and have moderate to severe asthma. Funding began
in fiscal year 2001 and continues through fiscal year 2005.
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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 conducted or supported in Alabama.
Funding
- Antiterrorism Funding to
Increase State Chemical Laboratory Capacity—In fiscal year
2003, CDC provided more than $1.8 million to Alabama to
help the state expand its chemical laboratory capacity to
prepare for and respond to chemical-terrorism incidents and
other chemical emergencies. This program expansion will allow
full participation of chemical-terrorism response laboratories
in the Laboratory Response Network.
Studies
- Measuring Folic Acid Levels
in Healthy Adults—The NCEH laboratory, in partnership with
the University of South Alabama, will examine the process
by which folic acid is absorbed, distributed, and metabolized in
healthy adults. The study also will determine whether
unmetabolized plasma folic acid can adversely influence
homocysteine levels in some people. NCEH will analyze 2,100
plasma samples. Survey results are expected in mid-2004.
- Blood Lead Screening in
Alabama—In response to community concerns about possible
elevations in blood lead levels among the children of
Anniston, the Agency for Toxic Substances and Disease
Registry (ATSDR) facilitated a lead screening program in spring
2001. This screening program focused on children younger than 6
years of age who live in select areas of Anniston. With
collaboration of the Community Against Pollution group,
regional Head Start programs, Northeast Alabama
Regional Medical Center’s Wellness Connection, county and
city school systems, and Anniston community centers, ATSDR
screened 410 children.
The NCEH laboratory analyzed the blood samples. Four of the
children tested had blood lead levels greater than 10 micrograms
of lead per deciliter of blood (µg/dL). Although project results
do not provide a complete picture of blood lead levels in
Anniston, they indicate that less than 1% of the population
tested had blood lead levels higher than the CDC guideline of 10
µg/dL. Screening project results also indicated that
approximately 25% of the children had blood lead levels between
5 and 10 µg/dL. Although these findings provided evidence that
children in Anniston are being exposed to lead, the source of
the lead is unknown. The health risks associated with these low
blood lead levels are not clear, but this evidence points to the
need for continued blood screening and education for exposure
prevention.
Services
- Helping State Public Health
Laboratories Respond to Chemical Terrorism—NCEH is working
with Alabama’s public health laboratory to prepare state
laboratory scientists to measure chemical terrorism agents or
their metabolites in individuals’ blood or urine. The NCEH
laboratory is transferring analytic methods for measuring
chemical terrorism agents (including cyanide-based compounds and
other chemicals) to Alabama. In addition, the NCEH laboratory
instituted a proficiency-testing program to measure the
compatibility of the state’s analytic results with results from
the NCEH laboratory.
- Blood Lead Laboratory
Reference System (BLLRS)—Six laboratories in Alabama
participate in NCEH’s standardization program to improve the
overall quality of laboratory measurements of blood lead levels.
This program helps laboratories nationwide evaluate their
performance on these critical laboratory tests. NCEH provides
BLLRS materials to the laboratories four times a year without
charge.
- Newborn Screening
Quality-Assurance Program—NCEH provided proficiency-testing
services and dried-blood-spot, quality-control materials to
monitor and help assure the quality of screening program
operations for newborns in Alabama. The importance of
accurate screening tests for genetic metabolic diseases cannot
be overestimated. Testing of blood spots collected from newborns
is mandated by law in almost every state to promote early
intervention that can prevent mental retardation, severe
illness, and premature death.
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Preventing Health Effects That Result from Environmental Hazards
NCEH promotes safe environmental public health practices to
minimize exposure to environmental hazards and prevent adverse
health effects. Following are examples of such activities that
NCEH conducted or supported in Alabama.
- Communities of Excellence
in Environmental Health—NCEH funded the School of Public
Health at the University of Alabama at Birmingham to
develop Communities of Excellence in Environmental Health in the
Deep South. This project’s goals are to create an advisory
partnership group that will guide the development and
implementation of an environmental health training program for
practitioners, deliver state-of-the-art training for
environmental health practitioners, and conduct community-based
research on environmental health interventions for rural
settings. Funding began in fiscal year 2001 and continues
through fiscal year 2004.
- Chemical Demilitarization—Before
the Anniston Chemical Agent Destruction Facility began
operations, NCEH’s Chemical Weapons Elimination Team examined
the facility’s design and operating procedures to ensure
protection of the workforce and surrounding communities. Since
the facility’s opening, NCEH has conducted several on-site
reviews to ensure its safety. Recently, NCEH examined
air-monitoring procedures and strategies, including the number
and placement of air monitors and the quality of data from these
systems. NCEH also is active in other prevention
activities—process safety, industrial hygiene, and medical
readiness—that coordinate to provide sound approaches to
preventing exposure to chemical agents. To ensure preparedness
of local medical and emergency personnel in responding to
incidents involving a chemical agent, NCEH provides consultation
services to medical and emergency personnel near storage sites
and can help review their capabilities to respond to emergencies
related to chemical agents.
- Lead Poisoning Prevention—The
Alabama Childhood Lead Poisoning Prevention Program (AL CLPPP)
has received NCEH funding since 1992. In 2001, the program
screened 12,077 children for lead poisoning. The number of
children under 6 years of age who had elevated blood lead levels
decreased from 1,501 in 1997 to 654 in 2001.
The AL CLPPP uses NCEH funding to develop and implement a
childhood lead poisoning elimination plan, targeted screening
plan, and case management plan for Alabama; to maintain and
enhance the Alabama statewide surveillance system; and to
increase primary prevention activities and strategic
partnerships.
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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 environmental hazards
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
exposures), biomonitoring to determine whether selected chemicals
in the environment get into people and how much, 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 as well as 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.
June 2004
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