Environmental public health tracking (EPHT), a type of public health or epidemiologic surveillance, is the ongoingmonitoring for and identification of local disease or injury excesses attributable to environmentalhazards and the dissemination of these data for development of interventions to prevent and/or reduce thefrequency and severity of these occurrences. This proposal seeks to undertake a regional, multi-institutionalEPHT project to develop collaborations among neighboring EPHT Partners in the northeast US (e.g, Maine,New Hampshire, Massachusetts, Connecticut, New York and New York City) for surveillance andepidemiologic research, to demonstrate new applications and developments in methods for data linkage,pattern detection and assessment of exposure-disease associations, and to train students and otherresearchers in the use and interpretation of these approaches for the study of the possible environmentalcauses of disease. Specifically, in addition to conducting a review of current surveillance methodology, weplan to investigate and validate the addition of new data fields relevant to environmental problems to currentreporting systems, such as birth certificates. We will review the current applications of ecologic analysismethods to EPHT, noting limitations and opportunities for improvement, develop training materials illustratingkey points with concrete, non-mathematical logic and examples, and provide practical guidance forimplementation. We also will explore new methods that exploit the spatial coherence of local environmentalexposures, such as geographically weighted regression (GWR) and multivariate methods, conductingspecific analyses to demonstrate their strengths and weaknesses for EPHT. We will work with EPHTpartners to identify and develop a regional EPHT epidemiologic study focusing on a problem of localimportance, such as the reproductive effects of exposure to arsenic in drinking water or air pollution, orassessment of the spatial pattern of childhood cancers and related environmental exposures. Initially, ourfocus will be on facilitating collaboration and data sharing while accommodating concerns aboutconfidentiality. To provide guidance, we will convene an advisory committee of representatives from partnerhealth agencies, partner environmental agencies, industry, NGOs and the public. We see these efforts asan important step from individual EPHT partner programs towards national EPHT network and collaboration.
