NNIP

"In January 2001, the Pew Environmental Health Commission called for the creation of a coordinated public health system to prevent disease in the United States by tracking and combating environmental health threats. In response, the U.S. Congress appropriated funding to the Centers for Disease Control and Prevention (CDC) in Fiscal Year (FY) 2002. This funding enabled CDC to develop the National Environmental Public Health Tracking Program (referred to as Tracking Program). The purpose of the CDC's Tracking Program is to establish a nationwide tracking network to obtain integrated health and environmental data and use it to provide information in support of actions that improve the health of communities. CDC is establishing the Tracking Network by drawing from a wide range of stakeholders with expertise from federal, state, and local health and environmental agencies; nongovernmental organizations (NGOs); state public health and environmental laboratories; and schools of public health. The difference between the Tracking Program and the Tracking Network is that the Tracking Program is much broader and includes not only the Tracking Network but the people, resources, and program management involved in building this network. The Tracking Network is a discrete product of the Tracking Program. The Tracking Program can use data gathered from the Tracking Network to identify areas and populations most likely to be affected by environmental contamination and to provide important information on the health and environmental status of communities. Analyses of data from the Tracking Network will provide valuable information on changes or trends in levels of pollutants, population exposure, and occurrence of noninfectious health effects and enable environmental public health practitioners and researchers to examine the possible relations among them. The information can be used to drive public health policy and actions that ultimately will reduce the burden of adverse health effects on the American public. This document, CDC's National Environmental Public Health Tracking Program: National Network Implementation Plan (NNIP), outlines the path that the Tracking Program is taking to develop and implement the Tracking Network over the next 5 years. The plan supports achieving success in both immediate and long-term time frames while providing direction and guidance to the many stakeholders who contribute to the Tracking Network's ongoing development as well as the overall program's implementation. The NNIP gives insight into the topics and approaches that lead to improved network performance, sustainability, quality, and focus. The NNIP outlines CDC's strategy for developing and implementing the Tracking Network by clarifying functions and components and describing approaches to developing the components. Specifically, the NNIP describes the background, context, needs, and goals of the Tracking Network; outlines the principal functions and components of the Tracking Network; discusses the steps needed to implement the components; and identifies the entities responsible for taking the implementation steps." - p. iiiExecutive summary -- 1. Introduction -- 2. What are the functions and uses of the tracking network? -- 3. What are the components of the tracking network? -- 4. How is the tracking network accessed? -- 5. What services does the tracking network provide? -- 6. What content is on the tracking network? -- 7. Implementation activities -- Appendix A: Summary of activities by responsible entities for tracking network development -- Appendix B: Overview of NNIP development -- Appendix C: Acronyms and abbreviationsTitle from PDF title screen (CDC, viewed Dec. 29, 2011)."August 2006.""C5116250."Available via the World Wide Web as an Acrobat .pdf file (PDF 1.27 MB, 71 p.)

Key clinical activities for quality asthma care: recommendations of the National Asthma Education and Prevention Program

In 1997, the National Asthma Education and Prevention Program (NAEPP), coordinated by the National Heart, Lung, and Blood Institute, published the second Expert Panel Report (EPR-2): Guidelines for the Diagnosis and Management of Asthma (National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Expert Panel Report 2: Guidelines for the diagnosis and management of asthma. Bethesda MD: US Department of Health and Human Services, National Institutes of Health, 1997; publication no. 97-4051. Available at http://www.nhlbi.nih.gov/guidelines/ asthma/asthgdln.pdf). Subsequently, the NAEPP Expert Panel identified key questions regarding asthma management that were submitted to an evidence practice center of the Agency for Healthcare Research and Quality to conduct a systematic review of the evidence. The resulting evidence report was used by the Expert Panel to update recommendations for clinical practice on selected topics. These recommendations (EPR-Update 2002) were published in 2002. (National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Guidelines for the diagnosis and management of asthma--update on selected topics 2002. J Allergy Clin Immunol 2002;110[November 2002, part 2]. Available at http://www.nhlbi.nih.gov/guidelines/asthma/index.htm). To improve the implementation of these guidelines, a working group of the Professional Education Subcommittee of the NAEPP extracted key clinical activities that should be considered as essential for quality asthma care in accordance with the EPR-2 guidelines and the EPR-Update 2002. The purpose was to develop a report that would help purchasers and planners of health care define the activities that are important to quality asthma care, particularly in reducing symptoms and preventing exacerbations, and subsequently reducing the overall national burden of illness and death from asthma. This report is intended to help employer health benefits managers and other health-care planners make decisions regarding delivery of health care for persons with asthma. Although this report is based on information directed to clinicians; it is not intended to substitute for recommended clinical practices for caring for persons with asthma, nor is it intended to replace the clinical decision-making required to meet individual patient needs. Readers are referred to the EPR-2 for the full asthma guidelines regarding diagnosis and management of asthma or to the abstracted Practical Guide (National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Practical guide for the diagnosis and management of asthma. Bethesda MD: US Department of Health and Human Services, National Institutes of Health, 1997; publication no. 97-4053. Available at http://www.nhlbi.nih.gov/health/prof/lung/asthma/practgde.htm) and to the EPR-Update 2002. The 1997 EPR-2 guidelines and EPR-Update 2002 were derived from a consensus of leading asthma researchers from academic, clinical, federal and voluntary institutions and based on scientific evidence supported by the literature. The 10 key activities highlighted here correspond to the four recommended-as-essential components of asthma management: assessment and monitoring, control of factors contributing to asthma severity, pharmacotherapy and education for a partnership in care. The key clinical activities are not intended for acute or hospital management of patients with asthma but rather for the preventive aspects of managing asthma long term. This report was developed as a collaborative activity between CDC and the NAEPP.Prepared by Seymour G. Williams, Diana K. Schmidt, Stephen C. Redd, William Storms.The material in this report originated in the National Center for Environmental Health, Division of Environmental Hazards and Health Effects.March 28, 2003.Includes bibliographical references (p. 8).12696781Environmental HealthPrevention and ControlTreatment and InterventionCurren

Acute idiopathic pulmonary hemorrhage among infants: recommendations from the Working Group for Investigation and Surveillance

This report presents CDC's recommended case definitions and surveillance practices for Acute Idiopathic Pulmonary Hemorrhage (AIPH). In 1994 and 1997, CDC reported clusters of acute pulmonary hemorrhage (APH) among infants in Cleveland, Ohio. Subsequent reviews of these investigations identified shortcomings in the conduct of the studies and concluded that the investigations did not prove an association between APH among infants and exposure to molds. In response to recommendations from these reviews, with assistance of external consultants, CDC staff developed a plan to conduct surveillance for and investigation of AIPH. In developing this response, CDC recommends a definition for a clinically confirmed case of AIPH among infants on the basis of evidence of blood in the airway, age </=1 year, absence of medical conditions related to pulmonary hemorrhage, and severe acute respiratory distress or respiratory failure. CDC recommends that pediatric intensive care units (PICUs) report cases that meet the CDC case definition to state health departments. CDC staff will study the number of reported cases of AIPH among infants and also review the Cleveland and Chicago case series to determine the degree to which the present case definition applies to them. If these reviews establish that AIPH among infants is a public health problem, on the basis of its magnitude or geographic or temporal distribution, targeted case surveillance will be initiated based on the distribution of cases. CDC staff will work with state and local health departments to investigate reported clusters of cases of AIPH among infantsBackground -- Case definition -- Feasibility study to determine the concordance of ICD codes for pulmonary hemorrhage with the CDC case definition -- Conclusion -- Acknowledgments -- Referencesprepared by Clive M. Brown, Stephen C. Redd, Scott A. Damon, Division of Environmental Hazards and Health Effects, National Center for Environmental Health.The material in this report originated in the National Center for Environmental Health and the Division of Environmental Hazards and Health Effects.Bibliography: p. 12.15017372Environmental HealthSurveillance and InvestigationCurren

Guidelines for handling decedents contaminated with radioactive materials

"Detonation of a nuclear weapon or activation of a radiological dispersal device could cause radioactively contaminated decedents. These guidelines are designed to address both of these scenarios. They could also be applicable in other instances where decedents' bodies are contaminated with radioactive material (e.g. reactor accidents, transportation accidents involving radioactive material, or the discharge of a decedent from a hospital after injection or implantation of a radiopharmaceutical). These guidelines suggest ways for medical examiners, coroners, and morticians to deal with loose surface contamination, internal contamination, or shrapnel on or in decedents' bodies.Detonation of a nuclear weapon or activation of a radiological dispersal device could cause radioactively contaminated decedents. These guidelines are designed to address both of these scenarios. They could also be applicable in other instances where decedents' bodies are contaminated with radioactive material (e.g. reactor accidents, transportation accidents involving radioactive material, or the discharge of a decedent from a hospital after injection or implantation of a radiopharmaceutical). These guidelines suggest ways for medical examiners, coroners, and morticians to deal with loose surface contamination, internal contamination, or shrapnel on or in decedents' bodies." - p. 1CDC-INFO Pub ID 998831998831prepared by Charles M. Wood, Frank DePaolo, R. Doggett Whitaker.Publication date from "created" and "modified" dates in document properties.Includes bibliographical references (p. 19-20) and selected bibliography (p. 20).Available via the World Wide Web.Environmental HealthPrevention and ControlCurren

CASPER toolkit

"Following any type of disaster, public health and emergency management professionals must be prepared to respond to and meet the needs of the affected public. The Community Assessment for Public Health Emergency Response (CASPER) enables public health practitioners and emergency management officials to determine rapidly the health status and basic needs of the affected community. CASPER uses valid statistical methods to gather information about health and basic needs, allowing public health and emergency managers to prioritize their response and distribution of resources accurately. Without information on the community, public health officials may make decisions based on anecdotal information; such decisions may not accurately reflect the need of the entire community. The Centers for Disease Control and Prevention (CDC), National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Health Studies Branch (HSB) published the first edition of the CASPER toolkit in 2009 and widely distributed the toolkit to the public health community. HSB developed this second edition to address partner feedback on the first edition and include advancements in technology and refinements in the methodology. This second edition is an updated guideline for field staff conducting CASPER. Public health department personnel, emergency management officials, academics, or other disaster responders who wish to assess household-level public health needs will find this toolkit useful for rapid data collection during a disaster response. CASPER may also be used for conducting Health Impact Assessments (HIAs) or other community-level surveys during non-emergency situations." - p. 11. Executive summary -- 2. Background -- 3. Phase I: Prepare for CASPER -- 4. Phase II: Conduct the assessment -- 5. Phase III: Data entry and analyses -- 6. Phase IV: Write the report -- 7. CDC support -- 8. Conclusion -- 9. References -- 10. Additional sources of information -- Appendix A: Steps to merge the two Excel files downloaded from Census 2010 and to calculate cumulative housing units for selection of census blocks -- Appendix B: Question bank -- Appendix C: CASPER preparedness template -- Appendix D: Example questionnaire -- Appendix E: CASPER tracking form (sample) -- Appendix F: Confidential referral form (sample) -- Appendix G: Introduction and consent script (sample) -- Appendix H: Agenda for just-in-time training of field interview teams -- Appendix I: Sample Interview teamsThe first edition of the Community Assessment for Public Health Emergency Response (CASPER) Toolkit was developed by the Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Health Studies Branch (HSB) in 2009. HSB has now developed this second edition to expand instruction and refine methodological procedures, including describing and incorporating advances in technology and recognizing the release of the U.S. Census 2010 data. HSB acknowledges the following individuals for their collaboration and commitment in the development of the second edition of the CASPER toolkit: Primary authors: Tesfaye Bayleyegn, Sara Vagi, Amy Schnall, Michelle Podgornik, Rebecca Noe, and Amy WolkinMode of access: Internet. (Acrobat .pdf file: 3.91 MB, 103 p.).Includes bibliographical references.Centers for Disease Control and Prevention (CDC). Community Assessment for Public Health Emergency Response (CASPER) Toolkit: Second edition. Atlanta (GA): CDC; 2012.

The Health impact of chemical exposures during the Gulf War: a research planning conference

On February 28 through March 2, 1999, the Centers for Disease Control and Prevention (CDC) and other agencies of the Department of Health and Human Services (HHS) brought together scientists, clinicians, veterans, veterans\ue2\u20ac\u2122 service organizations, Congressional staff, and other interested parties to discuss and make recommendations regarding the direction of future research on undiagnosed illnesses among Gulf War veterans and their links with multiple chemical and environmental exposures. The format for the conference included plenary sessions, concurrent workgroups, and a veterans\ue2\u20ac\u2122 forum. The plenary sessions were meant to provide background information and to stimulate dialog on research questions. The plenary sessions included an overview of research findings regarding the health impact of the Gulf War, a panel discussion of the experience of Gulf War veterans, a series of presentations on the possible health outcomes of low-level chemical exposures focusing on nervous system, immune system, and pulmonary system outcomes, a series of panel discussions on research and clinical findings regarding multiple chemical sensitivity among Gulf War veterans and civilian populations, a series of presentations on possible mechanisms of action of chemical exposures, and a panel discussion on methodological considerations in studying the health impact of chemical exposures during the Gulf War. The concurrent workgroups were asked to develop research recommendations in four areas: pathophysiology, etiology, and mechanisms of action; assessment and diagnosis of illnesses; treatment; and prevention of illnesses in future deployments. Each workgroup was asked to develop research recommendations that addressed specific issues. For the pathophysiology workgroup, these issues included synergistic and subclinical effects of chemicals, genetic susceptibility, biomarkers of susceptibility and exposure, and appropriate study methods. The assessment and diagnosis workgroup was asked to focus on case definition, overlap of conditions, the role of chronic multi-system conditions, biomarkers of illness, optimal methods for assessment and diagnosis, and validation of assessment approaches. The treatment workgroup was asked to focus on appropriate treatment paradigms, rehabilitation approaches, health care opportunities, education of physicians, and appropriate study methods. The prevention workgroup was asked to focus on health education and risk communication, approaches to environmental assessment, biomonitoring, and health preparedness. The workgroups were free to use whatever approach they found useful for developing research recommendations. In some cases there was considerable disagreement among workgroup members on the direction of the recommendations. Thus, the final recommendations of the workgroups were not necessarily endorsed by all workgroup members. This report summarizes the outcome of each of the four workgroup sessions. Chapters 2 - 5 present the recommendations as developed by the workgroups. Although the workgroups were asked to focus on research recommendations, some recommendations reflect clinical care, administrative, or policy issues. No attempt was made to filter non-research recommendations from this report. Chapter 6 provides a discussion of the workgroup deliberations and attempts to place the recommendations in the context of current Gulf War research activities. The recommendations developed at this conference represent the deliberations of the workgroup participants and do not necessarily imply endorsement by the veteran or scientific community as a whole or by the federal government. While some of the recommendations could be implemented in the short-term, many of the recommendations reflect long-term goals requiring significant restructuring of current systems and are unlikely to be easily implemented, especially in the time frame requested by Gulf War veterans. Some of the recommendations may not be feasible, given current federal regulations. Other recommendations reflect initiatives that have already been instituted by federal agencies responsible for the care of veterans.sponsored by Centers for Disease Control and Prevention (CDC) in coordination with other offices and agencies of the U.S. Department of Health and Human Services (DHHS), Office of Public Health and Science, DHHS ; National Institutes of Health (NIH) and Agency for Toxic Substances and Disease Registry (ATSDR).Title from title screen (viewed Apr. 27, 2001).Mode of access: Internet.Includes bibliographical references (p. 34-42)

State asthma program evaluation guide

The Centers for Disease Control and Prevention's (CDC) National Asthma Control Program and state asthma programs across the country are mobilizing their resources to reduce the burden of asthma in our communities. The sound evaluation practices detailed in Learning and Growing through Evaluation can help ensure that we use those resources effectively and efficiently; that we have a means of demonstrating the value of our programs; and that we are developing a body of knowledge that tells us "what works." Learning and Growing is an evaluation guide intended for use by state and territorial public health departments (SHDs) that are receiving CDC funding for state asthma programs. Other groups that focus on improving asthma management practices, whether or not they receive CDC funding, may also find elements of the guide useful in designing and implementing their own program evaluation activities.Module 1 -- Chapter 1. Evaluation and your state asthma program -- Chapter 2. Thinking strategically: the strategic evaluation plan -- Chapter 3. Planning for an evaluation: the individual evaluation plan -- Appendix A. Chapter notes -- Appendix B. Glossary -- Appendix C. The State Asthma Program Impact Model -- Appendix D. Hiring an evaluator -- Appendix E. Strategic evaluation plan outline -- Appendix F. Individual evaluation plan outline -- Appendix G. Evaluation training resources -- Appendix H, Cited referencesAvailable via the World Wide Web as an Acrobat .pdf file (1.18 MB, 149 p.).Includes bibliographical references.Centers for Disease Control and Prevention. Learning and Growing through Evaluation: State Asthma Program Evaluation Guide. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Air Pollution and Respiratory Health Branch, April 2010

Wastewater Treatment Systems for Safety Rest Areas

Intra Government Purchase Order No. 4-1-0188Design guidelines for rest-area wastewater treatment systems that are capable of complying with the requirements of PL 92-500 are presented. Also presented is guidance for determining wastewater flow and constituent concentration. Each wastewater treatment system presented (septic tanks, lagoons, extended aeration package plants, trickling filters, rotating biological filters, land treatment systems, intermittent sand filter systems, and disinfection) includes a process description, a discussion of the performance, flexibility, reliability, and operational procedures, preliminary design formulations, and references and selected bibliography. Also included is a flow chart showing a general design procedure for new and existing rest areas with emphasis on water supply needs and wastewater treatment systems

Health impact of chemical exposures during the Gulf War

The purpose of this document is to provide background information to participants in the upcoming conference.sponsored by Centers for Disease Control and Prevention ; in coordination with Office of Public Health and Science (Department of Health and Human Services), National Institutes of Health, and Agency for Toxic Substances and Disease Registry ; document prepared by Peter McClure ... [et al.].Title from title screen (viewed Sept. 28, 2005)."Submitted to U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Veteran's Health Activity Working Group."Mode of access: Internet.Includes bibliographical references