** Caption file: CEHRCDC.vnl ** Generated 2:02:05 PM on Friday, April 12, 2002 ** Using VNLcc 2.2.30 ** Copyright ©2002 VITAC Corporation >> HELLO AND WELCOME TO THIS SPECIAL SATELLITE BROADCAST, "CHILDREN'S ENVIRONMENTAL HEALTH INFORMATION RESOURCES." I'M JOE WASHINGTON, YOUR MODERATOR FOR THIS PROGRAM, AND WE'RE COMING TO YOU LIVE FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION IN ATLANTA, GEORGIA. ENVIRONMENTAL HEALTH AND SAFETY RISKS DISPROPORTIONATELY AFFECT CHILDREN. FROM PESTICIDES IN SCHOOLS AND PLAYGROUNDS TO NITRATES IN THE WATER, CHILDREN ARE AT INCREASED RISK FOR A VARIETY OF ADVERSE HEALTH EFFECTS SUCH AS DEVELOPMENTAL DELAYS AND ASTHMA. DURING TODAY'S PROGRAM, WE'LL IDENTIFY A NUMBER OF THESE RISKS, EXPLAIN HOW THEY SPECIFICALLY AFFECT CHILDREN, AND IDENTIFY MAJOR ONLINE RESOURCES CONTAINING VALUABLE INFORMATION. OUR PRESENTERS WILL DISCUSS USE OF THE INTERNET AS A TOOL IN FINDING INFORMATION SPECIFIC TO OUR TOPIC. THEN, AT THE END OF THE PROGRAM, THEY'LL INTRODUCE A QUESTION TO YOU, THE AUDIENCE, CONCERNING A CHILDREN'S ENVIRONMENTAL HEALTH ISSUE. ANSWERS TO THE QUESTIONS CAN BE FOUND USING VARIOUS WEBSITES. WE ENCOURAGE YOU TO CALL IN AND LET US KNOW HOW YOU FOUND THE ANSWER TO THE QUESTION, WHETHER BY USING THE RESOURCES PRESENTED TODAY OR PERHAPS OTHER RESOURCES THAT YOU MAY HAVE USED IN THE PAST. PLEASE KEEP IN MIND THAT WHILE WE'VE DONE OUR BEST TO CLEARLY PORTRAY THE WEBSITE SEARCHES INCLUDED IN THIS BROADCAST, THE FINER TEXT AND GRAPHICAL DETAIL ON SOME OF THE WEB PAGES MAY BE DIFFICULT FOR YOU TO SEE ON YOUR TELEVISION MONITORS. PLEASE FOLLOW ALONG WITH THE COURSE MATERIALS WE'VE PROVIDED ON OUR PARTNERS WEBSITE. WE'LL GIVE YOU THAT ADDRESS IN A MOMENT. ALSO, WE ENCOURAGE YOU TO RECORD TODAY'S PROGRAM AND REFER TO THE WEB ARCHIVE OF THIS BROADCAST. THE NARRATIVE DESCRIPTION OF THE INDIVIDUAL SEARCHES ARE DETAILED ENOUGH TO ALLOW YOU TO FOLLOW ALONG AND COMPLETE A SEARCH WHILE LISTENING TO THIS PROGRAM ONCE YOU ARE AT YOUR COMPUTERS. ALSO NOTE THAT WEBSITES CHANGE FREQUENTLY. THE SITES YOU SEE TODAY MAY CHANGE IN APPEARANCE BUT NOT IN PURPOSE OR GENERAL CONTENT BY THE TIME YOU HAVE A CHANCE TO TRY THE SITE YOURSELF. BEFORE WE INTRODUCE OUR PANELISTS, LET'S HEAR FROM DR. RICHARD JACKSON, DIRECTOR OF THE NATIONAL CENTER FOR ENVIRONMENTAL HEALTH HERE AT CDC. >> THE ENVIRONMENT IS EVERYTHING AROUND US -- THE AIR, THE WATER, THE FOOD, THE ENERGY IN OUR BODIES. EVERY MOLECULE IN A CHILD'S BODY COMES FROM THEIR ENVIRONMENT. HI, I'M DICK JACKSON FROM THE CENTER FOR ENVIRONMENTAL HEALTH AT CDC. BUT THE ENVIRONMENT DOESN'T SIMPLY ADD MATERIAL TO OUR BODY. IT SHAPES OUR BEHAVIOR -- OUR CHILD'S BEHAVIOR -- IT SHAPES OUR THINKING, AND MOST IMPORTANTLY, IT SHAPES OUR FUTURE. IT'S THE CHILD'S JOB TO IMMERSE ITSELF IN ITS ENVIRONMENT, TO TOUCH AND TASTE AND FEEL EVERYTHING AROUND IT. POUND FOR POUND, A CHILD EATS MORE FOOD, DRINKS MORE WATER, BREATHES MORE AIR THAN DOES AN ADULT. THERE ARE THREE AREAS THAT I'D LIKE TO BRING TO YOUR ATTENTION IN TERMS OF CHILDREN'S HEALTH AND THE ENVIRONMENT. THE FIRST IS THAT OF ASTHMA. THERE ARE 5 MILLION CHILDREN IN AMERICA TODAY WITH ASTHMA, AND THE RATES KEEP GOING UP. IN FACT, SOME HOSPITALS HAVE SET ASIDE AN ENTIRE ROOM IN THE EMERGENCY DEPARTMENT FOR THE TREATMENT OF CHILDREN WITH ASTHMA. IT COSTS $15 BILLION A YEAR, AND THAT DOESN'T INCLUDE WHAT PARENTS HAVE TO LOSE IN TERMS OF INCOME WHEN THEY HAVE TO STAY HOME FROM SCHOOL WITH A SICK CHILD. THE SECOND BIG ISSUE IS THAT OF TOXIC CHEMICALS IN OUR BODIES, AND FOR A LONG TIME WE DIDN'T KNOW WHAT THE TOXIC CHEMICALS WERE IN OUR BODIES. NOW WITH THE REPORT CARD THE CDC IS PUTTING OUT ON BODY BURDENS, WE HAVE PROFILED 27 CHEMICALS IN THE AMERICAN PEOPLE, AND WE'LL BE REPORTING ON 50 CHEMICALS THIS YEAR THAT ARE IN OUR BODIES. THIS IS USEFUL INFORMATION FOR RESEARCHERS AND FOR DOCTORS, CLINICIANS TRYING TO MAKE DECISIONS ABOUT EXPOSURES. AND THE THIRD BIG AREA -- AND THIS IS ONE SOMETIMES PEOPLE THINK IS GONE -- IS THAT OF CHILDHOOD LEAD POISONING. THERE ARE STILL ALMOST 900,000 CHILDREN IN AMERICA WITH ELEVATED LEVELS OF LEAD IN THEIR BODY, AND LEAD DIMINISHES INTELLIGENCE AND HAS LOTS OF OTHER SERIOUS HEALTH EFFECTS. WE CAN ELIMINATE CHILDHOOD LEAD POISONING BY THE YEAR 2010, AND CDC IS WORKING WITH MANY LOCAL AND STATE HEALTH DEPARTMENTS TO DO THAT. IN THE NEXT TWO HOURS, YOU WILL GAIN INFORMATION ABOUT WHERE TO GET CONTROL MEASURES AND WHERE TO GET MORE DATA ON THIS IMPORTANT ISSUE OF CHILDREN'S HEALTH AND ENVIRONMENT. I WANT TO THANK YOU FOR JOINING US FOR THIS PRESENTATION. >> THANK YOU, DR. JACKSON. OKAY, IT'S TIME NOW TO INTRODUCE OUR PANEL MEMBERS. STACEY ARNESEN IS THE ADVISER FOR SPECIAL PROJECTS IN THE SPECIALIZED INFORMATION SERVICES DIVISION AT THE NATIONAL LIBRARY OF MEDICINE IN BETHESDA, MARYLAND. GREG BODIN IS THE TECHNOLOGY COORDINATOR IN THE SOUTH CENTRAL REGION OF THE NATIONAL NETWORK OF LIBRARIES OF MEDICINE IN HOUSTON, TEXAS. AND ROSE FOSTER IS THE MANAGER OF THE MEDICAL EDUCATION AND OUTREACH GROUP AT THE OAK RIDGE INSTITUTE FOR SCIENCE AND EDUCATION IN OAK RIDGE, TENNESSEE. WELCOME TO ALL OF YOU. NOW, BEFORE WE BEGIN, ALLOW ME TO GO OVER A FEW DETAILS ABOUT TODAY'S BROADCAST. HOPEFULLY YOU'VE PRINTED A SET OF BROADCAST COURSE MATERIALS AND HAVE THEM AVAILABLE TO REFER TO DURING THE PROGRAM. IF YOU DID NOT PRINT THE COURSE MATERIALS, THEY ARE AVAILABLE ON OUR WEBSITE AT OUR "PARTNERS" LINK AT... IF YOU ALREADY HAVE THE MATERIALS, PLEASE KEEP THEM AVAILABLE IN FRONT OF YOU. WE'LL BE REFERRING TO MANY OF THE WEBSITES LISTED ON THE "TOPICS AND RESOURCES DISCUSSED DURING THE SATELLITE BROADCAST" DOCUMENT. IN ADDITION, THE CHILDREN'S ENVIRONMENTAL HEALTH RESOURCES SAMPLER DOCUMENT CONTAINS ADDITIONAL TOPICS AND RESOURCES THAT WE DON'T HAVE TIME TO COVER DURING TODAY'S BROADCAST. NOW, LET'S REVIEW THE OBJECTIVES FOR THIS PROGRAM. AT THE END OF TODAY'S SESSION, YOU SHOULD BE ABLE TO... NOW, STACEY, LET'S BEGIN WITH ANSWERING A COUPLE OF VERY IMPORTANT QUESTIONS -- WHAT IS ENVIRONMENTAL HEALTH, AND WHY ARE CHILDREN AT GREATER RISK TO ENVIRONMENTAL HAZARDS THAN ADULTS? >> THESE ARE VERY IMPORTANT QUESTIONS, JOE, AND NOT ALWAYS EASY TO ANSWER. TAKE THE FIRST QUESTION. SEVERAL YEARS AGO, THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL HEALTH POLICY COMMITTEE SURVEYED THEIR MEMBERS, OTHER GOVERNMENT AGENCIES, AND SEVERAL PUBLIC HEALTH ORGANIZATIONS AND ASKED THEM TO DEFINE ENVIRONMENTAL HEALTH. A TOTAL OF 28 DEFINITIONS WERE RECEIVED. LET'S LOOK AT JUST ONE OF THESE, THE DEFINITION FROM THE INSTITUTE OF MEDICINE. THIS IS A VERY GENERAL DEFINITION. SOME OF THE OTHER DEFINITIONS WERE MORE SPECIFIC AND DEFINED TOXIC AGENTS AS CHEMICAL, BIOLOGICAL, OR PHYSICAL. OTHER DEFINITIONS INCLUDED ECOLOGICAL FACTORS AFFECTING HUMAN HEALTH AS WELL. BUT WHY FOCUS SPECIFICALLY ON CHILDREN'S ENVIRONMENTAL HEALTH? HOW ARE CHILDREN DIFFERENT THAN ADULTS WHEN IT COMES TO ENVIRONMENTAL EXPOSURE? WELL, AS DESCRIBED BY THE NATIONAL RESEARCH COUNCIL, CHILDREN ARE NOT SIMPLY LITTLE ADULTS. IT IS WELL KNOWN THAT THEY ARE IN AN ACTIVE STATE OF GROWTH, AND THEIR NERVOUS, IMMUNE, REPRODUCTIVE, AND DIGESTIVE SYSTEMS ARE STILL DEVELOPING. THEIR ABILITY TO DETOXIFY AND EXCRETE TOXIC SUBSTANCES DIFFERS FROM THAT OF ADULTS BECAUSE OF THEIR DEVELOPING METABOLIC SYSTEMS. EXPOSURE TO ENVIRONMENTAL TOXICANTS DURING SPECIFIC PERIODS OF VULNERABILITY CAN LEAD TO IRREVERSIBLE DAMAGE OF ORGANS AND SYSTEMS. AS EXPLAINED BY THE CHILDREN'S ENVIRONMENTAL HEALTH NETWORK, YOUNG CHILDREN BREATHE FASTER AND EAT AND DRINK MORE IN PROPORTION TO THEIR BODY WEIGHT THAN ADULTS. THEREFORE, CHILDREN ABSORB MORE TOXICANTS, SUCH AS LEAD OR PESTICIDES, THAT ARE CONTAINED IN AIR, WATER, OR FOOD. THIS MAKES THEM MORE VULNERABLE TO ACUTE AND CHRONIC EFFECTS OF ENVIRONMENTAL HAZARDS. CHILDREN ALSO SPEND MORE TIME OUTDOORS THAN DO ADULTS, AND THEIR LIFE TAKES PLACE CLOSE TO THE GROUND. THEY EXPLORE THEIR SURROUNDINGS THROUGH HAND-TO-MOUTH BEHAVIOR AND ARE UNAWARE OF POTENTIAL RISKS. AND FINALLY, CHILDREN ARE EXPOSED TO TOXICANTS AT AN EARLY AGE AND FOR PROLONGED PERIODS OF TIME, WHICH GIVES THEM MORE TIME TO DEVELOP DISEASES WITH LONG LATENCY PERIODS. ALTHOUGH ALL CHILDREN ARE AFFECTED BY ENVIRONMENTAL HAZARDS, SOME CHILDREN HAVE HIGHER EXPOSURE RATES. BOTH RACE AND LIVING IN POVERTY CAN PUT CHILDREN AT INCREASED RISK OF EXPOSURE TO CERTAIN ENVIRONMENTAL HAZARDS. FOR EXAMPLE, ACCORDING TO A STUDY BY THE UNITED CHURCH OF CHRIST, APPROXIMATELY ONE IN FOUR CHILDREN LIVE WITHIN ONE MILE OF A HAZARDOUS WASTE SITE. MANY OF THESE ARE AFRICAN-AMERICAN, HISPANIC-AMERICAN, AND NATIVE-AMERICAN CHILDREN. ACCORDING TO THE CENTERS FOR DISEASE CONTROL AND PREVENTION, 8% OF LOW-INCOME CHILDREN ARE LEAD-POISONED COMPARED TO ONLY 2% OF MIDDLE AND 1% OF HIGH-INCOME CHILDREN. 11% OF AFRICAN-AMERICAN AND 4% OF MEXICAN-AMERICAN CHILDREN ARE LEAD-POISONED COMPARED TO 2% OF WHITE, NON-HISPANIC CHILDREN. AS A RESULT OF THE RISING CONCERN FOR THE HEALTH OF OUR CHILDREN, PRESIDENT CLINTON SIGNED A PRESIDENTIAL EXECUTIVE ORDER ON CHILDREN'S ENVIRONMENTAL HEALTH RISKS AND SAFETY RISKS IN 1997. LAST OCTOBER, PRESIDENT BUSH EXTENDED THIS EXECUTIVE ORDER FOR AN ADDITIONAL 18 MONTHS. PRIOR TO AND AS A RESULT OF THIS EXECUTIVE ORDER, SEVERAL GOVERNMENT AGENCIES INITIATED CHILDREN'S ENVIRONMENTAL HEALTH PROGRAMS. BOTH THE ENVIRONMENTAL PROTECTION AGENCY, OR EPA, AND THE AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY, OR ATSDR, HAVE PROGRAMS ON CHILDREN'S ENVIRONMENTAL HEALTH. SINCE THIS BROADCAST FOCUSES ON INFORMATION RESOURCES FOR CHILDREN'S ENVIRONMENTAL HEALTH, LET'S TAKE A LOOK AT THE WEBSITES ASSOCIATED WITH THESE PROGRAMS. THIS WILL GIVE YOU A FEEL FOR SOME GENERAL RESOURCES AVAILABLE ON CHILDREN'S ENVIRONMENTAL HEALTH ISSUES AND HOW THEY MAY ASSIST YOU AS PUBLIC HEALTH PROFESSIONALS. PLEASE NOTE THAT ALL OF THE URLs DISCUSSED IN THE BROADCAST CAN BE FOUND IN THE COURSE MATERIALS, SO YOU DON'T NEED TO WRITE THEM DOWN DURING THE BROADCAST. LET'S START WITH THE EPA SITE. THE ADDRESS IS www.epa.gov/children. THIS SITE CONTAINS INFORMATION ON HOW CHILDREN ARE EXPOSED TO HAZARDOUS SUBSTANCES, SUCH AS IN THE AIR THEY BREATHE OR THE WATER THEY DRINK, AND INFORMATION ON DISEASES AFFECTING CHILDREN, SUCH AS ASTHMA OR CANCER, AND HOW THESE DISEASES MAY BE CONNECTED TO ENVIRONMENTAL FACTORS. CLICK ON "WHERE YOU CAN GET INFO" ON THE LEFT SIDE OF THE SCREEN. THIS PAGE PROVIDES LINKS TO MANY PUBLICATIONS, INCLUDING "EPA's NATIONAL AGENDA TO PROTECT CHILDREN'S HEALTH" AT THE TOP OF THE PAGE. CLICK ON "CHILDREN'S ENVIRONMENT" TO FIND RESOURCES ON AIR, WATER, FOOD, AND "LIVE, LEARN, AND PLAY." CLICK ON "AIR" TO SEE A WEALTH OF INFORMATION ON INDOOR AIR QUALITY, RADON, TOBACCO SMOKE, OUTDOOR AIR QUALITY, AND OZONE AND U.V. RADIATION. THE LAST LINK UNDER "INDOOR AIR QUALITY" LEADS TO A DESCRIPTION OF AN INDOOR AIR COMMUNITY LEADER KIT FOR WOMEN AND CHILDREN THAT WAS DEVELOPED BY THE NATIONAL SAFETY COUNCIL. HEALTH DEPARTMENTS CAN USE THIS KIT TO EDUCATE THE PUBLIC ABOUT THE HAZARDS OF INDOOR AIR POLLUTANTS. A DIRECT LINK TO THE KIT, WHICH INCLUDES SLIDES, FACT SHEETS, AND OTHER OUTREACH ACTIVITIES, IS PROVIDED. NOW WE'LL GO BACK TO EPA's "OFFICE OF CHILDREN'S HEALTH PROTECTION HOME PAGE." THIS SITE ALSO CONTAINS NUMEROUS EPA REPORTS AND OTHER RESOURCES, WHICH WE DON'T HAVE TIME TO SHOW IN THE BROADCAST, SO YOU MAY WANT TO SPEND TIME AFTER THE BROADCAST EXPLORING THIS SITE. NOW LET'S TAKE A LOOK AT ANOTHER GENERAL RESOURCE FOR CHILDREN'S ENVIRONMENTAL HEALTH FROM THE ATSDR. THE URL FOR THE ATSDR's OFFICE OF CHILDREN'S HEALTH WEB PAGE IS www.atsdr.cdc.gov/child. THIS SITE DESCRIBES SEVERAL ATSDR ACTIVITIES ON CHILDREN'S ENVIRONMENTAL HEALTH. ONE OF THEIR MAJOR CHILDREN'S HEALTH INITIATIVES IS THE PEDIATRIC ENVIRONMENTAL HEALTH SPECIALTY UNITS, OR PEHSUs. THIS IS A COLLABORATIVE PROJECT WITH THE ASSOCIATION FOR OCCUPATIONAL AND ENVIRONMENTAL HEALTH CLINICS, OR AOEC, AND IS ALSO SUPPORTED BY THE EPA. CLICK ON "HEALTH PROMOTION AND EDUCATION ACTIVITIES" ON THE LEFT. THIS TAKES YOU TO INFORMATION ABOUT THE PEHSU PROGRAM. THE PROGRAM IS DESIGNED TO PROMOTE CHILDREN'S HEALTH BY ENCOURAGING MEDICAL SPECIALISTS WITH ENVIRONMENTAL EXPERTISE TO WORK WITH PEDIATRICIANS. TOGETHER THEY DEVELOP PEDIATRIC ENVIRONMENTAL HEALTH INFORMATION FOR ACCESS BY LOCAL HEALTHCARE PROVIDERS AND PARENTS. THE PEHSUs ARE LOCATED AT UNIVERSITIES AND FOCUS ON MEDICAL EDUCATION AND TRAINING, CLINICAL CONSULTATION AND OUTREACH BY TELEPHONE, AND CLINICAL EVALUATION OF CHILDREN WHO MAY HAVE BEEN EXPOSED TO HAZARDOUS SUBSTANCES IN THE ENVIRONMENT. MOST OF THE PEHSUs HAVE A WEBSITE THAT CAN BE ACCESSED FROM EITHER THE ATSDR OR AOEC WEBSITES. LET'S GO TO REGION 4, THE SOUTHEAST PEHSU, LOCATED AT EMORY UNIVERSITY HERE IN ATLANTA, GEORGIA. THE HOME PAGE DESCRIBES THE GOAL OF THE ORGANIZATION AND SUMMARIZES ITS SERVICES. THE LEFT-HAND SIDE PROVIDES LINKS TO SPECIFIC FEATURES OF THE PROGRAM. LET'S LOOK AT "TEACHING MATERIALS." THERE ARE LINKS TO SEVERAL POWERPOINT PRESENTATIONS ON ENVIRONMENTAL CAUSES OF DEVELOPMENTAL PROBLEMS AND RESPIRATORY DISEASES AND HEALTH CONCERNS ASSOCIATED WITH EXPOSURE TO LEAD AND PCBs. THESE ARE IMPORTANT TRAINING MATERIALS THAT CAN BE USED BY PUBLIC HEALTH PROFESSIONALS TO LEARN MORE ABOUT THESE ISSUES OR TO TRAIN OTHERS WHO ARE LESS FAMILIAR WITH THEM. THE WEBSITE ALSO CONTAINS A HISTORY OF INTEREST IN CHILDREN'S ENVIRONMENTAL HEALTH, LINKS TO OTHER RELATED RESOURCES, AND A BIBLIOGRAPHY. THE LAST GOVERNMENT AGENCY THAT I WOULD LIKE TO MENTION IS THE NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES, ONE OF THE NIH INSTITUTES. NIEHS, TOGETHER WITH THE ENVIRONMENTAL PROTECTION AGENCY, IS FUNDING SEVERAL RESEARCH PROGRAMS DEVOTED TO CHILDREN'S ENVIRONMENTAL HEALTH. THE PROGRAMS ARE LISTED ON THE NIEHS WEBSITE AT www.niehs.nih.gov/ external/resinits/ri-28.htm. AS DESCRIBED ON THIS WEBSITE, THESE CENTERS CONDUCT RESEARCH ON THE POSSIBLE ENVIRONMENTAL CAUSES OF ILLNESSES AND DISORDERS AFFECTING CHILDREN, INCLUDING RESPIRATORY DISEASES LIKE ASTHMA, ALLERGIES, AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE, THE IMPACT OF COMMON ENVIRONMENTAL CONTAMINANTS SUCH AS LEAD OR MERCURY ON GROWTH AND DEVELOPMENT, AND POTENTIAL ENVIRONMENTAL RISKS TO AFRICAN-AMERICAN AND HISPANIC-AMERICAN INFANTS AND CHILDREN. IN ADDITION TO THE FEDERAL GOVERNMENT, THERE ARE CHILDREN'S ENVIRONMENTAL HEALTH INITIATIVES AT THE STATE AND LOCAL GOVERNMENT LEVEL AND SEVERAL ORGANIZATIONS DEVOTED TO CHILDREN'S ENVIRONMENTAL HEALTH ISSUES. ONE SUCH ORGANIZATION IS THE CHILDREN'S ENVIRONMENTAL HEALTH NETWORK. LET'S TAKE A LOOK AT THEIR WEBSITE AT www.cehn.org. NUMEROUS RESOURCES ARE AVAILABLE ON THIS SITE, INCLUDING AN OVERVIEW OF CHILDREN'S ENVIRONMENTAL HEALTH AND A TRAINING MANUAL ON PEDIATRIC ENVIRONMENTAL HEALTH DEVELOPED A COUPLE OF YEARS AGO. THIS MANUAL WAS DESIGNED TO ASSIST HEALTH PROFESSIONALS IN INCORPORATING PEDIATRIC ENVIRONMENTAL HEALTH INTO TEACHING PROGRAMS. IN ADDITION, CEHN HAS DEVELOPED A RESOURCE GUIDE THAT LISTS RELATED ORGANIZATIONS AND DATABASES. CLICK ON THE RESOURCE GUIDE, AND THEN WE'LL SCROLL DOWN AND CLICK ON THE KEYWORD INDEX. LET'S LOOK FOR RESOURCES ON MERCURY BY CLICKING ON "MERCURY" IN THE INDEX. MANY RESOURCES, FROM DATABASES TO ORGANIZATIONS THAT CONTAIN INFORMATION ON MERCURY HAZARDS, ARE DESCRIBED, AND LINKS TO THOSE RESOURCES ARE PROVIDED. INTERNATIONAL ORGANIZATIONS ARE ALSO CONCERNED WITH THE SUSCEPTIBILITY OF CHILDREN TO ENVIRONMENTAL EXPOSURES. THE WORLD HEALTH ORGANIZATION MAINTAINS A WEBSITE CALLED "THE GATEWAY TO CHILDREN'S ENVIRONMENTAL HEALTH" THAT IS ACCESSED BY ENTERING THE URL www.who.int/peh/ceh. CLICK ON "ACTIVITIES" ON THE LEFT SIDE OF THE SCREEN, AND NOW WE'LL SCROLL DOWN TO "GLOBAL ACTIVITIES." THE DESCRIPTION OF A NEW HANDBOOK ON CHILDREN'S ENVIRONMENTAL HEALTH, WHICH WILL BE PUBLISHED THIS MONTH, AS WELL AS A LINK TO A SHORT LIST OF GLOBAL INDICATORS FOR CHILDREN'S ENVIRONMENTAL HEALTH ARE PROVIDED. THE LIST OF GLOBAL INDICATORS LINKS TOGETHER THE TYPE OF EXPOSURE, HEALTH OUTCOME, AND POLICIES. THESE ARE JUST A FEW OF THE MANY USEFUL RESOURCES FOR ORIENTING HEALTH PROFESSIONALS TO THE BROAD SUBJECT OF CHILDREN'S ENVIRONMENTAL HEALTH, JOE. MANY ADDITIONAL WEBSITES ARE LISTED IN THE RESOURCES SAMPLER. >> THANK YOU, STACEY, FOR THAT OVERVIEW OF GENERAL RESOURCES. THE WEB IS SO LARGE, HOWEVER, THAT IT CAN BE DIFFICULT TO LOCATE SPECIFIC INFORMATION. GREG, DO YOU HAVE ANY HINTS FOR SEARCHING THE WEB FOR RELIABLE SCIENTIFIC DATA? >> JOE, FINDING INFORMATION ON THE INTERNET CAN BE AN OVERWHELMING PROCESS. THERE ARE MANY DIFFERENT TOOLS THAT MAY BE USED TO SEARCH THE INTERNET. I'LL DISCUSS A FEW OF THE DIFFERENT METHODS AVAILABLE AND SHOW HOW THEY WORK IN FINDING MEDICAL INFORMATION. ONE OF THE MOST COMMON TOOLS USED FOR FINDING INFORMATION ON THE INTERNET IS THE SEARCH ENGINE. YOU TYPE IN A SEARCH TERM AND RETRIEVE WEBSITES RELATED TO THAT TERM. SEARCH ENGINES VARY IN HOW THEY DO THIS AND IN WHAT THEY ARE ABLE TO FIND. ONE IMPORTANT THING TO REMEMBER IS THAT A SEARCH ENGINE SEARCHES A DATABASE OF SITES AND NOT THE ENTIRE INTERNET. THERE IS NO WAY TO SEARCH THE ENTIRE INTERNET FOR A TOPIC. THEREFORE, IT'S A GOOD IDEA TO TRY MORE THAN ONE SEARCH ENGINE WHEN DOING WEB SEARCHES. EACH SEARCH ENGINE WORKS IN A DIFFERENT WAY. SOME ENGINES SCAN FOR RELEVANT TERMS IN THE TITLE OR HEADER OF THE WEB DOCUMENT. OTHERS LOOK AT THE BOLD HEADINGS ON THE PAGE FOR THEIR INFORMATION. THE FACT THAT SEARCH ENGINES GATHER INFORMATION DIFFERENTLY MEANS THAT EACH WILL PROBABLY YIELD DIFFERENT RESULTS. WEB SEARCH ENGINES SUCH AS GOOGLE, ALTAVISTA, NORTHERN LIGHT, WHICH IS A FEE-BASED SERVICE, AND EXCITE CAN RETRIEVE THOUSANDS OF ITEMS. THERE ARE MANY OTHER SEARCH ENGINES AVAILABLE, AND YOU MAY HAVE TO TRY SEVERAL TO FIND ONE THAT BEST MEETS YOUR NEEDS. THERE ARE ALSO METASEARCH ENGINES THAT WILL SIMULTANEOUSLY SEARCH SEVERAL ENGINES TO RETRIEVE YOUR INFORMATION. A QUICK EXAMPLE WILL SHOW HOW THIS WORKS. LET'S TRY THE SEARCH ENGINE GOOGLE, AT www.google.com. IF YOU TAKE A LOOK AT THE SCREEN, YOU'LL SEE A BOX WHERE YOU CAN INSERT YOUR SEARCH TERMS. IT'S USUALLY A GOOD IDEA TO BE SPECIFIC WHEN FORMULATING PHRASES FOR SEARCH ENGINES, OR ELSE YOU'LL GET AN OVERWHELMING NUMBER OF SITES. LET'S SAY THAT YOU JUST HEARD ABOUT THE TOXNET SYSTEM FROM THE NATIONAL LIBRARY OF MEDICINE, AN EXCELLENT RESOURCE FOR TOXICOLOGY AND ENVIRONMENTAL HEALTH INFORMATION, WHICH WILL BE DISCUSSED LATER IN THE BROADCAST. YOU WOULD LIKE TO TRY OUT THIS SYSTEM, BUT AREN'T SURE OF ITS URL. IN ORDER TO ACCESS THIS RESOURCE, YOU COULD SEARCH THE WORD "TOXNET" TO GET TO THIS WEBSITE. THE GOOGLE RESULTS PAGE SHOWS HOW THIS HAPPENS. THE DIRECT LINK TO THE TOXNET PAGE APPEARS FIRST BECAUSE IT'S THE MOST RELEVANT RESULT. REMEMBER THAT EACH SEARCH ENGINE DETERMINES RELEVANCE IN A DIFFERENT MANNER, SO YOU MAY GET DIFFERENT RESULTS BASED ON WHICH ONE YOU USE. EVEN A VERY SPECIFIC SEARCH FOR A PARTICULAR WEBSITE FOUND THOUSANDS OF RESULTS. WHILE SEARCH ENGINES WORK WELL FOR FINDING SPECIFIC SITES, USING THEM FOR GENERAL TOPIC SEARCHING MAY BE LESS EFFECTIVE. WHEN DOING A GENERAL SEARCH ON A TOPIC, IT'S OFTEN A GOOD IDEA TO USE A SUBJECT DIRECTORY. SUBJECT DIRECTORIES ARE DATABASES OF WEBSITES THAT ARE ORGANIZED BY TOPIC AND HAVE USUALLY HAD IRRELEVANT SITES REMOVED. EXAMPLES OF SUBJECT DIRECTORIES INCLUDE YAHOO AND THE DMOZ OPEN DIRECTORY PROJECT. IN ADDITION, THERE ARE A NUMBER OF HEALTH AND MEDICALLY ORIENTED DIRECTORIES ON THE WEB. MANY OF THEM HAVE BEEN DEVELOPED WITH THE INVOLVEMENT OF HEALTH PROFESSIONALS AND LIBRARIANS. THESE DIRECTORIES GENERALLY REVIEW WEBSITES AND SELECT ONLY THOSE THAT MEET ESTABLISHED CRITERIA. OF COURSE, THOSE CRITERIA MAY DIFFER AMONG THE DIRECTORIES, BUT YOU SHOULD BE ABLE TO FIND OR DISCERN THOSE CRITERIA FROM THE SITE ITSELF. SOME POPULAR MEDICAL SUBJECT DIRECTORIES INCLUDE MEDICAL MATRIX, HEALTHWEB, AND MEDLINEplus FROM THE NATIONAL LIBRARY OF MEDICINE. MEDICAL MATRIX IS A PHYSICIAN PEER-REVIEWED LIST. IT HAS LINKS TO MANY QUALITY MEDICAL SITES WITH AN EMPHASIS ON CLINICAL MEDICINE. SITES ARE ORGANIZED BY MEDICAL SPECIALTY. REGISTRATION IS REQUIRED TO USE THIS SITE, BUT IT IS FREE. THE ADDRESS IS www.medmatrix. THAT'S medmatrix.org. HEALTHWEB IS AN EASY-TO-USE COMPILATION OF HEALTH SPECIALTY CATEGORIES MAINTAINED BY MEDICAL SCHOOL LIBRARIES IN THE GREATER MIDWEST REGION OF THE NATIONAL NETWORK OF LIBRARIES OF MEDICINE. THAT ADDRESS IS www.healthweb.org. PLEASE NOTICE THAT TOPICS RELEVANT TO CHILDREN'S ENVIRONMENTAL HEALTH INCLUDE PEDIATRICS, PUBLIC HEALTH, AND TOXICOLOGY. CLICK ON "TOXICOLOGY" TO SEE A VARIETY OF RESOURCES INCLUDING LINKS TO CLINICAL INFORMATION, ONLINE PUBLICATIONS, AND DATABASES. MEDLINEPLUS FROM THE NATIONAL LIBRARY OF MEDICINE IS AN EXCELLENT RESOURCE FOR CONSUMER HEALTH INFORMATION. THAT WEBSITE IS www.medlineplus.gov. THE LIBRARIANS AT THE NLM HAVE ORGANIZED THIS MEDICAL SUBJECT DIRECTORY INTO LISTS OF TOPICS BY BODY SYSTEM SO THAT FINDING QUALITY WEBSITES IS EASY. IT ALSO INCLUDES DRUG INFORMATION AND A MEDICAL ENCYCLOPEDIA. MORE INFORMATION ON SEARCH ENGINES IS AVAILABLE IN COURSE MATERIALS ON THE WEBSITE. ONCE YOU'VE PERFORMED A SEARCH OF THE INTERNET AND RETRIEVED SITES, THE MOST IMPORTANT RESEARCH WORK STILL LIES AHEAD. REVIEWING AND DETERMINING THE QUALITY OF A WEBSITE IS A CRITICAL PART OF THE PROCESS. ESPECIALLY WHEN DEALING WITH MEDICAL INFORMATION, IT'S IMPORTANT TO HAVE A CRITICAL EYE AND NOT JUST ACCEPT YOUR SEARCH RESULTS AS QUALITY DATA. THE COURSE MATERIALS ON THE WEB INCLUDE A SECTION ON EVALUATING INTERNET RESOURCES. THERE ARE A NUMBER OF THINGS YOU NEED TO REMEMBER TO CHECK FOR WHEN LOOKING AT INFORMATION ON THE INTERNET. THESE ARE GENERALLY THE SAME THINGS A LIBRARIAN USES WHEN SELECTING MATERIALS FOR A LIBRARY. WE'LL START WITH THE FIRST ISSUE TO LOOK FOR, WHICH IS CURRENCY. HOW UP-TO-DATE IS THE INFORMATION? CAN YOU TELL FROM WHAT YOU'RE READING? FOR EXAMPLE, IS THERE A DATE ON THE MATERIAL, AND IF SO, DO YOU KNOW WHAT THAT DATE REPRESENTS? IN FACT, DOES IT MATTER HOW CURRENT THIS INFORMATION IS? SOMETIMES YOU'RE LOOKING AT STATIC INFORMATION THAT DOESN'T CHANGE OVER TIME, AND IN THAT CASE, IT MAY NOT NEED TO BE DATED. HOWEVER, TIMELINESS IS OFTEN IMPORTANT FOR HEALTH AND MEDICAL INFORMATION. THE NEXT ISSUE IS AUTHORITY. IN OTHER WORDS, WHO CREATED OR DEVELOPED THIS INFORMATION? IS ANY INFORMATION PROVIDED ABOUT THE AUTHOR, INCLUDING THEIR NAME AND ANY CREDENTIALS? DO YOU KNOW IF THE AUTHOR OR PRODUCER OF THE INFORMATION HAS THE QUALIFICATIONS NECESSARY TO BE CONSIDERED AN AUTHORITY? WHEN YOU READ A PUBLISHED JOURNAL ARTICLE OR BOOK, INFORMATION IS PROVIDED ABOUT THE AUTHOR AND EDITORS, AND GENERALLY, THE MATERIAL HAS BEEN SENT OUT FOR PEER REVIEW. THIS PROVIDES SOME ASSURANCE THAT THE INFORMATION IS ACCURATE AND BACKED BY APPROPRIATE RESEARCH. IF NOT A SPECIFIC INDIVIDUAL, IS THERE ANY INFORMATION PROVIDED ABOUT THE AFFILIATION OR PUBLISHER OF THE ELECTRONIC INFORMATION? THIS BRINGS US TO THE NEXT IMPORTANT ISSUE OF INFORMATION QUALITY CONTROL -- THE AFFILIATION OF THE SOURCE. EVEN IF NO INFORMATION IS PROVIDED ABOUT A SPECIFIC INDIVIDUAL, IS THERE ANY INFORMATION ABOUT THE INSTITUTIONAL AFFILIATION OF THE INFORMATION? IN SOME CASES, THE INSTITUTION MAY BE SERVING AS THE PUBLISHER AND MAY EXERCISE QUALITY CONTROL. HOWEVER, THE INSTITUTION OR ORGANIZATION MAY BE EXERCISING CONTENT CONTROL AS WELL, SO IT'S IMPORTANT TO BE CAUTIOUS. I ALSO SUGGEST THAT YOU EXAMINE AND TRY TO DETERMINE THE PURPOSE OF THE MATERIAL. THE WEB PRESENTS A BLEND OF ADVERTISING, SALES, ENTERTAINMENT, AND INFORMATION. IT'S NOT ALWAYS EASY TO DISTINGUISH AMONG THESE AND TELL WHAT THE PURPOSE OF A PARTICULAR ITEM IS, BUT IT'S IMPORTANT THAT YOU KEEP THIS IN MIND WHEN USING INFORMATION FROM THE INTERNET. ALSO, WHEN LOOKING AT THE MATERIAL YOU FIND, YOU NEED TO TRY TO DISCERN IF THE INFORMATION IS INTENDED FOR THE USE YOU WISH TO MAKE OF IT. THE INTENDED AUDIENCE MAY BE HEALTH PROFESSIONALS, OR IT MAY BE THE GENERAL PUBLIC. IT MAY BE FOR SPECIFIC ETHNIC GROUPS OR SPECIFIC PROFESSIONS. OF COURSE, IT'S EXTREMELY IMPORTANT TO KNOW IF THE INFORMATION IS ACCURATE. CAN YOU RELY ON IT? THIS MAY BE VERY DIFFICULT TO DETERMINE, PARTICULARLY IF YOU'RE RESEARCHING AN UNFAMILIAR TOPIC. YOU MAY LOOK FOR CITATIONS TO PUBLISHED, PEER-REVIEWED SOURCES. YOU MAY TRY TO VERIFY AT LEAST SOME OF THE INFORMATION INDEPENDENTLY THROUGH EXTERNAL SOURCES. IF YOU HAVE BASIC KNOWLEDGE, YOU CAN CHECK FOR IDENTIFIABLE ERRORS. ALL OF THESE ATTRIBUTES ARE CLUES TO THE RELIABILITY OF THE INFORMATION. IN ADDITION TO ACCURACY, IT'S IMPORTANT TO LOOK FOR OBJECTIVITY IN THE INFORMATION PROVIDED. IS THIS INFORMATION BEING USED TO SELL A PRODUCT, OR IS IT PURELY PROVIDED FOR THE EDUCATIONAL BENEFIT OF THE USER? IT'S IMPORTANT TO BE ABLE TO MAKE THE DISTINCTION BETWEEN SCIENTIFICALLY ACCURATE INFORMATION AND ADVERTISING. DOES THE SPONSOR OR PRODUCER HAVE ANY APPARENT BIAS OR CONFLICT OF INTEREST? IS THIS MERELY A WAY FOR THE SPONSOR OR PRODUCER TO PROMOTE THEIR PRODUCT? FOR EXAMPLE, IS A PHARMACEUTICAL COMPANY PROVIDING UNBIASED INFORMATION IF THE ITEM BEING DISCUSSED IS A PRODUCT THEY SELL? IS A HEALTHCARE ORGANIZATION PROVIDING UNBIASED AND COMPLETE INFORMATION OR ONLY INFORMATION ABOUT SERVICES THEY PROVIDE? NEXT, IS THE INFORMATION COMPLETE, OR IS THERE A DESCRIPTION OF WHAT'S ACTUALLY INCLUDED? CAN YOU IDENTIFY WHAT ASPECTS OF THE TOPIC ARE INCLUDED OR EXCLUDED? YOU MAY ALSO ASK, IS THIS IMPORTANT FOR YOUR PARTICULAR PURPOSE? HOW DEEPLY ARE THESE TOPICS DISCUSSED? IS THIS THE COMPLETE PICTURE OR JUST AN OVERVIEW? THE POINT IS THAT THERE ARE MANY WAYS TO LOOK AT THE ISSUE OF QUALITY ON THE INTERNET, BUT WHAT'S MOST IMPORTANT IS THAT YOU REMEMBER THAT JUST BECAUSE SOMEONE PUTS SOMETHING ON THE WEB OR DISTRIBUTES IT VIA THE INTERNET, IT MAY NOT BE THE LEVEL OF QUALITY OR COMPLETENESS YOU REQUIRE. >> WELL, THANK YOU, GREG, FOR HELPING TO MAKE THE ENORMITY OF THE INTERNET A LITTLE EASIER TO UNDERSTAND. NOW LET'S GET STARTED WITH TODAY'S HEALTH TOPICS. OUR FIRST SUBJECT IS EXPOSURE OF CHILDREN TO PESTICIDES AND ALTERNATIVE METHODS FOR PEST MANAGEMENT. >> PESTICIDES ARE EVERYWHERE IN OUR SOCIETY. WE USE THEM IN OUR HOMES, WORKPLACES, AND COMMUNITIES. STACEY, CAN YOU ENLIGHTEN US ABOUT THE DANGERS OF PESTICIDES TO CHILDREN AND WHERE WE CAN FIND MORE INFORMATION ABOUT THEM? >> JOE, WHEN PESTICIDE TOXICITY IS DISCUSSED, MOST PEOPLE USUALLY THINK OF AN ACUTE POISONING INCIDENT IN AN AGRICULTURAL OR HOME SETTING. HOWEVER, PESTICIDES ARE ALSO OF CONCERN BECAUSE OF POTENTIAL CHRONIC HEALTH PROBLEMS FROM LONG-TERM EXPOSURE. PATIENTS OFTEN TURN TO THEIR PRIMARY CARE PROVIDERS AS IMPORTANT SOURCES OF INFORMATION ON A WIDE VARIETY OF ISSUES, INCLUDING PESTICIDE-RELATED HEALTH CONDITIONS. HOWEVER, PROVIDERS DON'T ALWAYS HAVE A SOLUTION AND NEED TO KNOW HOW AND WHERE TO GET ANSWERS TO THESE QUESTIONS. ACCESS TO ACCURATE INFORMATION ON PESTICIDES IS ALSO CRITICAL FOR STATE AND LOCAL HEALTH DEPARTMENTS WHO ARE RESPONSIBLE FOR DEVELOPING STRATEGIES TO CONTROL PESTS IN THEIR COMMUNITIES. LET'S TAKE A LOOK AT A RECENT SITUATION -- THE WEST NILE VIRUS. DURING THE SUMMER OF 2000, SOME AREAS, INCLUDING NEW YORK AND MARYLAND, SPRAYED PESTICIDES IN ORDER TO REDUCE THE NUMBER OF MOSQUITOES THAT MAY HAVE CARRIED THE WEST NILE VIRUS. MANY PEOPLE WERE CONCERNED THAT EXPOSURE TO THE PESTICIDE MALATHION MAY BE WORSE THAN EXPOSURE TO WEST NILE VIRUS. SO WHERE ON THE WEB CAN HEALTH PROFESSIONALS FIND SCIENTIFIC DATA ON THE EFFECTS OF MALATHION? AND, MORE SPECIFICALLY, DATA THAT ADDRESSES EXPOSURE OF CHILDREN TO MALATHION? THE NATIONAL LIBRARY OF MEDICINE'S TOXICOLOGY AND ENVIRONMENTAL HEALTH INFORMATION PROGRAM MAINTAINS A NUMBER OF RELEVANT DATABASES. LET'S TAKE A CLOSER LOOK AT THE HAZARDOUS SUBSTANCES DATABANK, OR HSDB, WHICH IS PART OF THE TOXNET SYSTEM. FIRST ENTER THE URL toxnet.nlm.nih.gov. UNDER THE "FOR TOXICOLOGY DATA" HEADING, YOU WILL NOTICE A LINK TO HSDB. CLICK ON THAT LINK. THIS DATABASE IS A PEER-REVIEWED ONLINE HANDBOOK COVERING DETAILED INFORMATION ON OVER 4,500 CHEMICALS. WE ARE SPECIFICALLY INTERESTED IN THE EFFECTS OF MALATHION ON CHILDREN, SO ENTER "MALATHION CHILDREN" IN THE BOX UNDER "SEARCH IN HSDB RECORDS FOR." CLICK ON THE "SEARCH" BUTTON. AS YOU CAN SEE FROM THE RESULTS, THE CHEMICAL MALATHION IS RETRIEVED. OTHER CHEMICAL NAMES ARE RETRIEVED AS WELL, BUT THESE ARE RECORDS IN WHICH MALATHION MIGHT BE MENTIONED, BUT NOT THE MAIN TOPIC. NOW LET'S CLICK ON THE MALATHION RECORD, AND YOU WILL NOTICE THAT ALL REFERENCES TO THE SEARCH TERMS "MALATHION" AND "CHILDREN" ARE HIGHLIGHTED. THE SCREEN IS DIVIDED INTO THREE FRAMES. THE NAVIGATION BUTTONS ARE ON THE TOP SECTION OF THE SCREEN, THE TABLE OF CONTENTS IS TO THE LEFT, AND THE ACTUAL DATA ON THE RIGHT. THIS SEARCH HAS RETRIEVED WHAT THE DATABASE CALLS "BEST SECTIONS." THIS MEANS THAT OUT OF THE ENTIRE RECORD, WHICH IS OVER 150 PAGES LONG, THE SYSTEM HAS SELECTED THE SECTIONS THAT BEST MATCH YOUR SEARCH TERMS, "MALATHION" AND "CHILDREN," AND THESE ARE DISPLAYED FIRST. NOW, AS WE SCROLL DOWN THE RESULTS SCREEN, YOU'LL SEE PREVENTIVE MEASURES FOR ELIMINATING OR REDUCING EXPOSURE TO MALATHION. THE RECORD READS, "ACCESS OF UNAUTHORIZED PERSONS, ESPECIALLY CHILDREN, TO THE AREA TO BE TREATED MUST BE FORBIDDEN." FURTHER DOWN, YOU'LL READ THAT CENTRAL NERVOUS SYSTEM DEPRESSION AS A RESULT OF EXPOSURE TO MALATHION MAY BE MORE COMMON IN CHILDREN THAN ADULTS. ALSO, THE TREATMENT OVERVIEW HIGHLIGHTS THE CARE OF CHILDREN IN COMPARISON TO THAT OF ADULTS OR ADOLESCENTS. EVEN THOUGH YOU SPECIFICALLY SEARCHED FOR "CHILDREN," YOU STILL HAVE ACCESS TO THE ENTIRE RECORD. YOU CAN VIEW EXCERPTS FROM THE PUBLISHED LITERATURE ON HUMAN HEALTH EFFECTS OR CHEMICAL SAFETY AND HANDLING. REMEMBER, MOST OF THE RECORDS IN HSDB ARE PEER-REVIEWED, AND ALL DATA ARE REFERENCED. HSDB PROVIDES YOU WITH VALUABLE INFORMATION, FROM HEALTH EFFECTS AND EMERGENCY MEDICAL TREATMENT TO MANUFACTURING AND USE OF PESTICIDES AND THOUSANDS OF OTHER HAZARDOUS CHEMICALS. THIS INFORMATION CAN THEN BE USED TO DEVELOP PLANS FOR PESTICIDE USAGE IN YOUR COMMUNITY AND IN ASSESSING POTENTIAL HEALTH CONCERNS. HSDB REFERENCES THE SCIENTIFIC LITERATURE AND IS DESIGNED FOR HEALTH PROFESSIONALS AND RESEARCHERS. THE GENERAL PUBLIC MAY FIND THE FOLLOWING FACT SHEETS MORE APPROPRIATE. MANY OF YOU ARE FAMILIAR WITH FACT SHEETS DEVELOPED BY THE FEDERAL GOVERNMENT, ESPECIALLY THE CDC. HOWEVER, ANOTHER SOURCE OF INFORMATION IS STATE PUBLIC HEALTH OR ENVIRONMENTAL PROTECTION DEPARTMENTS. THEY MAY HAVE ALREADY DEVELOPED INFORMATION ON A TOPIC OF INTEREST OR A METHOD OF RISK COMMUNICATION THAT YOU CAN EMULATE. FOR INSTANCE, PARENTS ARE ALWAYS CONCERNED ABOUT THEIR CHILD'S SAFETY, ESPECIALLY WHEN CLIMBING ON PLAYGROUND EQUIPMENT. ALONG WITH THE USUAL CONCERNS ABOUT FALLING OFF AND BREAKING BONES, IT TURNS OUT THERE'S ANOTHER CONCERN. MANY WOOD PLAYGROUND STRUCTURES USE PRESSURE-TREATED LUMBER. THE LUMBER IS TREATED WITH AN ARSENIC-BASED PESTICIDE, CHROMATED COPPER ARSENATE, OR CCA. THIS CHEMICAL KEEPS TERMITES AND OTHER PESTS FROM DESTROYING THE WOOD. HOWEVER, THERE IS CONCERN THAT CHILDREN MAY BE EXPOSED TO HARMFUL LEVELS OF CCA AS IT RUBS OFF ONTO THEIR HANDS. IN RESPONSE TO QUESTIONS FROM PARENTS AND SCHOOLS, MANY HEALTH DEPARTMENTS HAVE DEVELOPED FACT SHEETS ON CCA. HERE'S AN EXAMPLE FROM THE CONNECTICUT DEPARTMENT OF HEALTH. THE FACT SHEET IS ON THEIR WEBSITE AT www.dph.state.ct.us/publications /BCH/EEOH/pressurtr.pdf. THEIR FACT SHEET HIGHLIGHTS POTENTIAL HEALTH PROBLEMS ASSOCIATED WITH CCA AND PROVIDES RECOMMENDATIONS FOR PREVENTING EXPOSURE. AS THE FACT SHEET STATES, "THE BEST WAY TO MINIMIZE ARSENIC LEACHING IS TO SEAL THE WOOD BY APPLYING A SEALANT EVERY TWO YEARS." IT ALSO STATES, "HAND WASHING IS EFFECTIVE IN REDUCING EXPOSURE, BUT THIS IS ONLY PRACTICAL ONCE A CHILD IS FINISHED PLAYING" AND THAT "SEALANTS ARE THE BEST WAY TO PROTECT CHILDREN FROM ARSENIC EXPOSURE FROM CCA-TREATED WOOD." >> STACEY, IS THERE ONE WEBSITE FOR HEALTH PROFESSIONALS TO GO TO ACCESS INFORMATION FROM INDIVIDUAL HEALTH DEPARTMENTS? >> YES, JOE. SEARCHING EACH HEALTH DEPARTMENT WOULD BE QUITE TEDIOUS. FORTUNATELY, THE CDC HAS DEVELOPED A SEARCH ENGINE THAT ALLOWS USERS TO SEARCH ONE, SEVERAL, OR ALL STATE HEALTH DEPARTMENTS AT THE SAME TIME. THE URL IS www.cdc.gov/search2.htm. LET'S USE THE CHROMATED COPPER ARSENATE EXAMPLE. IN THE BOX UNDER "ENTER WORDS," TYPE "CHROMATED COPPER ARSENATE AND CHILDREN." CLICK "SEARCH," AND THE RESULTS WILL APPEAR. YOU'LL SEE THAT THE FIFTH ITEM ON THE FACT SHEET IS FROM THE CONNECTICUT STATE DEPARTMENT OF HEALTH. THE THIRD ITEM RETRIEVED IS ANOTHER FACT SHEET ON CCA, THIS TIME FROM THE DEPARTMENT OF PUBLIC HEALTH IN WISCONSIN. RESOURCES DEVELOPED AT THE STATE AND LOCAL LEVEL HELP FACILITATE THE EXCHANGE OF INFORMATION BETWEEN PUBLIC HEALTH PROFESSIONALS. I WOULD LIKE TO NOTE THAT LAST MONTH, EPA ADMINISTRATOR CHRISTIE WHITMAN ANNOUNCED A VOLUNTARY DECISION BY INDUSTRY TO MOVE CONSUMER USE OF TREATED LUMBER PRODUCTS AWAY FROM A VARIETY OF PRESSURE-TREATED WOOD THAT CONTAINS ARSENIC BY THE END OF 2003. INSTEAD, NEW ALTERNATIVE WOOD PRESERVATIVES WOULD BE USED. OF COURSE, THERE ARE MANY OTHER PESTICIDE RESOURCES ON THE WEB, AND THEIR URLs CAN BE FOUND IN YOUR COURSE MATERIALS. HOWEVER, I WOULD LIKE TO DEMONSTRATE JUST ONE MORE SITE. THE EPA's OFFICE OF PESTICIDE PROGRAMS MAINTAINS A COMPREHENSIVE WEBSITE CONTAINING INFORMATION FOR HEALTH PROFESSIONALS AND CONSUMERS. ENTER www.epa.gov/pesticides. YOU'LL FIND INFORMATION ON WOOD PRESERVATIVES IN THE "CONCERNED CITIZENS" SECTION AND A PESTICIDE POISONING HANDBOOK FOR HEALTH PROVIDERS IN THE "SAFETY PROGRAMS" SECTION. THIS HANDBOOK IS AVAILABLE IN BOTH ENGLISH AND SPANISH. IN ADDITION, THERE ARE ALTERNATIVE METHODOLOGIES TO REDUCE PESTICIDE USAGE AROUND CHILDREN. IN AN EFFORT TO REDUCE EXPOSURE, MANY COMMUNITIES ARE NOW USING INTEGRATED PEST MANAGEMENT, OR IPM. WITH IPM, NONCHEMICAL METHODS ARE USED TO PREVENT AND CONTROL PESTS. PESTICIDES ARE ONLY USED AS A LAST RESORT. ONE OF EPA's HIGHEST PRIORITIES IS PROTECTING CHILDREN FROM UNNECESSARY EXPOSURE TO PESTICIDES. THEY HIGHLY ENCOURAGE SCHOOL OFFICIALS TO ADOPT IPM PRACTICES. FROM EPA's OFFICE OF PESTICIDE PROGRAMS, YOU CAN ACCESS A LINK TO THEIR IPM PROGRAM FOR SCHOOLS, AS SEEN HERE. THIS SITE PROVIDES LINKS TO TOOLKITS, CLASSES, GRANTS, AND OTHER RESOURCES THAT WILL ASSIST COMMUNITIES AND SCHOOLS IN ESTABLISHING IPM PROGRAMS. IPM HAS BEEN VERY SUCCESSFUL IN SOME AREAS. FOR EXAMPLE, A GRANT TO MONROE COUNTY, INDIANA, RESULTED IN A 92% REDUCTION OF PESTICIDE USE IN THEIR SCHOOLS. >> THANKS, STACEY, FOR THAT INTRODUCTION TO PESTICIDE RESOURCES ON THE WEB, INCLUDING NLM's HAZARDOUS SUBSTANCES DATABANK, THE STATE HEALTH DEPARTMENT WEBSITES, AND THE EPA OFFICE OF PESTICIDE PROGRAMS. NOW LET'S GO TO OUR NEXT SUBJECT, ENVIRONMENTAL TRIGGERS OF ASTHMA. >> ASTHMA IS A GROWING CONCERN IN THIS COUNTRY AS MORE AND MORE CHILDREN ARE DIAGNOSED WITH THE DISEASE. IT HAS A DISPROPORTIONATE IMPACT ON CHILDREN FROM LOW-INCOME AND MINORITY FAMILIES, AS EVIDENCED BY THE GREATER FREQUENCY OF SEVERE ASTHMA EPISODES THAT LEAD TO HOSPITALIZATION OR DEATH. NOW, ROSE, I UNDERSTAND THAT ASTHMA IS NOW ONE OF THE MOST PREVALENT CHRONIC DISEASES AFFECTING CHILDREN. IT AFFECTS AN ESTIMATED 4.4 MILLION CHILDREN, AND IT'S ONE OF THE LEADING CAUSES OF SCHOOL ABSENTEEISM ACCORDING TO THE NATIONAL HEALTH INTERVIEW SURVEY. DO YOU HAVE A WEBSITE FOR SCIENTIFIC INFORMATION ON ASTHMA? FOR EXAMPLE, WHERE WOULD A PUBLIC HEALTH PROFESSIONAL GO FOR STATISTICS ON THE APPARENT INCREASE IN CHILDHOOD ASTHMA OR RESEARCH STUDIES ON THE ENVIRONMENTAL CAUSES OF ASTHMA? >> CERTAINLY, JOE. FOR A WIDE VARIETY OF INFORMATION ON CHILDHOOD ASTHMA, INCLUDING STATISTICS, RESEARCH, AND FUNDING OPPORTUNITIES, I RECOMMEND THE NATIONAL CENTER FOR ENVIRONMENTAL HEALTH, OR NCEH. NCEH IS PART OF THE CDC, AND ONE OF ITS PRIMARY ACTIVITIES IS TO CONTROL ASTHMA AND TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF PEOPLE WITH THE DISEASE. LET'S GO TO THEIR WEBSITE AT www.cdc.gov/nceh/ airpollution/asthma. THE NCEH ASTHMA SITE LINKS TO NUMEROUS RESOURCES, INCLUDING A DESCRIPTION OF CDC's ACTIVITIES RELATED TO ASTHMA CONTROL, ASTHMA RESOURCES FROM OTHER ORGANIZATIONS, AND RESOURCES SUCH AS A SPEAKER'S KIT ON ASTHMA. LET'S FIRST LOOK AT THE "CHILDREN, ADOLESCENTS, AND ASTHMA PAGE." THIS IS A DESCRIPTION OF CDC's EFFORTS TO REDUCE THE NUMBER OF DEATHS, HOSPITALIZATIONS, EMERGENCY DEPARTMENT VISITS, SCHOOL DAYS MISSED, AND LIMITATIONS ON ACTIVITY DUE TO ASTHMA. UNDER THE ASTHMA CONTROL PROGRAM, CDC FUNDS NUMEROUS GRANTEES, INCLUDING HEALTH DEPARTMENTS, TO TRACK THE DISEASE, PLAN AND CONDUCT INTERVENTIONS, AND DEVELOP PARTNERSHIPS FOR CONTROLLING ASTHMA. CDC ALSO FUNDS SEVERAL SCHOOL DISTRICTS AND NONGOVERNMENTAL ORGANIZATIONS TO SUPPORT AND ADDRESS ASTHMA CONTROL WITHIN THE SCHOOL HEALTH PROGRAM. GOING BACK TO THE ASTHMA HOME PAGE, AND NOW SCROLL DOWN TO TAKE A LOOK AT THE SPEAKER'S KIT. CLICK ON "THE SPEAKER'S KIT," AND YOU WILL FIND A COMPLETE PROGRAM FOR PUBLIC HEALTH PROFESSIONALS TO USE AS THEY SHARE INFORMATION WITH OTHERS, INCLUDING PUBLIC HEALTH POLICYMAKERS, SCHOOL AND OTHER PUBLIC HEALTH NURSES, AND MEMBERS OF ASTHMA COALITIONS OR PARTNERSHIPS. EACH SECTION CAN BE VIEWED SEPARATELY, OR THE ENTIRE POWERPOINT PRESENTATION CAN BE DOWNLOADED TO YOUR OWN COMPUTER. INFORMATION ON ENVIRONMENTAL FACTORS RELATED TO ASTHMA IS INCLUDED IN THE KIT. >> HOW ABOUT STATISTICAL INFORMATION, ROSE? IS THAT AVAILABLE FROM CDC ALSO? >> YES, JOE, STATISTICAL INFORMATION IS AVAILABLE FROM THE NATIONAL CENTER FOR HEALTH STATISTICS, OR NCHS. LINKS TO THE ASTHMA STATISTICS ARE AVAILABLE FROM THE NCEH SITE, OR DIRECTLY FROM THE NCHS WEBSITE AT www.cdc.gov/nchs. NCHS IS A PART OF CDC AND COLLECTS AND DISSEMINATES DATA ON VITAL EVENTS SUCH AS HEALTH STATUS, LIFESTYLE AND EXPOSURE TO UNHEALTHY INFLUENCES, AND THE ONSET AND DIAGNOSIS OF ILLNESS. USERS OF THESE DATA ARE MEDICAL RESEARCHERS AND OTHERS IN THE HEALTH COMMUNITY. NOW, BACK AT THE NCEH ASTHMA PAGE, LET'S CLICK ON "FAST STATS 'A' TO 'Z' FOR ASTHMA." HERE WE HAVE STATISTICAL DATA, COMPREHENSIVE DATA, AND RELATED LINKS FOR ASTHMA FROM NCHS. CLICK ON "HEALTH E-STAT ASTHMA DATA," AND YOU'LL SEE THE LATEST FACT SHEET RELEASED IN OCTOBER ON "NEW ASTHMA ESTIMATES -- TRACKING PREVALENCE, HEALTHCARE, AND MORTALITY." SCROLLING DOWN A BIT, IF YOU WANT TO SEE AGE-ADJUSTED ESTIMATES, YOU CAN CLICK ON THE CDC ASTHMA SURVEILLANCE SUMMARY. THIS REPORT SUMMARIZES AND REVIEWS NATIONAL DATA FOR SPECIFIC ENDPOINTS -- SELF-REPORTED ASTHMA PREVALENCE, OFFICE VISITS, EMERGENCY ROOM VISITS, HOSPITALIZATIONS, AND DEATHS. >> ROSE, THANK YOU FOR DEMONSTRATING THOSE RESOURCES FROM CDC. SINCE INCREASINGLY MORE CHILDREN ARE DIAGNOSED WITH ASTHMA, IT CERTAINLY PRESENTS A COMPELLING REASON TO UNDERSTAND MORE CLEARLY THE ENVIRONMENTAL CAUSES. DO YOU HAVE ANY RESOURCES THAT MIGHT BE USEFUL TO OUR AUDIENCE? >> I CERTAINLY DO, JOE. WE KNOW THAT MANY ENVIRONMENTAL FACTORS OR TRIGGERS CAN RESULT IN ASTHMATIC EPISODES. SOME OF THESE ALLERGENS COMMONLY FOUND IN HOUSEHOLDS INCLUDE COCKROACH REMNANTS, CAT DANDER, CIGARETTE SMOKE, MOLD, OR DUST MITES. I'M GOING TO DEMONSTRATE TWO DATABASES FROM THE NATIONAL LIBRARY OF MEDICINE THAT CAN ASSIST IN LEARNING ABOUT SOME OF THE ENVIRONMENTAL FACTORS OR TRIGGERS. YOU HAVE ALREADY SEEN ONE OF THE TOXNET DATABASES, HSDB. NOW WE'LL GO TO THE SAME WEBSITE BY ENTERING THE URL toxnet.nlm.nih.gov, BUT THIS TIME I'LL SELECT THE DATABASE TOXLINE. TOXLINE IS NLM's EXTENSIVE BIBLIOGRAPHIC DATABASE COVERING THE BIOCHEMICAL, PHARMACOLOGICAL, PHYSIOLOGICAL, AND TOXICOLOGICAL EFFECTS OF DRUGS AND OTHER CHEMICALS. IT CONTAINS MORE THAN 3 MILLION CITATIONS, ALMOST ALL WITH ABSTRACTS AND/OR INDEXING TERMS AND C.A.S. REGISTRY NUMBERS. LIKE HSDB, TOXLINE IS ALSO AVAILABLE FREE OF CHARGE ON THE WEB. LET ME BEGIN BY FIRST EXPLAINING THE DIFFERENCES BETWEEN THE TWO SEARCH CAPABILITIES IN THIS DATABASE, TOXLINE. THE REFERENCES ARE DRAWN FROM VARIOUS SOURCES AND ARE GROUPED INTO TWO MAJOR COMPONENTS, TOXLINE CORE AND TOXLINE SPECIAL. TOXLINE CORE COVERS MUCH OF THE STANDARD JOURNAL LITERATURE IN TOXICOLOGY. IT IS A SEARCHABLE SUBSET OF THE MUCH LARGER METLINE DATABASE OF MEDICAL LITERATURE AND IS ACCESSIBLE THROUGH PubMed, NLM's SEARCH ENGINE IS USED TO ACCESS THE 11 MILLION CITATIONS IN MEDLINE. TOXLINE SPECIAL COMPLEMENTS TOXLINE CORE WITH REFERENCES FROM AN ASSORTMENT OF SPECIALIZED JOURNALS AND OTHER SOURCES SUCH AS TECHNICAL REPORTS, RESEARCH PROJECTS, AND ARCHIVAL COLLECTIONS. TODAY'S DEMONSTRATION OF TOXLINE WILL FOCUS ON ENVIRONMENTAL TRIGGERS OF CHILDHOOD ASTHMA. LET'S FIRST COME UP WITH SOME TERMS THAT MIGHT ASSIST US IN OUR SEARCH. SINCE WE ARE LOOKING FOR FACTORS OR TRIGGERS CAUSING ASTHMA IN CHILDREN, LET'S USE THE WORDS "ASTHMA" AND "CHILDREN." WE'LL ALSO ADD THE WORD "TRIGGER" TO FOCUS ON POTENTIAL AGGRAVATORS OF THE DISEASE. LET'S FIRST SEARCH USING THE TOXLINE SPECIAL, WHICH HAPPENS TO BE THE DEFAULT OPTION. IN THE SEARCH BOX, WE'LL TYPE "ASTHMA," "CHILDREN," AND "TRIGGERS." THE DATABASE WILL SEARCH FOR WORDS USED IN ALL FIELDS, WHICH IS THE DEFAULT UNLESS YOU SPECIFY THAT YOU WOULD LIKE TO SEARCH TITLES OF ARTICLES OR IF YOU'RE LOOKING FOR A SPECIFIC AUTHOR. TO LIMIT YOUR SEARCHES TO THESE FIELDS, USE THE PULL-DOWN MENU TO SELECT EITHER "TITLES" OR "AUTHORS." KEEP IN MIND TOXLINE IS A BIBLIOGRAPHIC DATABASE, WHICH ALLOWS YOU TO LIMIT YOUR SEARCHES TO THE PUBLICATION YEAR. WE'LL USE THE DEFAULT IN YEAR FOR OUR SEARCH. AFTER CLICKING ON "SEARCH," WE SEE THAT WE HAVE 32 REFERENCES OR RECORDS, AND 20 ARE DISPLAYED ON THE FIRST PAGE. ALL REFERENCES DISPLAYED ARE RELEVANCY-RANKED ACCORDING TO YOUR SEARCH TERMS, AND EACH REFERENCE CONSISTS OF THE TITLE, AUTHOR, AND SOURCE AND DATE OF PUBLICATION. TO SEE A COMPLETE RECORD WITH ABSTRACT OF WHEN IT'S AVAILABLE, CLICK ON THE TITLE OF A REFERENCE IN WHICH YOU'RE INTERESTED. FOR EXAMPLE, LET'S TAKE A CLOSER LOOK AT RECORD NUMBER 7, "AGE AND THE IMPACTS OF TRIGGERS IN CHILDHOOD ASTHMA." CLICK ON THE LINK TO VIEW THE FULL RECORD AND SCROLL DOWN TO VIEW THE TITLE, SOURCE, AND ABSTRACT INCLUDED IN THIS REFERENCE. NOTICE ALL THREE OF OUR SEARCH TERMS APPEAR IN RED. THE AUTHORS' NAMES, MEDICAL SUBJECT HEADINGS, AND KEYWORDS ARE HIGHLIGHTED IN BLUE, UNDERLINED, AND ARE HOT LINKED. SO BY CLICKING ON AN AUTHOR, YOU CAN FIND OTHER ARTICLES BY THAT AUTHOR OR CLICK ON A KEYWORD OF INTEREST TO FIND OTHER ARTICLES INDEXED BY THEIR KEYWORD. THE ABSTRACT MENTIONS THE 12 COMMON TRIGGERS IN EPISODES OF CHILDHOOD ASTHMA, WHICH INCLUDE ENVIRONMENTAL FACTORS SUCH AS AIR POLLUTION AND CIGARETTE SMOKE AS WELL AS OTHER TYPES. NOW LET'S REPEAT OUR SEARCH IN TOXLINE CORE ON PubMed USING THE SAME SEARCH TERMS. CLICK "MODIFY SEARCH" TO RETURN TO OUR PREVIOUS SEARCH. THIS TIME CHANGE THE DEFAULT FROM TOXLINE SPECIAL AND SELECT TOXLINE CORE ON PubMed AND CLICK ON "SEARCH." NOTICE THAT EVEN THOUGH WE ARE NOT SEARCHING THE TOXLINE DATABASE PER SE, OUR SEARCH HAS TAKEN US TO PubMed, THE SEARCH ENGINE FOR MEDLINE. BUT OUR SEARCH IS AUTOMATICALLY LIMITED TO THE TOXICOLOGY SUBSET OF MEDLINE. USING TOXLINE CORE ON PubMed, 29 CITATIONS ARE RETRIEVED, AND THE FIRST 20 CITATIONS ARE DISPLAYED. AS WITH TOXLINE SPECIAL, THE INITIAL VIEW OF THE RECORD INCLUDES THE AUTHORS LISTED FIRST, AND THEN THE TITLE AND SOURCE INFORMATION. TO SEE A COMPLETE RECORD WITH ABSTRACT OF WHEN IT'S AVAILABLE, CLICK ON THE "AUTHOR" LINK AND VIEW THE FULL RECORD. FOR EXAMPLE, LET'S TAKE A CLOSER LOOK AT ONE OF THE CITATIONS RETRIEVED, "ASTHMA AND THE HOME ENVIRONMENT OF LOW-INCOME URBAN CHILDREN -- PRELIMINARY FINDINGS FROM THE SEATTLE COUNTY HEALTHY HOMES PROJECT,"JOURNAL OF URBAN HEALTH. THESE ARE STUDY RESULTS OF INTERVENTION PROGRAMS FOR ASTHMA. AS WE SCROLL DOWN AGAIN, NOTICE THE TITLE, SOURCE, AND ABSTRACT INCLUDED FOR THIS REFERENCE. THERE ARE SEVERAL WAYS TO VIEW THE SAME RECORD, AND EACH WAY ALLOWS YOU TO SEE DIFFERENT INFORMATION ABOUT A PARTICULAR ARTICLE. FOR EXAMPLE, RETURNING TO THE LIST OF CITATIONS BY USING THE BACK BUTTON ON YOUR BROWSER'S TOOL BAR, YOU CAN SEE THAT THE CITATIONS ARE DISPLAYED IN THE DEFAULT SUMMARY FORMAT. THE PULL-DOWN MENU NEXT TO THE DISPLAY BUTTON ON THE ACTION BAR ALLOWS YOU TO SELECT A DIFFERENT DISPLAY FORMAT. FOR EXAMPLE, CHOOSING THE ABSTRACT FORMAT ALLOWS YOU TO SEE THE ABSTRACTS FOR ALL RECORDS. TO SAVE THE CITATION OR OTHERS THAT ARE OF INTEREST, USE THE "DISPLAY" PULL-DOWN MENU TO SELECT A FORMAT. NEXT CLICK ON THE CHECKED BOXES NEXT TO EACH CITATION YOU WANT TO SAVE, THEN CLICK "SAVE"... AND YOUR ITEMS WILL BE SAVED IN THE SELECTED FORMAT AS PLAIN TEXT. THE RECORDS CAN THEN BE VIEWED IN A WORD-PROCESSING PROGRAM OR ENTERED INTO A DATABASE-MANAGEMENT PROGRAM. NOW THAT WE ARE BACK TO THE RETRIEVAL SCREEN, LET'S TAKE A LOOK AT RELATED ARTICLES OF THE SELECTED CITATION. NOTICE THERE ARE OVER 100 RETRIEVED CITATIONS OF CLOSELY RELATED ARTICLES DEALING WITH INNER-CITY CHILDREN AND ASTHMA. THERE ARE MORE RELATED ARTICLES WITH EACH. >> NOW, ROSE, SUPPOSE SOMEONE WANTED THE FULL OR COMPLETE ARTICLE INSTEAD OF A CITATION OR ABSTRACT. IS THERE A WAY TO GET IT? >> YES, JOE. WHAT YOU CAN DO IS, AS WE GET TO THE DISPLAY HERE, IF IT'S AVAILABLE, PubMed WILL DISPLAY AN ICON IN THE ABSTRACT FORMAT. SOMETIMES THE ARTICLES ARE AVAILABLE FOR FREE, BUT USUALLY A FEE FOR THE ARTICLE OR A SUBSCRIPTION TO THE JOURNAL IS REQUIRED. HOWEVER, IF THE FULL TEXT IS NOT AVAILABLE ONLINE, THERE IS A WAY TO ORDER A COPY. NOTICE ON THE ACTION BAR THERE'S AN "ORDER" BUTTON. BY CLICKING ON THIS BUTTON, YOU WILL BE ABLE TO ORDER THE FULL-TEXT COPY OF THE SELECTED ARTICLES FROM A LIBRARY IN YOUR AREA. BUT BEFORE YOU USE THIS FEATURE, YOU MUST ESTABLISH AN AGREEMENT SERVICE FOR THIS SERVICE CALLED "LOANSOME DOC" WITH A PARTICIPATING LIBRARY. IF YOU NEED TO FIND A LIBRARY, CLICK ON "GO" UNDER "HOW TO REGISTER FOR INFORMATION ON LIBRARIES IN YOUR AREA." ONCE YOU'VE REGISTERED WITH LOANSOME DOC, YOU CAN ORDER FULL-TEXT COPIES OF ARTICLES BY CLICKING ON THE CHECK BOX TO THE LEFT OF EACH CITATION, AND THEN CLICK "ORDER." FOLLOW THE INSTRUCTIONS, AND YOUR COPY WILL BE ON ITS WAY. BUT PLEASE NOTE THAT MANY LIBRARIES CHARGE A FEE FOR EACH ARTICLE ORDERED. JOE, MOST DOCUMENT DELIVERY IS DONE THROUGH THE NATIONAL NETWORK OF LIBRARIES OF MEDICINE, OR NNLM. GREG WORKS FOR THE NETWORK OF LIBRARIES. GREG, COULD YOU PLEASE TELL US MORE ABOUT THE NNLM SERVICES FOR HEALTH PROFESSIONALS? >> SURE, ROSE. THE NATIONAL NETWORK OF LIBRARIES OF MEDICINE IS AN INTRICATE SYSTEM DESIGNED TO ADVANCE THE PROGRESS OF MEDICINE AND IMPROVE PUBLIC HEALTH BY PROVIDING ALL U.S. HEALTH PROFESSIONALS EQUAL ACCESS TO BIOMEDICAL INFORMATION AND BY IMPROVING THE PUBLIC'S ACCESS TO INFORMATION TO ENABLE THEM TO MAKE INFORMED DECISIONS ABOUT THEIR HEALTH. THE NNLM IS COORDINATED BY THE NATIONAL LIBRARY OF MEDICINE AND CARRIED OUT THROUGH A NATIONWIDE NETWORK OF HEALTH SCIENCE LIBRARIES AND INFORMATION CENTERS. IT CONSISTS OF EIGHT REGIONAL MEDICAL LIBRARIES, MORE THAN 140 RESOURCE LIBRARIES, AND NEARLY 4,700 PRIMARY ACCESS LIBRARIES. THE REGIONAL MEDICAL LIBRARIES ADMINISTER AND COORDINATE SERVICES IN THE NETWORK'S EIGHT GEOGRAPHICAL REGIONS. FOR EXAMPLE, I WORK AT THE SOUTH CENTRAL REGION BASED AT THE HOUSTON ACADEMY OF MEDICINE TEXAS MEDICAL CENTER LIBRARY IN HOUSTON, TEXAS. THIS REGION SERVES ARKANSAS, LOUISIANA, NEW MEXICO, OKLAHOMA, AND TEXAS. THE NNLM SERVES ALL HEALTH PROFESSIONALS -- PHYSICIANS, NURSES, ALLIED HEALTH PROFESSIONALS, RESEARCHERS, ADMINISTRATORS, STUDENTS -- ANYONE WHO NEEDS ACCESS TO BIOMEDICAL INFORMATION. WE REACH OUT TO ALL HEALTH PROFESSIONALS NO MATTER WHERE THEY'RE LOCATED, AND ASSIST THEM WITH THEIR INFORMATION NEEDS. OUTREACH EFFORTS ARE UNDER WAY TO SPECIFICALLY HELP PUBLIC HEALTH PROFESSIONALS, UNDERSERVED HEALTH PROFESSIONALS, AND RURAL AND INNER-CITY AREAS AND SPECIAL POPULATIONS GAIN TIMELY ACCESS TO HEALTH INFORMATION. THE PARTICIPATING LIBRARIES PROVIDE ASSISTANCE WITH ACCESS TO BOOKS AND JOURNALS, COPIES OF ARTICLES, REFERENCE SERVICES, AND INTERNET AND DATABASE SEARCH TRAINING. TO FIND A MEDICAL LIBRARY TO HELP YOU, JUST CALL 1-800-338-7657 OR SEARCH OUR MEMBER DATABASE AT nnlm.gov/members. >> THANK YOU, GREG, FOR TELLING OUR AUDIENCE HOW THEY CAN HOOK UP TO A MEDICAL LIBRARY. AND THANK YOU, ROSE, FOR THAT COMPREHENSIVE OVERVIEW OF ASTHMA RESOURCES. NOW LET'S TURN TO OUR THIRD SUBJECT FOR TODAY -- FUNDING RESOURCES FOR LEAD-POISONING PREVENTION. I THINK MOST OF US ARE FAMILIAR WITH THE HAZARDS OF LEAD, ESPECIALLY LEAD-BASED PAINT. OVER 80% OF HOMES BUILT BEFORE 1978 CONTAIN LEAD-BASED PAINT. THIS, AS WELL AS LEAD FROM OTHER SOURCES, CAUSES ILLNESS IN VULNERABLE AGE GROUPS, PARTICULARLY CHILDREN. LEAD HAS BEEN SHOWN TO DAMAGE A CHILD'S CENTRAL NERVOUS SYSTEM, KIDNEYS, AND REPRODUCTIVE SYSTEM, AND AT HIGHER LEVELS CAN CAUSE COMA, CONVULSIONS, AND DEATH. RESIDENTS OF OLDER HOMES, COMMUNITY ASSOCIATIONS, AND PUBLIC HEALTH OFFICIALS ARE ALL CONCERNED WITH THIS PROBLEM AND HOW IT CAN BE SOLVED. GREG, WHERE DO WE GO TO FIND OUT HOW TO CONTROL AND HOPEFULLY STOP THIS PROBLEM IN OUR COMMUNITIES? >> UNFORTUNATELY, JOE, THIS IS A PROBLEM THAT'S PREVALENT THROUGHOUT THE UNITED STATES. IN FACT, ACCORDING TO THE CDC, ABOUT A MILLION CHILDREN UNDER THE AGE OF 6 HAVE BLOOD LEAD LEVELS HIGH ENOUGH TO ADVERSELY AFFECT THEIR INTELLIGENCE, BEHAVIOR, AND DEVELOPMENT. I'D LIKE TO LOOK AT SEVERAL RESOURCES THAT MAY BE HELPFUL TO PUBLIC HEALTH PROFESSIONALS WHO ARE AWARE OF THE LEAD-POISONING ISSUE, BUT WHO ARE SEEKING INFORMATION THAT CAN ASSIST THEM IN SOLVING THIS PROBLEM. I'D LIKE TO ALSO FOCUS ON RESOURCES THAT IDENTIFY FUNDING AVAILABLE FOR LEAD-POISONING PREVENTION AND LEAD ABATEMENT, AS WELL AS GENERAL GRANT-WRITING RESOURCES. AN EXCELLENT RESOURCE TO START WITH IS THE CDC CHILDHOOD LEAD POISONING PREVENTION PROGRAM SITE AT www.cdc.gov/nceh/lead. THIS SITE SERVES AS AN EXCELLENT CLEARINGHOUSE FOR INFORMATION ON THE LEAD-POISONING ISSUE. CLICK ON THE HEADING "PUBLICATIONS" TO VIEW VARIOUS RESOURCES CONCERNING THE LEAD-POISONING PROGRAM. INFORMATION ON LEAD-POISONING SCREENING, MORBIDITY, AND MORTALITY DATA AND OTHER RELATED INFORMATION IS AVAILABLE HERE. CLICK ON THE HEADING "ABOUT THE PROGRAM" TO THE LEFT OF YOUR SCREEN TO LEARN MORE ABOUT THE LATEST FUNDING OPPORTUNITIES FOR STATE AND LOCAL HEALTH DEPARTMENTS. THE CDC PROVIDES FUNDING FOR THESE DEPARTMENTS TO DETERMINE THE EXTENT OF CHILDHOOD LEAD POISONING, TO SCREEN CHILDREN FOR ELEVATED LEAD LEVELS IN BLOOD, AND TO DEVELOP NEIGHBORHOOD-BASED EFFORTS TO PREVENT CHILDHOOD LEAD POISONING. BY CLICKING ON THE LINK "KEY CONTACTS" HALFWAY DOWN THE PAGE, YOU CAN LEARN ABOUT FUNDED LEAD-POISONING PROGRAMS ALREADY IN EXISTENCE IN YOUR STATE. FOR EXAMPLE, IF YOU LOOK AT THE FIRST ENTRY FOR ALABAMA, YOU'RE GIVEN THE CONTACT INFORMATION FOR THE PROGRAM COORDINATOR AND SURVEILLANCE CONTACT FOR THAT STATE'S PROGRAM. ANOTHER GOOD RESOURCE IS THE SITE FOR THE UNITED STATES DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, OR HUD, LOCATED AT www.hud.gov. WHILE THIS MAY NOT SEEM LIKE AN OBVIOUS RESOURCE FOR LEAD-POISONING INFORMATION, HUD ACTUALLY CONTAINS A SIGNIFICANT AMOUNT OF INFORMATION ON LEAD ABATEMENT FUNDING RESOURCES. ON YOUR RESOURCE SAMPLER IS THE ADDRESS TO ACCESS THE HEALTHY HOMES AND LEAD HAZARD CONTROL PROGRAMS AVAILABLE FROM THE HUD WEBSITE OR FOLLOW THE LINKS UNDER "GRANTS" FROM THE HOME PAGE. HERE, WE'RE LOOKING AT AN ARCHIVE LISTING OF 2001 FUNDING OPPORTUNITIES. IF YOU SCROLL DOWN THROUGH THE LISTING, YOU'LL SEE A LINK ENTITLED "HEALTHY HOMES AND LEAD HAZARD CONTROL PROGRAMS." CLICK ON THIS LINK TO SEE WHAT'S AVAILABLE FOR LEAD ABATEMENT. HERE'S A LIST OF CURRENTLY AVAILABLE GRANTS WITH LINKS FOR FORMS, DEADLINES, CONTACT INFORMATION, ET CETERA. IN 2001, HUD FUNDED $67 MILLION IN GRANTS UNDER THIS PROGRAM. INFORMATION ON 2002 GRANTS SHOULD BE AVAILABLE IN THE NEAR FUTURE. NOW WE'LL LOOK AT A MORE GENERAL SITE FOR GRANTS-RELATED INFORMATION. THE CATALOG OF FEDERAL DOMESTIC ASSISTANCE SITE CONTAINS A GREAT RESOURCE CALLED THE FEDERAL COMMONS. IT'S LOCATED AT www.cfda.gov/federalcommons. THIS SITE IS INTENDED TO SERVE AS A RESOURCE FOR FINDING FEDERAL GRANT-RELATED INFORMATION. THIS SITE HAS ORGANIZED THE GRANTS-RELATED WEB PAGES OF GOVERNMENT AGENCIES BY TOPICS UNDER HEADINGS SUCH AS ENVIRONMENTAL QUALITY. THIS IS A MORE GENERAL SITE BECAUSE THE LINKS TAKE YOU TO THE GRANTS PAGE OF THE PARTICULAR AGENCY, NOT TO A SPECIFIC OPPORTUNITY. FOR EXAMPLE, FROM THE HOME PAGE, CLICK ON THE "ENVIRONMENTAL QUALITY" LINK UNDER THE HEADING "GRANT TOPICS." THIS NEXT PAGE IS FURTHER BROKEN DOWN BY TOPIC TO ASSIST YOU IN FINDING INFORMATION MORE SPECIFIC TO YOUR NEEDS. HEADINGS INCLUDE WATER-POLLUTION CONTROL, AIR-POLLUTION CONTROL, SOLID WASTE MANAGEMENT, PESTICIDES CONTROL, RADIATION CONTROL, AND FINALLY RESEARCH EDUCATION AND TRAINING. A NONGOVERNMENT RESOURCE THAT MAY BE HELPFUL IS THE COMMUNITY TOOLBOX FOR CHILDREN'S ENVIRONMENTAL HEALTH, WHICH IS A PROJECT OF THE TIDES CENTER. THE ADDRESS IS www.communitytoolbox.org. CLICK ON "GRANTMAKING" ON THE LEFT SIDE OF THE SCREEN TO REACH THE COMMUNITY TOOLBOX PAGE ON FUNDING INFORMATION FOR GENERAL CHILDREN'S ENVIRONMENTAL HEALTH ISSUES, AS WELL AS LEAD-POISONING PREVENTION. THESE PROGRAMS PRIMARILY FUND COMMUNITY-BASED ORGANIZATIONS RATHER THAN STATE PUBLIC HEALTH DEPARTMENTS. CLICK ON "CHILDHOOD LEAD-POISONING PREVENTION" TO ACCESS GRANTMAKING GUIDELINES AND FORMS FOR THIS FUNDING PROGRAM. >> GREG, THESE RESOURCES SHOULD BE QUITE HELPFUL TO THOSE INTERESTED IN FUNDING SPECIAL PROJECTS. BUT PROBABLY ONE OF THE MOST INTIMIDATING PARTS OF APPLYING FOR GRANTS IS THE APPLICATION PROCESS ITSELF. DO YOU HAVE ANY RESOURCES THAT MIGHT ASSIST OUR VIEWERS IN WRITING AND PREPARING GRANT PROPOSALS? >> YOU'RE RIGHT, JOE. MANY PEOPLE ARE DISCOURAGED FROM APPLYING FOR GRANTS BECAUSE THE APPLICATION PROCESS CAN SEEM SO DAUNTING. STILL, OTHERS UNINTENTIONALLY ELIMINATE THEMSELVES FROM SELECTION BECAUSE THEY HAVEN'T FOLLOWED THE GRANT-APPLICATION INSTRUCTIONS CORRECTLY. ONE RESOURCE I'D LIKE TO HIGHLIGHT IS THE ENVIRONMENTAL PROTECTION AGENCY'S GRANT-WRITING TUTORIAL. THE ADDRESS IS... CLICK "CONTINUE" AT THE BOTTOM OF THE SCREEN AND THE NEXT ONE TO GET TO THE TUTORIAL. IT WOULD BE BEST TO GO THROUGH THIS AT YOUR OWN PACE, BUT LET ME GIVE YOU A QUICK OVERVIEW OF THE SECTION ON ENVIRONMENTAL JUSTICE THROUGH POLLUTION-PREVENTION GRANTS. THE TABLE OF CONTENTS ON THE LEFT OF YOUR SCREEN LISTS THE TOPIC AREAS FOR THE TUTORIAL... CLICK ON THE HEADING "PROGRAM SPECIFICS" TO GET INFORMATION ON THE ENVIRONMENTAL JUSTICE PROGRAMS THAT THE TUTORIAL ADDRESSES. BY CLICKING ON THE "EXAMPLES" BUTTON, THE TUTORIAL WILL SHOW YOU ACTUAL EXAMPLES OF ENVIRONMENTAL GRANTS. YOU CAN SELECT AN EXAMPLE OF AN ENVIRONMENTAL JUSTICE SMALL GRANT, AN EXAMPLE OF AN ENVIRONMENTAL JUSTICE THROUGH POLLUTION-PREVENTION GRANT, AND EXAMPLES OF ENVIRONMENTAL-EDUCATION GRANTS. LET'S CLICK ON THE LINK TO THE EXAMPLE OF ENVIRONMENTAL JUSTICE THROUGH POLLUTION-PREVENTION PROGRAM. THIS PAGE LISTS THE BASIC COMPONENTS OF THE GRANT PROPOSAL, INCLUDING THE COVER LETTER, SUMMARY SHEET, INTRODUCTION OF THE ORGANIZATION, PROBLEM STATEMENT OR NEEDS ASSESSMENT, PROJECT OBJECTIVES, METHODS OR DESIGN EVALUATION, BUDGET, AND AN EXAMPLE OF A COMPLETED SF424 FORM REQUIRED FOR GOVERNMENT GRANTS. USING THE SITE MAY ASSIST NEW GRANT WRITERS WITH THE PROCESS OF APPLYING FOR GOVERNMENT FUNDING OR ASSIST ALL USERS IN DEMYSTIFYING THE PROCESS. >> THANK YOU, GREG, FOR THAT HELPFUL OVERVIEW ON LOCATING INFORMATION ON FUNDING SOURCES AND GRANT WRITING. I THINK THIS WILL HELP OUR AUDIENCE LOCATE GRANT MONEY, NOT ONLY FOR LEAD-POISONING PREVENTION BUT ALSO FOR OTHER ENVIRONMENTAL HEALTH ISSUES. NOW LET'S GO TO OUR FOURTH TOPIC -- HEALTHY PEOPLE 2010. ROSE, CAN YOU TELL US MORE ABOUT THE HEALTHY PEOPLE INITIATIVE AND HOW IT IMPACTS CHILDREN IN THEIR ENVIRONMENT? >> OF COURSE, JOE. HEALTHY PEOPLE 2010 IS THE PREVENTION AGENDA AND A SET OF HEALTH OBJECTIVES FOR THE NATION TO ACHIEVE BY THE YEAR 2010. THESE OBJECTIVES SERVE AS THE BASIS FOR STATE AND COMMUNITY PLANS TO IMPROVE HEALTH. HEALTHY PEOPLE 2010 HAS TWO MAIN GOALS... THE FIRST GOAL OF INCREASING QUALITY OF LIFE IS DONE BY LOOKING AT SPECIFIC QUANTIFIABLE CONDITIONS AND ATTEMPTING TO REDUCE THEM. THE SECOND GOAL OF REMOVING HEALTH DISPARITIES IS AN ACKNOWLEDGEMENT THAT OFTEN THE QUALITY OF HEALTHY LIFE CAN BE VARIED BASED ON RACE, ETHNIC BACKGROUND, OR SOCIAL-ECONOMIC DIFFERENCES. THE GOAL IS TO ERADICATE THESE DIFFERENCES TO ASSIST IN ACHIEVING THESE GOALS. THERE ARE 467 OBJECTIVES AND 28 FOCUS AREAS IN HEALTHY PEOPLE 2010. SOME OF THE FOCUS AREAS ARE ACCESS TO QUALITY HEALTH SERVICES, EDUCATIONAL AND COMMUNITY-BASED PROGRAMS, AND, OF COURSE, OUR TOPIC TODAY, ENVIRONMENTAL HEALTH. THE IDEA IS TO GIVE STATES AND COMMUNITIES GUIDELINES SO THEY CAN GENERATE THEIR OWN PLANS TO MEET THE TWO OVERALL GOALS. WHY DON'T WE TAKE A LOOK AT THE HEALTHY PEOPLE WEBSITE? THE URL IS... THIS WEBSITE HAS A GREAT DEAL OF USEFUL INFORMATION, INCLUDING THE HEALTHY PEOPLE PUBLICATIONS, IMPLEMENTATION PLANS FOR IMPROVING HEALTH AND DATA RESOURCES. BY CLICKING ON THE "PUBLICATIONS" LINK ON THE LEFT-HAND SIDE OF THE SCREEN, YOU'LL SEE A LIST OF PUBLICATIONS THAT CAN BE VIEWED, DOWNLOADED, OR ORDERED. ONE OF THESE PUBLICATIONS IS HEALTHY PEOPLE 2010 -- UNDERSTANDING AND IMPROVING HEALTH. THIS IS THE ENTIRE INITIATIVE. YOU HAVE THE OPTION TO VIEW IT AS HTML, MICROSOFT WORD, OR PDF. HTML MEANS THAT IT'S VIEWED AS A WEB PAGE. IF YOU WANT TO PRINT IT, YOU WILL NEED TO PRINT EACH SECTION AT A TIME. ON THE OTHER HAND, THE PDF VERSION CAN PRINT THE ENTIRE DOCUMENT AT ONCE. HOWEVER, TO REVIEW THE PDF VERSION, YOU MUST HAVE ADOBE ACROBAT READER. THE READER IS AVAILABLE FOR FREE, AND THE URL IS IN THE COURSE MATERIALS. IF YOU ONLY WANT TO FOCUS YOUR SEARCH ON ONE OF THE HEALTHY PEOPLE 2010 SUBJECT AREAS, YOU CAN EASILY DO THAT IN HTML. SO IF YOU'RE INTERESTED IN SECTION 8, ENVIRONMENTAL HEALTH, CLICK ON THE HTML LINK NEXT TO THAT SECTION. HERE YOU CAN READ THE OBJECTIVES AND BEGIN TO PLAN HOW YOU'LL MEET THESE IN YOUR LOCAL AREA. LET'S LOOK AT SOME OF THESE OBJECTIVES. BY SCROLLING DOWN THE TABLE OF CONTENTS, YOU CAN QUICKLY GO TO YOUR TOPIC OF INTEREST. LET'S LOOK AT "TOXICS AND WASTE." THIS LINK TAKES YOU TO OBJECTIVE 8-11 ON LEAD POISONING. ELIMINATE ELEVATED BLOOD LEAD LEVELS IN CHILDREN IS ONE OF THE FEW OBJECTIVES IN THIS SECTION THAT SPECIFICALLY TARGETS CHILDREN. BY READING THROUGH THE OBJECTIVE, YOU CAN SEE WHAT THE BASE LINE IS FOR BLOOD LEAD LEVELS IN CHILDREN AND WHAT THE TARGET GOAL IS. IN THIS CASE, THE GOAL IS THE TOTAL ELIMINATION OF BLOOD LEVELS EXCEEDING 10 MICROGRAMS PER DECILITER IN CHILDREN. ALTHOUGH NOT SPECIFICALLY STATED, MOST OF THE OBJECTIVES IMPACT CHILDREN. FOR EXAMPLE, CHILDREN ARE AT HIGHER RISK FOR PESTICIDE EXPOSURE BECAUSE OF THEIR SIZE AND THEY'RE MORE LIKELY TO GO NEAR PLACES WHERE PESTICIDES MAY BE IMPROPERLY STORED OR APPLIED WHILE THEY PLAY. SO SCROLLING DOWN TO OBJECTIVE 8-13, REDUCE PESTICIDE EXPOSURE THAT RESULTS IN A VISIT TO A HEALTHCARE FACILITY, APPLIES TO CHILDREN AS WELL AS ADULTS. ANOTHER USEFUL RESOURCE UNDER "PUBLICATIONS" IS THE HEALTHY PEOPLE 2010 TOOLKIT -- A FIELD GUIDE TO HEALTH PLANNING. GOING BACK TO THE "PUBLICATIONS" PAGE, SCROLL DOWN AND CLICK ON "TOOLKIT." THE TOOLKIT INCLUDES RESOURCES AND TOOLS TO ASSIST YOU IN PLANNING STATE OR LOCAL PROGRAMS. BUT HOW CAN THE HEALTHY PEOPLE 2010 ENVIRONMENTAL HEALTH OBJECTIVES BE APPLIED TO CHILDREN IN PARTICULAR? IN DECEMBER 2000, THE EPA'S OFFICE OF CHILDREN'S HEALTH PROTECTION AND NATIONAL CENTER FOR ENVIRONMENTAL ECONOMIC OFFICE OF POLICY, ECONOMICS AND INNOVATION, ISSUED A REPORT ENTITLED... THIS REPORT CAN HELP LINK THE HEALTHY PEOPLE 2010 ENVIRONMENTAL HEALTH OBJECTIVES WITH OTHER MEASURES WITH THE HEALTH OF OUR CHILDREN. IT IS AVAILABLE FROM THE EPA'S OFFICE OF CHILDREN'S PROTECTION, WHICH WAS DISCUSSED EARLIER IN THIS BROADCAST. ENTER... TO LOCATE THE REPORT. HERE SECTIONS OF THE REPORT CAN BE REVIEWED AS HTML FILES OR CLICK ON "DOWNLOAD OR ORDER THIS REPORT" IN THE TOP RIGHT-HAND CORNER TO DOWNLOAD THE ENTIRE DOCUMENT AS A PDF FILE. CLICK ON THE "CONCENTRATIONS OF LEAD IN BLOOD" TO SEE THIS REPORT OR SCROLL DOWN TO SEE STATISTICS AND GRAPHS THAT SHOW THE LEVELS HAVE DECLINED OVER THE YEARS. RACE AND INCOME LEVELS APPEAR TO BE FACTORS IN WHO WAS MORE HIGHLY AT RISK. NOTICE THAT AT THE BOTTOM OF THE PAGE, IT GIVES YOU HEALTHY PEOPLE 2010 OBJECTIVES. THIS INFORMATION WOULD BE USEFUL FOR -- THE APPENDICES OF THE REPORT GIVES YOU ADDITIONAL SOURCES THAT WOULD BE HELPFUL IN PLANNING YOUR ACTIVITIES. ANOTHER GOOD RESOURCE FOR LINKING ENVIRONMENTAL HEALTH INFORMATION TO THE HEALTHY PEOPLE 2010 OBJECTIVE IS THE PARTNERS IN INFORMATION ACCESS FOR PUBLIC HEALTH PROFESSIONALS -- HEALTHY PEOPLE 2010 INFORMATION ACCESS PROJECT FOUND AT... THE SITE LINKS YOU TO INFORMATION RELATED TO HEALTHY PEOPLE 2010. A MAIN FEATURE IS THE LINK TO THE SCIENTIFIC LITERATURE VIA PubMed. CLICK ON "ENVIRONMENTAL HEALTH" TO SEE WHAT INFORMATION IS AVAILABLE. THE FIRST ITEM ON THE PAGE IS THE LINK TO THE HEALTHY PEOPLE 2010 ENVIRONMENTAL HEALTH CHAPTER, WHICH WE LOOKED AT EARLIER. FURTHER DOWN, YOU CAN SEE HEALTHY PEOPLE 2010 ENVIRONMENTAL HEALTH OBJECTIVES WITH RELATED LINKS. FOR EXAMPLE, UNDER "WATER QUALITY," THERE ARE TWO LINKS. THE FIRST GOES TO MEDLINEplus TOPIC ON DRINKING WATER FOR LINKS TO FULL-TEXT RESOURCES FOR THE PUBLIC. MEDLINEplus, AS GREG MENTIONED EARLIER, IS NLM'S CONSUMER HEALTH DATABASE. THE SECOND LINK FOR HEALTHY PEOPLE 2010 AND ENVIRONMENTAL HEALTH WATER QUALITY TAKES US TO A LIST OF GOVERNMENT AGENCIES AND ORGANIZATIONS THAT HAVE RESOURCES ON WATER QUALITY. THIS SITE WAS CREATED BY THE PUBLIC HEALTH FOUNDATION TO HELP HEALTH PROFESSIONALS FIND ADDITIONAL INFORMATION TO ASSIST THEM IN DEVELOPING PLANS TO MEET HEALTHY PEOPLE 2010 OBJECTIVES. LET'S GO BACK TO THE PARTNERS ENVIRONMENTAL HEALTH SITE. AS YOU SCROLL DOWN, YOU'LL NOTICE BIG RED BUTTONS NEXT TO EACH OBJECTIVE AS SEEN HERE, NEXT TO SECTION 8-16, INDOOR AIR. THE RED BUTTON MEANS THAT AN EVIDENCE-BASED SEARCH STRATEGY WAS CREATED ON THE TOPIC IN PubMed. THESE SEARCH STRATEGIES FOCUS ON RETRIEVING REFERENCES TO PUBLIC HEALTH MODELS, INTERVENTIONS, OR GUIDELINES. THIS IS A WAY FOR YOU TO EASILY SEARCH THE DATABASE WITHOUT HAVING TO DEVELOP YOUR OWN SEARCH STRATEGY. LET'S CLICK ON THE BUTTON NEXT TO INDOOR AIR. WE ARE TAKEN TO THE SEARCH -- RESULTS IN PubMed FOR THE SEARCH. HOWEVER, THE SEARCH IS NOT FOCUSED ONLY ON CHILDREN. WE CAN EASILY MODIFY THE SEARCH BY CLICKING ON "LIMITS." GO TO THE DROPDOWN BOX, "AGES." HERE YOU CAN HIGHLIGHT THE AGE YOU ARE INTERESTED IN. LET'S SELECT "ALL CHILD." CLICK ON "GO" UP NEAR THE TOP OF THE SEARCH PAGE. AND NOW WE'RE BACK AT PubMed'S SEARCH RESULTS PAGE AND HAVE 21 REFERENCES ALL RELATED TO CHILDREN AND INDOOR-AIR QUALITY, SUCH AS THE SECOND REFERENCE ON SOCIAL DEMOGRAPHIC CORRELATES OF INDOOR-ALLERGEN SENSITIVITY AMONG UNITED STATES' CHILDREN. >> THANK YOU, ROSE. THESE RESOURCES SHOULD HELP THOSE IN OUR AUDIENCE DEVELOP AND IMPLEMENT LOCAL PLANS TO ACHIEVE THE HEALTHY PEOPLE 2010 GOALS. WE'LL TURN NOW TO OUR FIFTH SUBJECT ON FOOD SAFETY, SPECIFICALLY METHYLMERCURY AND PREGNANCY. THERE HAVE BEEN A NUMBER OF RECENT CASES CONCERNING THE CONTAMINATION OF FOOD EITHER BY CHEMICAL OR BIOLOGICAL AGENTS. WE'VE ALL HEARD ABOUT SALMONELLA IN EGGS, E. COLI IN MEAT, AND LISTERIA IN LUNCHMEAT AND CHEESE. PROPER PREPARATION OF THESE FOODS CAN OFTEN PREVENT ILLNESS, BUT IN SOME CASES, THERE IS NO WAY TO DECONTAMINATE THE FOOD. MERCURY CONTAMINATION OF FISH IS A GOOD EXAMPLE. ON THE ONE HAND, EXPERTS TELL US THAT FISH IS GOOD FOR US, AND THEN WE HEAR THAT FISH CONTAMINATED WITH MERCURY, OR MORE SPECIFICALLY METHYLMERCURY, IS DANGEROUS, ESPECIALLY FOR YOUNG CHILDREN AND PREGNANT WOMEN. STACEY, CAN YOU SHOW US SOME WEBSITES THAT WILL GIVE INFORMATION ABOUT WHAT TYPES OF FISH MAY BE CONTAMINATED AND HOW TO DETERMINE SAFE AMOUNTS OF FISH TO EAT? >> SURE, JOE. FIRST, LET'S EXAMINE SOME SOURCES FOR INFORMATION ON SAFE FISH CONSUMPTION. ONE SUCH SITE IS FROM THE FOOD AND DRUG ADMINISTRATION'S CENTER FOR FOOD SAFETY AND APPLIED NUTRITION. THE ADDRESS IS... IT CONTAINS DOCUMENTS THE FDA USED IN MAKING DECISIONS FOR THE METHYLMERCURY ADVISORY. THE INFORMATION WAS INITIALLY ISSUED IN JANUARY OF 2001 AND REISSUED IN MARCH 2001 WITH A CLARIFICATION. UNDER THE FDA METHYLMERCURY ADVISORY HEADING, CLICK ON THE FIRST PDF FILE FOR THE REVISED FDA CONSUMER ADVISORY. IT'S TITLED "AN IMPORTANT MESSAGE FOR PREGNANT WOMEN AND WOMEN OF CHILDBEARING AGE WHO BECOME PREGNANT ABOUT THE RISKS OF MERCURY IN FISH." THE ADVISORY STRESSES THAT SEAFOOD CAN BE AN IMPORTANT PART OF A BALANCED DIET FOR PREGNANT WOMEN, CAN BE A GOOD SOURCE OF HIGH-QUALITY PROTEIN AND OTHER NUTRIENTS, AND IS LOW IN FAT. THE SITE READS, "BY BEING INFORMED ABOUT METHYLMERCURY AND KNOWING THE KINDS OF FISH THAT ARE SAFE TO EAT, YOU CAN PREVENT ANY HARM TO YOUR UNBORN CHILD AND STILL ENJOY THE HEALTH BENEFITS OF EATING SEAFOOD." THIS ADVISORY RECOMMENDS THAT PREGNANT WOMEN, WOMEN PLANNING TO BECOME PREGNANT, NURSING MOTHERS, AND SMALL CHILDREN CONSUME NO MORE THAN 12 OUNCES OF FISH A WEEK. ALSO CERTAIN LARGE, LONG-LIVING FISH, SUCH AS SHARK AND MACKEREL, SHOULD NOT BE CONSUMED IN ANY QUANTITY AS THEIR SIZE AND LIFE SPAN CAN ALLOW METHYLMERCURY TO ACCUMULATE. NOW, WE'RE GOING TO USE THE BACK BUTTON TO RETURN TO THE LIST OF DOCUMENTS USED BY FDA IN MAKING ITS RECOMMENDATIONS ON METHYLMERCURY. THE NEXT ITEM UNDER THE FDA METHYLMERCURY ADVISORY IS A TABLE CONTAINING MERCURY LEVELS IN SEAFOOD. THIS IS USEFUL IN DETERMINING WHICH FISH ARE THE SAFEST TO EAT. NOW WE CAN GO BACK A PAGE AND AS YOU SCROLL DOWN, YOU'LL FIND INFORMATION ABOUT THE ADVERSE EFFECTS OF METHYLMERCURY FROM NUMEROUS SOURCES, SUCH AS THE NATIONAL ACADEMY OF SCIENCES, THE AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY, THE DEPARTMENT OF AGRICULTURE, AND THE WORLD HEALTH ORGANIZATION. I WOULD LIKE TO NOTE THAT THE FDA RECENTLY ANNOUNCED THAT IT WILL SOON SCHEDULE A MEETING OF ITS FOOD ADVISORY COMMITTEE TO REVIEW ISSUES SURROUNDING METHYLMERCURY IN COMMERCIAL SEAFOOD. THIS REVIEW WILL INCLUDE A RE-EXAMINATION OF FDA'S MOST RECENT CONSUMER ADVISORY THAT WE JUST LOOKED AT. PLEASE CHECK BACK AT THEIR WEBSITE IN THE FUTURE FOR POSSIBLE UPDATES. ANOTHER SOURCE FOR INFORMATION ON THE TOPIC IS THE ENVIRONMENTAL PROTECTION AGENCY OR EPA. THEY ARE WORKING TO REDUCE THE AMOUNT OF MERCURY IN THE ENVIRONMENT. WE CAN BEGIN AT EPA'S OFFICE OF SCIENCE AND TECHNOLOGY, FISH AND WILDLIFE CONTAMINATION PAGE AT www.epa.gov/waterscience/fish. NUMEROUS RESOURCES BOTH FROM THE EPA AND OTHER ORGANIZATIONS ARE LISTED. SOME OF THESE TARGET HEALTH PROFESSIONALS SUCH AS THE LINK TO THE LETTER TO HEALTH PROFESSIONALS AND THE OUTREACH MATERIALS FOR COMMUNICATING FISH ADVISORY INFORMATION. OTHERS TARGET CONSUMERS LIKE THE LINK TO THE NATIONAL ADVICE FOR WOMEN AND CHILDREN ON MERCURY IN NONCOMMERCIAL FISH. LET'S SEE IF THIS ADVISORY PROVIDES SOME GUIDANCE ABOUT THE NUTRITIONAL VALUE OF FISH VERSUS THE POSSIBLE HARMFUL EFFECTS OF MERCURY. IT IS SIMILAR TO THE FDA ADVISORY, BUT IT DOES CAUTION THAT PREGNANT WOMEN SHOULD LIMIT THEIR CONSUMPTION OF FISH TO ONLY 6 TO 8 OUNCES PER WEEK AND CHILDREN TO 2 OUNCES PER WEEK. NOW, THIS INFORMATION SEEMS TO CONTRADICT WHAT WE LOOKED AT PREVIOUSLY ON THE FOOD AND DRUG ADMINISTRATION'S SITE. THE FDA CAUTIONED NOT TO CONSUME MORE THAN 12 OUNCES PER WEEK. BUT IF YOU READ CAREFULLY, HOWEVER, NOTICE THAT THE EPA SITE ADDRESSES WHAT SEEMS TO BE A DISCREPANCY. WOMEN MAY SAFELY EAT UP TO 12 OUNCES OF STORE-BOUGHT FISH PER WEEK, INCLUDING THAT SERVED IN RESTAURANTS, BUT LESSER AMOUNTS OF FISH CAUGHT BY INDIVIDUALS, OR WHAT IS KNOWN AS NONCOMMERCIALLY CAUGHT FISH. IN ADDITION TO THE ADVISORIES, THIS SITE ALSO PROVIDES INFORMATION TO ASSIST THE LOCAL HEALTH DEPARTMENTS IN CREATING THEIR OWN FISH-CONSUMPTION WARNINGS. NOW WE'RE GOING TO GO BACK A PAGE AND UNDER THE REPORT AND CHEMICAL-SPECIFIC FACT SHEETS, THERE'S A LINK TO A MERCURY UPDATE, THE IMPACT ON FISH ADVISORIES. CLICK ON THIS FACT SHEET. THE PURPOSE OF IT IS TO SUMMARIZE CURRENT INFORMATION ON SOURCES, FATE AND TRANSPORT, OCCURRENCE IN HUMAN TISSUE, RANGE OF CONCENTRATIONS IN FISH TISSUE, FISH ADVISORIES, FISH-CONSUMPTION LIMITS, TOXICITY, AND REGULATIONS FOR MERCURY. WE GO BACK A PAGE, WE CAN SEE THAT THE COMPLETE NATIONAL GUIDANCE FOR ASSESSING CHEMICAL CONTAMINANT DATA FOR USE IN FISH ADVISORIES IS ALSO AVAILABLE. THIS DOCUMENT CONTAINS INFORMATION FROM FISH-SAMPLING PROCEDURES TO ASSESSING THE RISK AND SETTING FISH-CONSUMPTION LIMITS. YOU CAN ALSO VIEW FISH ADVISORIES FOR INDIVIDUAL STATES BY SEARCHING THE NATIONAL LISTING OF FISH AND WILDLIFE CONSUMPTION ADVISORIES DATABASE COMPILED BY THE EPA. MANY STATES HAVE ISSUED ADVISORIES FOR FISH OBTAINED FROM SPECIFIC BODIES OF WATER. WE DON'T HAVE TIME IN THE BROADCAST TO DEMONSTRATE THIS SITE, BUT YOU MAY WANT TO LOOK AT IT LATER. YOU CAN LINK TO THE DATABASE FROM THE www.epa.gov/waterscience/fish WEBSITE. FOR MORE INFORMATION ON THE ADVERSE EFFECTS OF METHYLMERCURY, DON'T FORGET TO SEARCH OTHER DATABASES SUCH AS THE HAZARDOUS SUBSTANCES DATABANK THAT WE DISCUSSED EARLIER IN THE BROADCAST. >> THANK YOU, STACEY, FOR PROVIDING HEALTH PROFESSIONALS USEFUL INFORMATION ON THE CONTAMINATION OF FISH WITH METHYLMERCURY AND HOW TO DEVELOP SAFE FISH-CONSUMPTION GUIDELINES AND COMMUNICATE THEM TO THE PUBLIC. NOW LET'S GO TO OUR FINAL TOPIC -- THE USE OF GEOGRAPHIC INFORMATION SYSTEMS FOR PUBLIC HEALTH. MANY PEOPLE ARE CONCERNED ABOUT POLLUTION IN THEIR COMMUNITIES AND PUBLIC HEALTH PROFESSIONALS ARE OFTEN ASKED TO PROVIDE INFORMATION ABOUT POTENTIAL HEALTH CONCERNS FROM POLLUTION. BUT WHERE CAN YOU GO FOR INFORMATION ABOUT HAZARDOUS WASTE SITES OR RELEASES OF TOXIC CHEMICALS INTO YOUR NEIGHBORHOODS, AND WHERE CAN YOU GET RELIABLE INFORMATION CONCERNING THE CHEMICALS FOUND IN YOUR COMMUNITY? ROSE, CAN YOU ASSIST OUR AUDIENCE IN IDENTIFYING THESE TYPES OF RESOURCES? >> OF COURSE, JOE. THERE ARE A NUMBER OF INTERNET RESOURCES AVAILABLE FOR IDENTIFYING AND LOCATING POLLUTION SOURCES. IN SOME CASES, THIS INFORMATION IS FURTHER LINKED TO TOXICOLOGICAL DATA ABOUT THE SPECIFIC CHEMICALS AND TO HEALTH ASSESSMENTS OF POLLUTING SITES. SOME OF THESE SYSTEMS ARE JUST TEXT-BASED, BUT, INCREASINGLY, MANY ALLOW FOR MAPPING OF ENVIRONMENTAL DATA, ALONG WITH OTHER TYPES OF DATA SUCH AS DEMOGRAPHICS AND THE LOCATIONS OF SCHOOLS AND ROADS. THESE SYSTEMS ARE CALLED GEOGRAPHIC INFORMATION SYSTEMS OR G.I.S. LET'S TAKE A LOOK AT SCORECARD, A G.I.S. SYSTEM DEVELOPED BY ENVIRONMENTAL DEFENSE. ENTER THE URL... SCORECARD TRACKS MANY HAZARDS ACROSS THE NATION, INCLUDING AIR POLLUTANTS, LEAD HAZARDS, LAND CONTAMINATION, ANIMAL WASTE FROM FACTORY FARMS, TOXIC RELEASES FROM INDUSTRY, AS WELL AS THE STATUS OF THE CLEAN WATER ACT AND WATERSHED INDICATORS. USERS CAN EASILY GET AN ENVIRONMENTAL REPORT CARD ON THEIR COMMUNITIES BY ENTERING THEIR ZIP CODE ON THE RIGHT-HAND SIDE OF THE SCREEN UNDER "FIND YOUR COMMUNITY." ENTER THE ZIP CODE 26559, WHICH IS IN MARION COUNTY, WEST VIRGINIA. WE CAN RETRIEVE STATISTICS ON AIR QUALITY AND LAND AND WATER POLLUTION FROM MARION COUNTY. SCROLL TO THE CATEGORY "WASTE" TO LINK TO REPORTS ON THE FACILITIES POLLUTING THE COMMUNITY AND TO INFORMATION ON THE CHEMICAL POLLUTANTS. AT THE END OF THE PAGE, THERE IS A LINK TO AVAILABLE MAPS. CLICK ON "EXPLORE THE MAPS" TO SEE A MAP OF MARION COUNTY AND THE SURROUNDING AREA. THROUGH THE SELECT VIEW DROPDOWN BOX, YOU CAN SELECT THE TYPE OF MAP TO VIEW, SUCH AS TOXIC RELEASES, SUPERFUND SITES, OR AIR QUALITY. LET'S KEEP THE DEFAULT TOXIC RELEASE INVENTORY. TO THE RIGHT OF THE MAP, THE GRAPH RELATED TO THE TYPE OF POLLUTION SELECTED IS DISPLAYED. CLICKING ON THE MAP ALLOWS YOU TO ZOOM IN OR OUT, OR YOU CAN GENERATE A REPORT ON MARION COUNTY WITH INFORMATION ABOUT THE HEALTH EFFECTS OF CHEMICALS RELEASED IN THE ENVIRONMENT. CLICK ON T.R.I. POLLUTION SOURCES SORTED BY HEALTH EFFECT. NOTE THAT THE LINKS TO KNOWN AND SUSPECTED DEVELOPMENTAL AND REPRODUCTIVE TOXICANTS ARE LISTED. CLICK ON THE NUMBER OF POUNDS RELEASED NEXT TO THE SUSPECTED DEVELOPMENTAL TOXICANTS TO RETRIEVE A LIST OF CHEMICALS RELEASED IN MARION COUNTY THAT HAVE THAT CLASSIFICATION. FROM THIS PAGE, CLICK ON "METHYL ETHYL KETONE" FOR INFORMATION ON ITS HEALTH EFFECTS USED IN INDUSTRY AND REGULATORY COVERAGE. LINKS TO ADDITIONAL RESOURCES SUCH AS ATSDR AND EPA FACT SHEETS ON METHYL ETHYL KETONE ARE ALSO AVAILABLE FROM THIS PAGE. THESE ARE JUST A FEW OF THE FEATURES AVAILABLE ON SCORECARD. ADDITIONAL FEATURES INCLUDE AN ENVIRONMENTAL JUSTICE REPORT, PROVIDING DEMOGRAPHIC INFORMATION INCLUDING DISTRIBUTIONS OF ENVIRONMENTAL BURDENS BY RACE, ETHNICITY, INCOME, CHILDHOOD, POVERTY, EDUCATION, AND HOMEOWNERSHIP. NOW LET'S TAKE A LOOK AT ANOTHER G.I.S. RESOURCE CALLED GATHER -- THE ACRONYM FOR... THIS SYSTEM IS AVAILABLE FROM ATSDR. ATSDR FOCUSES ON THE EFFECT OF HAZARDOUS SUBSTANCES ON PUBLIC HEALTH. SOME OF THE ATSDR FUNCTIONS INCLUDE CONDUCTING PUBLIC HEALTH ASSESSMENTS OF WASTE SITES, HEALTH CONSULTATIONS CONCERNING SPECIFIC HAZARDOUS SUBSTANCES, AND DEVELOPING HEALTH SURVEILLANCE AND REGISTRIES. GATHER PROVIDES PUBLIC HEALTH PROFESSIONALS WITH ACCESS TO SPACIAL DATA THAT IS PERTINENT TO THE ANALYSIS OF PUBLIC HEALTH ISSUES RELATED TO HAZARDOUS WASTE SITES. THE URL IS... HERE WE CAN CREATE A MAP OF HAZARDOUS WASTE SITES ANALYZED BY ATSDR. GATHER DOES NOT CONTAIN AS MANY SOURCES OF POLLUTION AS SCORECARD, BUT FOCUSES ON HAZARDOUS SITES ATSDR HAS ASSESSED. YOU CAN SEARCH BY CITY, COUNTY, STATE, OR ZIP CODE, OR EVEN BY THE FACILITY NAME. LET'S DO A CITY SEARCH BY CLICKING ON THE RADIO BUTTON NEXT TO "BY CITY" ON THE LEFT SIDE OF THE SCREEN UNDER "SEARCH FOR A SITE." I'LL TYPE IN FARMINGTON AND CHOOSE NEW HAMPSHIRE FROM THE DROPDOWN MENU AND CLICK ON "GO." THE RESULTS GIVE ME THE HAZARDOUS WASTE SITES IN THAT CITY. IN THIS CASE, JUST THE CARDINAL LANDFILL. CLICK ON THE NAME OF THE SITE TO DRAW THE MAP. THE MAP SHOWS THE LOCATION OF THE COMPANY. ON THE LEFT-HAND SIDE OF THE MAP IN THE LEGEND AREA, SELECT ADDITIONAL ITEMS TO BE DISPLAYED. FOR EXAMPLE, SCROLL DOWN AND LOOK AT DEMOGRAPHIC INFORMATION FOR CHILDREN UNDER 6 YEARS OLD NEAR THE COMPANY. LOCATE ON THE BOX IN FRONT OF THE SELECTION AND THE MAP WILL BE REDRAWN. NOW CLICK ON "ROADS" AND GET A BETTER IDEA OF WHERE THE SITE IS LOCATED. NOW LET'S TAKE A LOOK AT THE ICONS AT THE TOP OF THE MAP, THE TOOL BAR. THESE ICONS ARE TOOLS TO GET MORE INFORMATION ABOUT THE AREA. LET'S DISCUSS JUST A FEW OF THEM. THE FIRST ONE, WHICH LOOKS LIKE A HAND, ALLOWS YOU TO MOVE THE MAP OR PAN. THE ONES THAT LOOK LIKE MAGNIFYING GLASSES WITH A PLUS OR MINUS IN THE MIDDLE ALLOWS YOU TO ZOOM IN OR OUT. THE MOST IMPORTANT ONE TO REMEMBER IS THE QUESTION MARK. THIS IS THE HELP ICON AND CAN GIVE YOU MORE INFORMATION ON HOW TO USE GATHER. A LINK IS ALSO PROVIDED TO A DEMOGRAPHIC MAP IN PDF FORMAT FOR EASY PRINTING. NOW THAT WE HAVE THE NAME AND EXACT LOCATION OF THE HAZARDOUS WASTE SITE, LET'S GET MORE INFORMATION ABOUT STUDIES CONDUCTED BY ATSDR ON THE SITE. CLICK ON "ATSDR SITE DOCS" TO OBTAIN ANY DOCUMENTS THAT MAY BE AVAILABLE. SCROLLING ACROSS THE PAGE, YOU CAN SEE THAT THE TABLE LISTS THE NAME OF THE SITE, THE TYPE OF DOCUMENTS PREPARED BY ATSDR, THE DATE THEY WERE COMPLETED, AND WHETHER THE SITE POSES A PUBLIC HEALTH HAZARD. IN SOME CASES, THE FULL TEXT OF THE DOCUMENT IS AVAILABLE ONLINE. FOR THE CARDINAL LANDFILL, WE SEE THE FULL TEXT OF THE PUBLIC HEALTH ASSESSMENT IS AVAILABLE. CLICK ON "VIEW TEXT" TO RETRIEVE THE DOCUMENT. SCROLLING DOWN THE TABLE OF CONTENTS, WE SEE SECTION 5 IS A DISCUSSION OF ADULT AND CHILDREN'S HEALTH ISSUES. AND SECTION 6 PROVIDES CONCLUSIONS ABOUT THE SITE. LET'S CLICK ON "CONCLUSIONS." THE REPORT INDICATES THAT THE SITE WAS A PUBLIC HEALTH HAZARD IN THE PAST AND THAT FOR SOME OF THE DRINKING WELLS, THE KNOWN EXPOSURES WERE UNLIKELY TO RESULT IN NONCANCER HEALTH EFFECTS FOR ADULT RESIDENTS, BUT COULD HAVE AFFECTED YOUNG CHILDREN OR DEVELOPING FETUSES. HOWEVER, RESIDENTS NOW RECEIVE DRINKING WATER FROM THE TOWN'S WATER SUPPLY AND ARE NO LONGER AT RISK FOR EXPOSURE. MORE DETAILED INFORMATION ON HEALTH CONCERNS, HOW THE SITE WAS ANALYZED, AND ON WHAT BASIS DECISIONS WERE MADE ARE ADDRESSED IN SECTIONS ONE THROUGH FIVE. BUT PLEASE NOTE THAT NOT ALL OF THE ATSDR PUBLIC HEALTH ASSESSMENT DOCUMENTS ARE AVAILABLE ONLINE YET. THERE ARE OTHER G.I.S. SYSTEMS FOR MAPPING ENVIRONMENTAL DATA, WHICH ARE LISTED IN YOUR RESOURCES SAMPLER. >> THESE SYSTEMS SEEM QUITE COMPLICATED, ROSE. ARE THEY DESIGNED FOR THE NOVICE INTERNET USER? >> THEY CAN BE QUITE TRICKY. HOWEVER, THE G.I.S. SOFTWARE IS RAPIDLY EVOLVING, WHICH MEANS THAT THERE ARE CONSTANT IMPROVEMENTS TO THE MAPPING SYSTEMS, MAKING THEM EASIER TO USE. I THINK OUR AUDIENCE WILL SEE MAJOR ENHANCEMENTS IN THESE SYSTEMS OVER THE NEXT COUPLE OF YEARS. IN THE MEANTIME, THEY ARE IMPORTANT RESOURCES AND CAN PROVIDE A WEALTH OF DATA FOR PUBLIC HEALTH PROFESSIONALS TO USE WHEN ADDRESSING HEALTH HAZARDS IN THEIR COMMUNITIES. SO I THINK IT'S WORTH THE EXTRA EFFORT TO BECOME FAMILIAR WITH THEM. >> THANK YOU, ROSE, FOR THAT OVERVIEW OF GEOGRAPHIC INFORMATION SYSTEMS. WE'RE GOING TO POSE A PROBLEM TO YOU, THE AUDIENCE. PUBLIC HEALTH PROFESSIONALS ARE OFTEN ASKED ABOUT THE SAFETY OF DRINKING WATER. THERE'S CONCERN FOR BIOLOGICAL CONTAMINANTS SUCH AS CRYPTOSPORIDIUM, AS WELL AS CHEMICAL CONTAMINANTS LIKE LEAD AND NITRATES. IN ADDITION, DRINKING-WATER QUALITY VARIES FROM PLACE TO PLACE DEPENDING ON THE CONDITION OF THE SOURCE WATER AND THE TREATMENT IT RECEIVES. SUPPOSE YOUR HEALTH DEPARTMENT SERVES A LARGE AGRICULTURAL COMMUNITY. LAST YEAR, A NEARBY COUNTY EXPERIENCED PROBLEMS WITH HIGH LEVELS OF NITRATES IN THE WATER SUPPLY FROM RUNOFF OF FERTILIZERS. YOU'RE CONCERNED THAT A SIMILAR PROBLEM COULD AFFECT YOUR AREA. A MAJOR HEALTH CONCERN OF HIGH NITRATE LEVELS IN WATER IS METHEMOGLOBINEMIA, A CONDITION ESPECIALLY FOUND IN INFANTS UNDER 6 MONTHS. THIS SERIOUS ILLNESS IS DUE TO THE CONVERSION OF NITRATE TO NITRITE IN THE BODY, WHICH CAN INTERFERE WITH THE OXYGEN-CARRYING CAPACITY OF THE CHILD'S BLOOD. PREGNANT WOMEN ARE ALSO SUSCEPTIBLE TO NITRITE-INDUCED METHEMOGLOBINEMIA. NOW YOU NEED TO DEVISE A PLAN TO ADVISE COMMUNITY OFFICIALS AND THE PUBLIC. OKAY. NOW LET'S HEAR FROM YOU, OUR AUDIENCE, ON WHERE TO GO TO FIND INFORMATION ON DRINKING-WATER CONTAMINATION. AND WE HAVE CINDY FROM COLORADO ON THE PHONE. CINDY? HELLO? >> HI. >> HI. >> I THINK I KNOW OF SEVERAL GOOD SOURCES OF INFORMATION ON THIS TOPIC. >> OKAY. >> FIRST I WOULD GO TO EPA SINCE THEY'RE RESPONSIBLE FOR THE SAFETY OF PUBLIC DRINKING-WATER SYSTEMS AND ALSO HAVE INFO ON TESTING PRIVATE WELLS. THEY ALSO HAVE FACT SHEETS ON WATER CONTAMINANTS INCLUDING NITRATES. I THINK THE WORLD HEALTH ORGANIZATION AND THE NATIONAL ENVIRONMENTAL EDUCATION AND TRAINING FOUNDATION ALSO HAVE GUIDELINES. FOR SCIENTIFIC BACKGROUND INFORMATION ON THE NITRATES AND OTHER CHEMICALS YOU MIGHT FIND IN WATER, I WOULD CHECK THE TOXNET DATABASES, ESPECIALLY HSDB OR TOXLINE. WHEN I'M PREPARING A TALK FOR COMMUNITY GROUPS, I OFTEN FIND MATERIALS ON MEDLINEplus THAT ARE SUITABLE FOR A GENERAL AUDIENCE, AND I CONTACT MY STATE HEALTH DEPARTMENT OR ENVIRONMENTAL PROTECTION DEPARTMENT FOR MORE LOCAL INFORMATION. >> OKAY. ALL RIGHT. VERY GOOD. THANK YOU VERY MUCH FOR THAT INFORMATION. THAT'S ALL THE TIME WE HAVE FOR OUR PROBLEM SCENARIO. NOW LET'S HEAR FROM DR. WILLIAM YASNOFF, CDC REPRESENTATIVE FOR THE PARTNERS IN INFORMATION ACCESS FOR PUBLIC HEALTH PROFESSIONALS GROUP. >> THE PURPOSE OF THE PARTNERS IN INFORMATION ACCESS FOR PUBLIC HEALTH PROFESSIONALS IS TO IMPROVE ACCESS TO ONLINE ELECTRONIC PUBLIC HEALTH INFORMATION FOR PUBLIC HEALTH PROFESSIONALS. IT'S A PARTNERSHIP OF TWO DIFFERENT TYPES OF ORGANIZATIONS -- PUBLIC HEALTH ORGANIZATIONS SUCH AS APHA, ASPH, ASTHO, NHO, PUBLIC HEALTH FOUNDATION -- IN PARTNERSHIP WITH GOVERNMENT AGENCIES SUCH AS THE NATIONAL LIBRARY OF MEDICINE AND ITS NATIONAL NETWORK OF LIBRARIES OF MEDICINE, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, AND HEALTH RESOURCES AND SERVICES ADMINISTRATION. THE PARTNERSHIP HAS BEEN INVOLVED IN A NUMBER OF ACTIVITIES SPONSORING MEETINGS, SPONSORING SATELLITE BROADCASTS FOR TRAINING SUCH AS THIS ONE, AND ALSO PROVIDING SMALL GRANTS FOR CONNECTIVITY TO THE INTERNET TO IMPROVE INFORMATION ACCESS. SOME OF THE SUCCESSFUL PROJECTS THAT HAVE BEEN COMPLETED BY THE PARTNERSHIP INCLUDE A MAJOR AIDS-TRAINING BROADCAST SIMILAR TO THIS ONE. ALSO THE TRAINING SUBCOMMITTEE HAS COMPLETED A NUMBER OF TASKS INCLUDING AN INVENTORY OF INFORMATION-ACCESS TRAINING RESOURCES, WHICH HAS BEEN CONTRIBUTED TO THE PUBLIC HEALTH FOUNDATION'S DATABASE CALLED trainingfinder.org, WHICH IS AVAILABLE ON THE WEB. ALSO A BIBLIOGRAPHY OF PUBLIC HEALTH TRAINING. FINALLY, THAT GROUP HAS RECOMMENDED CHANGES TO MEDLINE TO MAKE ACCESS TO PUBLIC HEALTH LITERATURE EASIER AND FASTER. AND THOSE CHANGES HAVE BEEN ADOPTED. >> THANK YOU, DR. YASNOFF. BEFORE TAKING YOUR QUESTIONS, STACEY WOULD LIKE TO DIRECT YOUR ATTENTION TO JUST A FEW MORE RESOURCES ON CHILDREN'S ENVIRONMENTAL HEALTH. >> JOE, IT'S AMAZING HOW MANY RESOURCES YOU CAN FIND ON THE WEB ON THIS TOPIC. DURING THIS BROADCAST, WE'VE DEMONSTRATED SOME OF THE MAJOR RESOURCES AVAILABLE FOR PUBLIC HEALTH PROFESSIONALS AND SHOWN HOW THEY MIGHT ASSIST YOU WITH YOUR WORK OR RESEARCH. AS WE MENTIONED EARLIER, THE COURSE MATERIALS FOR THIS BROADCAST ARE ON THE PARTNERS AND INFORMATION ACCESS FOR PUBLIC HEALTH PROFESSIONALS WEBSITE AND CONTAIN LINKS TO THE RESOURCES DISCUSSED TODAY. HOWEVER, THERE ARE ADDITIONAL TOPICS THAT WE DID NOT HAVE AN OPPORTUNITY TO COVER, SO WE HAVE INCLUDED AN EXTENSIVE SAMPLER WITH LINKS TO RESOURCES ON THESE OTHER TOPICS. GO TO THE BROADCAST WEBSITE AT... AND CLICK ON THE "CHILDREN'S ENVIRONMENTAL HEALTH RESOURCES SAMPLER." LET'S TAKE A QUICK LOOK AT A FEW OF THESE RESOURCES. TWO VERY IMPORTANT ISSUES THESE DAYS, BUT ONES THAT WE DID NOT HAVE A CHANCE TO DISCUSS, ARE CHILDHOOD CANCER AND CANCER CLUSTERS AND ENDOCRINE DISRUPTERS. THE SAMPLER CONTAINS LINKS TO SEVERAL IMPORTANT RESOURCES ON BOTH OF THESE TOPICS, AS SEEN HERE FOR CHILDHOOD CANCER AND CANCER CLUSTERS. LINKS ARE ALSO PROVIDED TO SEVERAL COMPUTER-BASED LEARNING APPLICATIONS IN PEDIATRIC ENVIRONMENTAL HEALTH AND TOXICOLOGY, SUCH AS THESE CASE STUDIES PRODUCED BY THE UNIVERSITY OF ILLINOIS AT CHICAGO AND THE UNIVERSITY OF UTAH. IN ADDITION, SEVERAL CONSUMER HEALTH RESOURCES ARE INCLUDED TO ASSIST YOU IN EDUCATING THE PUBLIC ABOUT ENVIRONMENTAL HAZARDS TO CHILDREN, INCLUDING THE ATSDR ToxFAQs, MEDLINEplus, AND THE NEW YORK ONLINE ACCESS TO HEALTH. I WOULD ALSO LIKE TO HIGHLIGHT THE NATIONAL CHILDREN'S STUDY OF ENVIRONMENTAL EFFECTS ON CHILD HEALTH AND DEVELOPMENT. THEIR ADDRESS IS www.nichd.nih.gov/about/despr/ cohort/index.htm. THE PURPOSE IS TO CONDUCT A LONGITUDINAL STUDY OF ENVIRONMENTAL INFLUENCES ON CHILDREN'S HEALTH AND DEVELOPMENT. THE IDEA IS TO FOLLOW CHILDREN FROM BEFORE BIRTH TO ADULTHOOD. ENVIRONMENTAL INFLUENCES ARE BROADLY DEFINED AS BIOLOGICAL, PHYSICAL, AND PSYCHOSOCIAL INFLUENCES. THIS PROJECT IS IN THE PLANNING PHASE AND IS BEING DEVELOPED BY SEVERAL FEDERAL AGENCIES WITH THE NATIONAL INSTITUTE FOR CHILD HEALTH AND HUMAN DEVELOPMENT AT N.I.H. AS THE LEAD AGENCY. AND MORE INFORMATION ON THE STUDY IS AVAILABLE FROM NICHD. ANOTHER USEFUL FEDERAL RESOURCE IS A DATABASE OF ALL FEDERALLY FUNDED RESEARCH RELATED TO ADVERSE HEALTH EFFECTS IN CHILDREN FROM EXPOSURE TO ENVIRONMENTAL HEALTH OR SAFETY RISKS. THIS COMPREHENSIVE DATABASE IS CALLED CHEHSIR FOR CHILDREN'S ENVIRONMENTAL HEALTH AND SAFETY INVENTORY OF RESEARCH. THE URL IS... oaspub.epa.gov/chehsir/ chehsir.page. RECORDS IN THE DATABASE INCLUDE THE TITLE AND DESCRIPTION OF THE PROJECT, INVESTIGATORS' NAMES AND ADDRESSES, STUDY CHARACTERISTICS, AGENTS, AND HEALTH EFFECTS, CONDITIONS, OR OUTCOMES. CHEHSIR COMPLEMENTS ANOTHER OF NLM'S TOXNET DATABASES, THE DEVELOPMENTAL AND REPRODUCTIVE TOXICOLOGY DATABASE OR DART. WHILE CHEHSIR DESCRIBES ONGOING RESEARCH PROJECTS, DART CITES THE PUBLISHED LITERATURE. YOU CAN ACCESS DART FROM THE TOXNET HOME PAGE AT toxnet.nlm.nih.gov. >> STACEY, I NOTICED THAT THE RESOURCE SAMPLER ONLY INCLUDES WEB LINKS TO A FEW SPECIFIC CHEMICAL AGENTS, SUCH AS MERCURY AND LEAD. BUT WHERE WOULD OUR AUDIENCE FIND INFORMATION ON CHEMICALS NOT LISTED HERE? >> THAT'S A GOOD QUESTION. SOME OF THE DATABASES DEMONSTRATED TODAY AND MANY OF THE RESOURCES LISTED IN THE GENERAL ENVIRONMENTAL HEALTH SECTION OF THE SAMPLER WILL CONTAIN INFORMATION ON NUMEROUS CHEMICAL AGENTS. ATSDR, FOR EXAMPLE, HAS DETAILED TOXICOLOGY PROFILES AND CONSUMER-ORIENTED TOX FACTS FOR MANY CHEMICALS. AND THE TOXNET DATABASES LIKE HSDB AND TOXLINE CONTAIN INFORMATION ON THOUSANDS OF CHEMICALS. AND REMEMBER, IF YOU DON'T SEE THE TYPE OF RESOURCE YOU NEED IN THE SAMPLER, GREG'S PRESENTATION ON SEARCH ENGINES WILL ASSIST YOU IN LOCATING IT. >> THANK YOU, STACEY, FOR THOSE ADDITIONAL RESOURCES. IT'S NOW TIME FOR OUR PANELISTS TO HEAR YOUR QUESTIONS AND CONCERNS REGARDING INFORMATION ON CHILDREN'S ENVIRONMENTAL HEALTH. YOU CAN EITHER CALL IN OR FAX US YOUR QUESTIONS NOW. WE HAVE OUR FIRST FAX QUESTION HERE. STACEY, THIS QUESTION'S FOR YOU. IT READS, "YOU MENTIONED THAT FDA IS REVIEWING THE METHYLMERCURY AND FISH CONSUMPTION ADVISORY FOR PREGNANT WOMEN. THIS IS A BIG CONCERN IN MY AREA, AND OUR HEALTH DEPARTMENT HAS RECEIVED A NUMBER OF CALLS ABOUT IT. DO YOU KNOW IF THERE'S ANYTHING ON THE WEB TO TELL ME MORE ABOUT IT?" >> YES. THAT'S A GOOD QUESTION. SINCE IT WAS JUST RECENTLY RELEASED, FDA DID PUT OUT A PRESS RELEASE ON IT, AND YOU CAN ACCESS THAT PRESS RELEASE FROM THEIR WEBSITE. IF YOU JUST GO TO THEIR HOME PAGE, WHICH I BELIEVE IS JUST www.fda.gov, YOU CAN ACCESS THEIR PRESS RELEASES OR NEWS SECTION AND GET MORE INFORMATION ON THAT PRESS RELEASE. AND THAT'S A GOOD POINT. A LOT OF THESE WEBSITES HAVE INFORMATION ON NEWS OR PRESS RELEASES THAT ARE RELEVANT TO THEIR AREAS. FOR EXAMPLE, I ALSO MENTIONED ABOUT THE CCA PROBLEM, AND THE EPA ADMINISTRATOR MADE SOME ANNOUNCEMENTS ABOUT THAT. EPA ALSO HAS A NEWSROOM OR PRESS-RELEASE SECTION YOU CAN GET MORE INFORMATION ON THAT. >> OKAY. I HAVE A FAX QUESTION FOR ROSE. THIS ONE READS, "IN MANY CASES, I ONLY HAVE A TRADE NAME FOR A PESTICIDE OR OTHER CHEMICAL THAT I NEED INFORMATION ON. WHERE CAN I GO TO GET THE GENERIC NAME SO I CAN GET MORE INFORMATION?" >> WELL, BY GOING TO TOXNET AND SELECTING THE CHEMICAL DATABASE, ChemIDplus, YOU'LL BE ABLE TO FIND MOST OF THE INFORMATION THAT YOU'RE LOOKING FOR AND MORE. NOT ONLY WILL YOU BE ABLE TO FIND THE TRADE OR GENERIC NAMES, BUT YOU CAN GET THE CASH-REGISTRY NUMBER. YOU CAN DO MOLECULAR STRUCTURE SEARCHING. YOU CAN FIND OUT HOW THE CHEMICAL IS CLASSIFIED. STACEY, DO YOU HAVE ANYTHING ELSE YOU MIGHT WANT TO ADD ON THAT? >> YEAH, IN FACT, YOU CAN PROBABLY JUST SEARCH ONE OF THE TOXNET DATABASES, LIKE HSDB OR TOXLINE, EVEN WITH YOUR TRADE NAME BECAUSE WE HAVE A BUILT-IN SYNONYM CHECKER THAT WILL LOOK FOR THAT TRADE NAME AND WILL SEARCH NOT ONLY THAT TRADE NAME BUT ALSO THE GENERIC NAME AND OTHER SYNONYMS FOR YOU AS WELL AUTOMATICALLY. >> OKAY. QUESTION HERE FOR YOU, GREG. "I AM INTERESTED IN FINDING FUNDING SOURCES FOR AN ASTHMA-INTERVENTION PROJECT IN MY COMMUNITY. ANY SUGGESTIONS ON HOW OR WHERE TO LOOK?" >> I WOULD START WITH SOME OF THE GOVERNMENT AGENCIES, SUCH AS THE CDC, THE NATIONAL HEART, LUNG, AND BLOOD INSTITUTE. THEY MAY HAVE, IN ADDITION TO THE GENERAL INFORMATION RESOURCES, FUNDING INFORMATION THAT MIGHT BE HELPFUL. IN ADDITION, I WOULD PROBABLY GO TO ONE OF THE GENERAL SEARCH ENGINES THAT I TALKED ABOUT AT THE BEGINNING AND PUT IN TERMS SUCH AS FUNDING, ASTHMA, INTERVENTION, LOOKING TO SEE IF THERE ARE OTHER RESOURCES FROM NONGOVERNMENT AGENCIES, COMMUNITY ORGANIZATIONS THAT MIGHT ALSO BE HELPFUL. >> OKAY. STACEY AND ROSE, YOU CAN TAG-TEAM THIS ONE AGAIN IF YOU WANT. "YOU DID A COUPLE OF DEMONSTRATIONS OF MEDLINE AND TOXLINE, BUT I'M STILL NOT QUITE SURE HOW TO FORMULATE GOOD SEARCHES. ARE THERE ANY TUTORIALS OR CLASSES I CAN TAKE?" >> WELL, I'LL TAKE THAT ONE. FOR PubMed, YOU'LL FIND A RELATIVELY VERY GOOD TUTORIAL. A LOT OF PEOPLE DON'T -- WILL NOT SOMETIMES LOOK AT THE SELF-HELPS THAT WE HAVE. BUT IF YOU LOOK ON THE RIGHT-HAND SIDE ON THE BAR, ON THE LEFT-HAND SIDE OF PubMed, YOU'LL SEE A TUTORIAL -- VERY GOOD ONE THAT YOU CAN TRY. AND TOXNET, THERE'S ALSO A HELP SECTION. IT'S NOT A TUTORIAL, BUT IT WILL ANSWER MOST OF THE QUESTIONS THAT YOU MAY HAVE AS YOU TRY TO FORMULATE YOUR SEARCH STRATEGIES. STACEY, ANYTHING ELSE YOU WANT TO ADD? >> NO, I THINK YOU'VE COVERED IT, ROSE. >> YOU'LL GET ANOTHER CHANCE, STACEY. ANOTHER QUESTION HERE, THIS ONE FROM ARKANSAS. "WHAT TYPE OF SITES ARE LOCATED ON THE ATSDR GATHER WEBSITE?" >> I ASSUME IN THIS CASE WHEN THEY SAY SITES, THEY'RE LOOKING AT THE HAZARDOUS WASTE SITES. I BELIEVE THEY LIST THE VARIOUS NATIONAL PRIORITY LIST HAZARDOUS WASTE SITES THAT ARE THERE. THEY ALSO -- ATSDR IS CALLED IN ANY TIME PEOPLE HAVE A CONCERN IN THEIR AREA ABOUT A PARTICULAR PLANT OR DUMP SITE. THEY CAN CALL ATSDR AND ASK THEM FOR AN INVESTIGATION. ANY TIME ATSDR HAS DONE AN INVESTIGATION, THEY WILL HAVE INFORMATION ON THEIR WEBSITE. AND IN THE GATHER SYSTEM, THEY'RE TRYING TO MAKE SURE THAT THEY HAVE LINKS TO ALL OF THAT INFORMATION FOR YOU. >> OKAY. THANKS A LOT. THAT IS ALL THE TIME WE HAVE FOR QUESTIONS. BEFORE WE CONCLUDE THE PROGRAM, WE WANT YOU TO KNOW THAT VIDEOTAPES OF THIS BROADCAST WILL BE AVAILABLE FROM THE PUBLIC HEALTH FOUNDATION. TO ORDER A COPY, CALL... YOU MAY ALSO FAX YOUR REQUEST TO... OR VISIT THE ONLINE BOOKSTORE AT... MUCH THANKS TO ALL OUR PANEL MEMBERS FOR JOINING US TODAY. AND THANK YOU FOR TAKING THE TIME TO BE WITH US TO DISCUSS CHILDREN'S ENVIRONMENTAL HEALTH INFORMATION RESOURCES. REMEMBER, ALL OF THE RESOURCES DISCUSSED TODAY ARE AVAILABLE FROM THE PARTNERS WEBSITE. WE WISH YOU THE BEST OF LUCK WITH YOUR PROGRAMS. ON BEHALF OF EVERYONE AT CDC AND THE PUBLIC HEALTH TRAINING NETWORK, I'M JOE WASHINGTON WISHING YOU A GOOD DAY FROM ATLANTA.