NCEH in Partnership with Illinois
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 that result 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 Illinois collaborate on a variety of
environmental health projects throughout the state. In fiscal
years 2000–2004, NCEH awarded more than $11.7 million
in direct funds and services to Illinois for various projects.
These projects include activities related to controlling asthma,
planning a state biomonitoring program, and preventing childhood
lead poisoning. In addition, Illinois 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 conducted or supported in Illinois.
Asthma
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Replication and Implementation of
Scientifically Proven Asthma Interventions—NCEH funded three
organizations in Illinois to implement a scientifically
evaluated asthma intervention that decreases acute-care visits,
decreases hospitalizations, and increases compliance with
asthma-care plans. These organizations were the American Lung
Association of Metropolitan Chicago (funded fiscal years
2000–2003), the PCC Community Wellness Center (funded
fiscal years 2002–2004), and the Southern Illinois Healthcare
Foundation (funded fiscal years 2002–2004).
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Inner-City Asthma Intervention—NCEH
funded the Cook County Hospital Department of
Pediatrics/Pediatric Allergy Division to provide inner-city
families with asthma education and individualized asthma-control
plans. Funding began in fiscal year 2000 and ended in fiscal
year 2003.
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Controlling Asthma in American
Cities—To decrease asthma-related morbidity, NCEH funds the
University of Illinois to use innovative collaborative
approaches to improve overall asthma management among urban
children up to 18 years of age. Funding began in fiscal year
2001 and will end in fiscal year 2004.
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Addressing Asthma from a Public
Health Perspective—NCEH funds the Illinois Department of
Public Health (IDPH) to develop asthma-control plans that
include disease tracking, science-based interventions, and
statewide partnerships to reduce the burden of asthma in home,
school, and occupational environments. Funding began in fiscal
year 2000 and will end in fiscal year 2004.
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Asthma Surveillance and
Interventions in Hospital Emergency Departments—NCEH funded
Northwestern University to forge partnerships among
universities, hospital emergency departments, and state and
local health departments to improve asthma care. Funding began
in fiscal year 2001 and ended in fiscal year 2003.
Environmental Public Health Tracking
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National Environmental Public
Health Tracking Program: Infrastructure Enhancement and Data
Linkage Demonstration Project—NCEH is funding IDPH to
establish an enhanced environmental public health tracking
network (EPHTN) to address the information gap in documenting
possible links between environmental hazards and chronic
diseases, as well as to relate and report health effects data
with environmental data. IDPH is developing a process for
reporting infectious diseases using the Internet. Funding began
in fiscal year 2002 and will end in fiscal year 2004.
Health
Studies
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Assessing Mercury Exposure Among
Young Children in Chicago—NCEH was asked by the Chicago
Department of Public Health (CDPH) to examine levels of
mercury in the blood and urine in a population of Chicago
children who may be exposed to this chemical through its
ritualistic or cultural use. Children younger than 10 years of
age were enrolled from CDPH clinics and from homes identified
during door-to-door visits. Urine and blood samples were
collected from participating children, and parents were asked to
answer questions about demographic information and potential
sources of mercury exposure. Additional anonymous urine samples
were collected from three health clinics.
In July 2003, the NCEH laboratory analyzed mercury levels in
urine samples from 347 children. The study did not find elevated
mercury levels that could be attributed to elemental mercury
exposure. Investigators did find a greater-than-background
exposure to mercury in blood samples; however, this finding
occurred in a small population of children and may have been due
to their diets. All levels measured were below the level of
concern for mercury exposure. The study began in fiscal year
2003 and will end in fiscal year 2005.
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 Illinois.
Funding
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Antiterrorism Funding to Increase
State Chemical Laboratory Capacity—In fiscal year 2003, CDC
provided more than $650,000 to Illinois to help expand
chemical laboratory capacity to prepare for and respond to
chemical-terrorism incidents and other chemical emergencies.
This expansion will allow full participation of
chemical-terrorism response laboratories in the Laboratory
Response Network.
In addition, NCEH funds laboratory development and the purchase
of state-of-the-art equipment in public health laboratories in
Illinois to develop a network of chemical laboratories and
transfer technology to measure chemical agents.
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Biomonitoring Grants—In
fiscal years 2001 and 2002, NCEH awarded planning grants to
Illinois to develop an implementation plan for a state
biomonitoring program. In this way, the state could make
decisions about which environmental chemicals within its borders
were of health concern and could make plans for measuring levels
of those chemicals in the Illinois population.
Studies
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Chicago High-Intensity Targeted
Screening—High-Intensity Targeted Screening is one approach
being used to improve our ability to screen children at risk for
lead exposure. Using this approach, teams from NCEH and from the
local childhood lead poisoning prevention program visited homes
in Chicago in October 2001 to screen children for
elevated blood lead levels. The NCEH laboratory provided
training and technical oversight to local staff and analyzed 646
blood samples for lead. Of the 646 children tested, 31% had a
blood lead level greater than 10 micrograms per deciliter, the
CDC level of concern. Families of children who had elevated
blood lead levels were offered appropriate medical treatment and
an evaluation of lead hazards in their homes.
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Age-Related Eye Disease Study—The
National Eye Institute conducted the Age-Related Eye Disease
Study, a 10-year multicenter study, to investigate the natural
history of age-related macular degeneration and cataracts and
the role of various risk factors in their development and
progression. The study tested the effects of nutritional
supplementation on preventing and controlling these diseases
through a randomized, placebo-controlled clinical trial. NCEH
measured serum samples for carotenoids; lipids; zinc; copper;
and vitamins A, E, and C. Ingalls Memorial Hospital in
Harvey was one of the 10 study centers.
Study results showed that people at high risk for advanced AMD,
a leading cause of vision loss, lowered their risk by 25% when
treated with a high-dose combination of vitamins C and E,
beta-carotene, and zinc. In the same high-risk group, which
includes people with intermediate AMD or with advanced AMD in
only one eye, the nutrients reduced the risk for vision loss
caused by advanced AMD by about 19%. For study participants who
had either no AMD or who were in the early stages of AMD, the
nutrients provided no apparent benefit.
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Serum Carotenoids and α-Tocopherol
and Risk for Nonmelanoma Skin Cancer—For this study, NCEH
measured carotenoids and tocopherols in blood samples collected
from participants for a National Cancer Institute trial
conducted at eight clinical centers around the United States,
including Northwestern University School of Medicine in
Chicago. Findings suggested that the risk for future
basal-cell carcinoma was not related to levels of any of the
carotenoids measured or to α-tocopherol. Serum levels of
α-carotene, β-carotene, lycopene, and α-tocopherol also were not
related to the risk for a subsequent squamous cell carcinoma.
However, an increased risk of squamous cell carcinoma was
associated with higher levels of lutein, zeaxanthin, and β-cryptoxanthin.
Services
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Newborn Screening Quality
Assurance Program—NCEH provides proficiency-testing services
and dried-blood-spot, quality-control materials to monitor and
help assure the quality of screening program operations for
newborns in Illinois. 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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Lipid Standardization Program (LSP)—NCEH
provides two lipid research laboratories in Illinois with
accuracy-based standardization support for analytic measurement.
These laboratories are involved in one or more ongoing lipid
metabolism longitudinal studies or clinical trials that
investigate risk factors and complications associated with
cardiovascular disease. The LSP, supported by NCEH’s Lipid
Reference Laboratory, provides quarterly analytic performance
challenges and statistical assessment reports that allow program
participants to monitor performance over time and thus ensure
the accuracy and comparability of study results and findings.
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Helping State Public Health
Laboratories Respond to Chemical Terrorism—NCEH is working
with the Illinois 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 analytic methods for measuring chemical-terrorism
agents (including cyanide-based compounds and other chemicals)
to Illinois. In addition, NCEH instituted a proficiency-testing
program to measure the comparability of the state’s analytic
results with results from the NCEH laboratory.
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 Illinois.
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Childhood Lead Poisoning
Prevention Program—The Illinois Childhood Lead Poisoning
Prevention Program (IL CLPPP) has received NCEH funding
since 1991. NCEH has also funded the City of Chicago (Chicago
CLPPP) under a separate cooperative agreement since 2001.
Illinois is among the states screening the highest number of
children under age 6 years for lead. In 2001, IL CLPPP and
Chicago CLPPP together reported screening 187,385 children for
lead poisoning. The number of children under 6 years of age who
had elevated blood lead levels decreased from 32,061 in 1997 to
15,323 in 2001. These decreases in blood lead levels are due to
state program efforts funded in part by NCEH.
IL CLPPP and Chicago CLPPP are using NCEH funds to implement a
childhood lead poisoning elimination plan for the state and
Chicago, respectively, to increase targeting screening and
primary prevention activities, to maintain existing surveillance
systems, to increase protective policies, and to build strategic
partnerships.
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Center of Excellence in
Environmental Health—NCEH is funding the Illinois Center
of Excellence in Environmental Health. The center’s mission
is to lead and support the development of a community of
excellence in environmental health in Illinois by building the
capacities of local and state environmental health stakeholders,
especially departments of public health, to respond to
environmental health challenges. Health department partners
include CDPH, IDPH, and the Oak Park Department
of Health. Other center partners include the U.S.
Environmental Protection Agency Region 5, the Illinois Poison
Center, and the Illinois Environmental Council.
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. These issues include 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 to what extent,
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.
September 2004
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