NCEH in
Partnership With Louisiana
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 Louisiana collaborate on a variety of
environmental health projects throughout the state. In fiscal
years 2001–2004, NCEH awarded more than $1.2 million in
direct funds and services to Louisiana for various projects. These
projects include activities related to environmental public health
tracking, biomonitoring, and childhood lead poisoning prevention.
In addition, Louisiana 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 Louisiana.
- Environmental Public Health
Tracking Projects—NCEH is funding a cooperative agreement
with the Louisiana Department of Health and Hospitals (LDHH)
to demonstrate and evaluate methods for linking data from
ongoing, existing health effects surveillance systems with data
from existing surveillance and monitoring systems for human
exposure and environmental hazards. LDHH will partner with the
Louisiana Department of Environmental Quality (LDEQ) to
complete program objectives.
One of the primary objectives of the program is to link data on
tumors, groundwater contaminants, and drinking water in regions
surrounding 33 creosote hazardous waste sites. Another is to
develop and implement communication strategies to disseminate
information about public health and the environment to the
general public, industry, government agencies, and legislators.
The program also will to establish and formalize mechanisms for
interagency collaboration and data sharing for an environmental
public health tracking network. Funding began in fiscal year
2004 and continues through fiscal year 2006.
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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 Louisiana.
Funding
- Antiterrorism Funding to
Increase State Chemical Laboratory Capacity—In 2003, CDC
provided more than $915,000 to Louisiana to help expand
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.
In addition, NCEH continues to fund laboratory development and
the purchase of state-of-the-art equipment in Louisiana’s public
health laboratories to develop a network of chemical
laboratories and transfer technology to measure chemical agents.
- Biomonitoring Grants—In
2001 and 2002, NCEH awarded planning grants to LDHH to
develop an implementation plan for a state biomonitoring
program. In this way, the department 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 Louisiana population.
Studies
- National Heart, Lung, and
Blood Institute (NHLBI) Premier Study—The NHLBI Premier
Study, conducted in 1998–2003, was a randomized, multicenter
clinical trial to determine the effects of implementing
recommended lifestyle interventions on blood pressure (BP). The
study was conducted at four clinical centers, including one in
Baton Rouge. In collaboration with NHLBI, NCEH laboratory
scientists measured serum samples for folate, vitamin B12, and
vitamin A/E/carotenoids for this intervention trial.
The study’s primary outcome measure was the change in systolic
BP 6 months after the intervention. The secondary outcome
measure was the change in systolic BP 18 months after the
intervention and the change in diastolic BP 6 and 18 months
after the intervention. Additional health outcomes included
incidence of hypertension and levels of fasting lipids, glucose,
insulin, and homocysteine. Study results showed that people with
above-optimum BP, including those with stage 1 hypertension, can
make multiple lifestyle changes that lower BP and reduce their
risk for cardiovascular disease.
- Investigation of Blood
Dioxin Levels in Calcasieu Parish—Calcasieu Parish has many
companies that produce petroleum-based chemicals, chlorinated
hydrocarbon solvents, and other organic chemicals. In 1998, the
U.S. Environmental Protection Agency (EPA) asked the Agency for
Toxic Substances and Disease Registry (ATSDR) to review the
results of blood tests for several residents of the parish. Test
results in several samples indicated elevated levels of
dioxin-like substances.
ATSDR and the Association of Occupational and Environmental
Clinics (AOEC) conducted individualized education sessions with
each community member who participated in the investigation to
address the resulting data and community-based environmental
issues. In response to test results and community concerns,
ATSDR conducted an exposure investigation in 1998. Blood samples
were collected from 28 residents of Mossville, a small
community in Calcasieu Parish. The NCEH laboratory analyzed
samples for chlorinated dibenzodioxins, chlorinated
dibenzofurans, and co-planar polychlorinated biphenyls. Test
results indicated unusual levels of dioxin compounds in some of
the samples. As a result of these findings, ATSDR conducted an
expanded exposure investigation in Calcasieu Parish in 2002 to
determine whether residents had been exposed to unusual levels
of dioxin and volatile organic compounds (VOCs). Results
indicated that some residents had elevated levels of selected
VOCs. Some of these higher levels may be due to cigarette
smoking or occupational exposures. Environmental sampling
conducted during this investigation will provide results to
address the concerns of current exposure to environmental
dioxins in participants’ homes. Questionnaire data are being
analyzed to identify likely sources of exposure. In addition,
repeat samples are being taken from several participants for
retesting to determine whether measured levels remain high.
Services
- Newborn Screening Quality
Assurance Program—NCEH provides proficiency-testing services
and dried-blood-spot, quality-control materials to monitor and
help assure quality screening program operations for newborns in
Louisiana. 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.
- Blood Lead Laboratory
Reference System (BLLRS)—Six laboratories in Louisiana
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.
- Lipid Standardization
Program (LSP)—NCEH provides two lipid research laboratories
in Louisiana 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. These
allow program participants to monitor performance over time and
thus ensure the accuracy and comparability of study results and
findings.
- Helping State Public Health
Laboratories Respond to Chemical Terrorism—NCEH is working
with Louisiana’s public health laboratory to prepare
state laboratory scientists to measure chemical-terrorism agents
or their metabolites in people’s blood or urine. NCEH trained
state scientists to operate state-of-the-art laboratory
instruments and use specific methods to analyze
chemical-terrorism agents. In addition, NCEH transferred methods
for measuring nerve agents, cyanide, and trace metals to the
state laboratory and instituted a proficiency-testing program to
measure the comparability of the state’s analytic results with
results from the NCEH laboratory.
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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
Louisiana.
- Childhood Lead Poisoning
Prevention Program—The Louisiana Childhood Lead Poisoning
Prevention Program (LA CLPPP) has received NCEH funding
since 1998. In 2001, the program screened 44,456 children for
lead poisoning; 1,060 children under 6 years of age had elevated
blood lead levels.
LA CLPPP is using NCEH funds to develop and implement a
childhood lead poisoning elimination plan, increase its targeted
screening efforts in identified high-risk areas and populations,
improve primary prevention activities, and facilitate
comprehensive case management of children with elevated blood
lead levels. All of these activities will be strengthened by the
involvement of existing partnerships and the use of surveillance
data.
- Public Health Inspections
of Cruise Ships—NCEH established the model Vessel Sanitation
Program in 1975 to combine industry cooperation with CDC’s
ability to aggressively protect the health of travelers. The
program helps the industry develop and implement 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. These inspections result in safer vessels and
sanitation programs that protect the health of passengers and
crew members. In 2003, CDC’s Vessel Sanitation Program conducted
six inspections of cruise vessels that have stops in
Louisiana.
- Preventing Health Effects
that Result from Environmental Hazards—NCEH funded a
cooperative agreement with the Tulane University School of
Public Health and Tropical Medicine, Center for Applied
Environmental Public Health. This center formed a
collaborative partnership with environmental health
professionals at the LDHH Office of Public Health’s Center
for Environmental Health to develop distance-learning
training modules for entry-level environmental health
professionals. Funding began in fiscal year 2001 and continues
through fiscal year 2004.
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.
July 2004
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