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Table of Content
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- The U.S. Man and Biosphere (MAB) Program
Dean Bibles,
- Chair, US MAB
- National Institutes of Health Involvement in the U.S. MAB Program
- The National Cancer Institute
Dr. Gordon Cragg,
- National Institutes of Health, Chief, Natural Products Branch; U.S. MAB National Committee Representative
- The Research Association of Medical and Biological Organizations (RAMBO)
New Mexico Public Health - Existing cooperation with Long-Term Ecological Research for studies on Hantavirus
Dr. Gary Simpson,
- New Mexico Division of Public Health
Dr. Terry Yates,
- Chairman of the Department of Biology at the University of New Mexico
- Center for Disease Control Representative
Dr. Chet Moore,
- Division of Vector-Borne & Infectious Diseases, Ft. Collins, CO
- State/Regional Perspective
- Water related health problems
- Health risks via atmospheric dispersion
- Man encrochement in wildlife habitat
- Environmental poverty and its cohorts educational deprivation in geographical isolation
Dr. Paul Erwin,
- State of Tennessee Department of Health, East Tennessee Regional Health Director
- Demonstration of the Southern Appalachian Assessment
Dr. Cory Berish,
- Environmental Protection Agency, Atlanta, GA
Dr. Rick Dubrow,
- Environmental Protection Agency, Atlanta, GA
Dr. Karl Hermann,
- Environmental Protection Agency, Denver, CO
- Facilitated Discussion: Identify priority issues
Patrick Bohan,
- Center for Disease Control, National Center for Environmental Health
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The U.S. Man and Biosphere (MAB) Program
Dean Bibles
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Chair, US MAB
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USMAB looks at the relationship between human health and natural resources,
based on interdisciplinary research: social and natural scientists work together.
15 federal agencies are involved, in addition to private and public agencies,
participation being purely voluntary.
It has come obvious that no one can do everything all alone, and therefore USMAB is
a worldwide leader in true inter-disciplinary research.
By its variety, MAB really offers the perfect context for problem-solving.
MAB was really a result of the increased environmental awareness and
the rising of environmental movments from the 1960s, as well as the thought
at first that man was an intruder to the environment, and, later, as the sharing of
scientific information occured after the cold war, the understanding that
man was part of the environment.
USMAB first got involved in the relationship between human health and natural resources
when they commited to provide 4,000 lbs of Pacific yew bark for Taxol research.
The involvement and commitment of the employees was such that people were
working on weekends, in harsh natural environments and furnished a total
of 400,000 lbs of yew bark.
USMAB encourages study, research, education and biosphere reserves for the
sustainibility of the human race.
So far there are no treaty regulating the program or the 337 biosphere
reserves created around the world, but this is not desired either.
3 research of the program are coming close to a call :
- the tropical ecosystems division (South and Latin America)
- the northern latitudes division (Northern part of Canada)
- the marine and coastal division
So far actions are done at the national level but USMAB
is now trying to go through political boundaries, especially with Canada
and Mexico. USMAB is also strongly supporting regional approaches and is
taking the actions necessary to assist the nation in goal achieving
sustainibility in the early 21st century by exploring ways to
open the national commitee to new players and at the same time
play an active role in many actions that are taking place to
address issues facing the nation and the world.
USMAB and human health fit together in the sharing of information,
the prospection for medicinal plants, as well as the focusing of the
research agenda, the necessity of designing research projects together.
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National Institutes of Health Involvement in the U.S. MAB Program
Dr. Gordon Cragg
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National Institutes of Health, Chief, Natural Products Branch; U.S. MAB National Committee Representative
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NIH has the premier biomedical research institute.
It is entirely funded through grants and contracts
with a total budget of 30 billion dollars/year, a drop in
the bucket compared to the total budget for healthcare of 200
trillion dollars/year.
70-80 % of the budget goes to funding grants, and
only 15-25 % of the proposals submitted are actually funded.
Of the 17 institutes belonging to NIH, the following
are particularly interested in USMAB for the interaction
between environmental changes and human health:
- the National Institute of Allergies and Infectious Diseases
- interest in the emerging and re-emerging of infectious diseases
- concern with AIDS, sexually transmitted diseases, tuberculosis and drug resistant TB
- vaccine development against asthma, allergic diseases, entheric diseases and immunologic
diseases, respiratory diseases, and tropical diseases.
- the National Cancer Institute
- the National Institute of Child Health and Human Development
- interest in surveys on the relationship between population density
and environmental changes
- the National Institute of Diabetes and Digestive and Kidney Diseases
- interest in the link between nutrition and particular diseases
- the National Institute of Environmental Health Sciences
- the National Heart, Lung and Blood Institute
- the National Institute of Mental Health
- the National Institute of Aging
- the Fogety International Center
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Table of Content
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The National Cancer Institute
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Drug discovery and development, as well as cancer
prevention and control, are 2 areas of interest for the National
Cancer Institute with SAMAB. Cancer prevention and control is
done through 2 programs: the Surveillance Epidemiology and End
Results Reporting Program (SEER), that follows occurrence of cancers
throughout cancers, tracing influencing factors, and the Prostate
Lung, Colo-Rectal and Ovarian Cancer Screening Trial (PLCO), that
studies the impact of screening for these various diseases.
The Developmental Therapeutics Program is based on rational
drug design and synthesis, and large-scale screening, the major
area for future discovery. Major emphasis is put on the discovery
of new classes of active compounds. Natural
through natural products, semi-synthetic products (derived
from natural products), and synthetic products (modeled after
natural products) represent more than 60% of the drugs.
Nevertheless synthesis is not always economically viable, such
as in the case of taxol.
The following are examples of plant derived anti-cancer drugs:
- Vinblastine
Vintristine
- Catharantus roseus
- Etoposide
- derivative of podophyllotoxin
- Teniposide
- podophyllum peltatum
- Taxol
- taxus species
- OPT-11
- derivatives of camptothecin
- Topotecan
- camptotheca acuminatus
Pre-clinical development takes 10 to 15 years and
costs up to 300 million dollars.
The components of natural product drug discovery are:
- Collection contracts
- Extraction lab
- Repository
- Screening lab
- Chemical isolation
Plant collection is done in:
- South-East Asia
- Central Africa and Madagascar
- Central and South America
Marine Organism collection is done in:
Microbial projects involve:
- Fungi
- Cyanobacteria (blue-green algae)
- Marine anaerobes
- Marine protozoa
A total of more than 400,000 samples are stored.
The national repository has over 90,000 plant extracts,
and about 20,000 marine organism extracts. The drugs are distributed
to commercial companies only if an agreement is signed to give
royalties to the original country, to get the country to grow
the natural product, and to provide other compensation. In general
1 extract in 5-10,000 leads to a drug, and 1 in 40-50,000 to a
cancer drug.
Important collection data are:
- Taxonomy
- Plant part
- Hazard oodle
- Local name
- Collection location and habitat
- Medicinal use: parts used and preparation
Formulation has to provide a vehicle for administration:
most drugs act like sand in water.
Pharmacology determines the route of administration,
oral being the best, as well as the bioavailability, metabolism,
routes and rates of excretion - what happens once injected:
- some bound to proteins and can't get to cancer cells
- some rapidly metabolize to inactive products
- some go straight to the systems with no time to carry any action.
Toxicology determines the initial clinical doses,
the organ toxicity, and the reversibility of toxic effects in
rodents and dogs. The drug has to be determined to be non-toxic
in three different animal systems, usually rodent, mice and rats.
Clinical trials are done in several phases
- Phase I
- Determine the maximum tolerated dose
- assess toxicity
- Phase II
- Evaluate the efficacy against specific cancers
- evaluate chronic and accumulative toxicities
- Phase III
- Compare efficacy of new agent with the best available drugs
- determine the efficacy of combination of new agents and other drugs.
The bulk supply has to ensure alternative sources.
Taxol for example requires the stripping of a lot of bark.
The current yields are 1 g/30 lbs of bark (73% recovery)
which represents 1.5 trees for each gram of taxol, each tree being
100-200 years old. A patient requirement is 500 mg/course with
4 courses necessary which means 2 g/patient. This represents,
for the 12,000 patients in the U.S., 24 kg, which means 720,000
lbs of bark, equivalent to 36,000 trees. Alternative sources can
be found in:
- related species and genera
- cultivation
- tissue culture
- synthesis/semi-synthesis (possible for taxol from the needles of trees)
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Table of Content
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The Research Association of Medical and Biological Organizations (RAMBO)
New Mexico Public Health - Existing cooperation with Long-Term Ecological Research for studies on Hantavirus
Dr. Gary Simpson
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New Mexico Division of Public Health
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Dr. Terry Yates
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Chairman of the Department of Biology at the University of New Mexico
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The working group is made of an incredibly diverse number of organizations:
- New Mexico Department of Health
- Indian Health Service
- Office of the Medical Investigator
- Navajo Nation
- University of New Mexico School of Medicine/University
of New Mexico Hospital
- Arizona Department of Health
- Utah Department of Health
- Center for Disease Control and Prevention
- Colorado Department of Health
In the spring of 1993 an unexplained death of a young
couple was reported: they died of overwhelming respiratory failure
of unclear etiology. It took from there 19 days to find out the
etiology, and this entire investigation changed field sampling
methods. The PCR was:
- Hantavirus
- Never seen before
- Homologous sequences from different patients
- Homologous sequences in deer mouse, the reservoir/vector
rodent
It is an extremely non-specific undifferentiated febrile illness
with flu-like symptoms: fever, muscle-ache, feeling awful. The
respiratory symptoms come later and arise suspicion.
It takes about 36 hours for the onset of the sickness,
and 12 hours then for the onset of the pulmonary death.
The lab parameters are:
- Elevated white blood cell count
- Low platelet count
- Atypical lymphocites
The hantavirus was first called 'sin nombre'. It
is a previously undescribed hantavirus of the family Bunyaviridas,
described as the etiologic agent of 'hantavirus pulmonary syndrome'
(HPS). Its mortality rate is over 50% and its primary reservoir
is the deer mouse. Frozen tissue of the deer mice prior to 1993
at the Museum of Southwestern Biology tested positive for this
virus.
The deer mouse is pretty much distributed all over
the U.S. and Canada. As far as trends are concerned, we witness
little glitch of cases each spring and major outbreaks (5 times
the number of cases of the spring) in the fall (October/November).
The deer mouse population was 1 deer mouse/acre this
fall, 12 in the spring, a very high density. A long term ecological
research network was set up in the Sevillata site, an area where
major American biomes meet: it provides a high diversity in plants
and animals, including a lot of species of paramiscus.
From this investigation was created the
Research Association of Medical and Biological Organization (RAMBO).
It involves:
- University of New Mexico
- Department of Biology
- Museum of Southwestern Biology
- Sevilleta LTER
- Earth Data Analysis Center
- Division of Governmental Research
- New Mexico Department of Health
- Public Health Division
- Division of Epidemiology, Evaluation and Planning
- Scientific Laboratory Division
- Vital Records and Statistics Bureau
- University of New Mexico School of Law
- New Mexico Health Policy Commission
- Los Alamos National Laboratory
- Sandia National Laboratory
- New Mexico Medical Review Organization
- Santa Fe Institute
- National Center for Genome Research
- U.S. Indian Health Service
- HQ West Epidemiology Branch
- Center for Disease Control
- Southwest Field Activities National Center of Infectious
Disease
RAMBO is based on monthly working group meetings,
a listserver
(RAMBO@lanl.gov)
and a webpage
(acl.lanl.gov/RAMBO).
RAMBO is based on connectivity, access to major databases.
Its attributes are:
- Opportunity driven (with vision)
- Access to interorganization resources
- Collaborative utilization of diverse databases and information resources
- Multidisciplinary approach to complex problems
- Specialized technical resources (communication, data access, security, patient confidentiality law,...)
- "Process" group: group that looks at the interaction and issues in the process of the 2 demonstration project
RAMBO initiatives, in 9 months only, have been:
- Hantavirus and plague demonstration projects
- Project to develop statewide infectious disease surveillance,
telecommunication network
- Facilitation of development of statewide immunization
information system
- Proposal to test telemed (distributed database clinical
management system) in New Mexico primary care settings
- Facilitation of investigation of infectious disease
clusters
- Facilitation of immunization strategy for high risk
elderly (Alliance for Improved Senior Health)
- Facilitation of Northern New Mexico telemedicine
project
- Facilitation of statewide nosocomial TB OSHA working
group
- Facilitation of statewide working group addressing
issues of privacy and ownership of genetic medical information
- Support of clinical database analyses by Parallel
Data Mining Agents (PADMA)
- Facilitation of Hispanic collaborative for research
and education in science and technology initiatives
- Facilitation of Russian-American cooperative infectious
disease epidemiology project
The RAMBO meeting of Sevillata gathered people who manage
health related data and who want to act.
Demonstration projects were chosen according to the following
criteria:
- Do-able within a reasonable time-frame
- Every single organization has to contribute something
The following 2 projects were selected:
- Hantavirus outbreak are correlated with climate changes
- The cyclic nature of human plague cases is predictable
based on environmental data
Cycles have been observed in the population of deer
mice in Sevilleta. The virus is only present in desert shrub habitat
locally extinct in other habitats. Increase in rodents started
in 1991. The population of the mice is linked to El Niño,
a water current caused by a water temperature difference between
Tahiti and Darwin, Australia, under -1 degree. El Niño results
in more moisture in the South-West, a late winter and an early
spring rain and snowfall. This results in a bloom of C3 plants
in Sevilleta (usually minor contributors to the ecosystem) that
in turn produce large amounts of seeds. The consequence is an
increase in food supply and therefore an increase in rodent population. All the
reservoirs occur in one family of mammals, myradie. Each strain
of the hantavirus is very host specific.
As far as the evolution of the reservoir species
is concerned, they got on the North American continent around
20 million years ago and diversified throughout North America.
The expansion of grassland at the time allowed expansion of those
grassland species who then adapted to other habitats. They got
to South America around 7 million years ago. The hantavirus arrived
in North America 20 million years ago and is predicted to happen
in South America.
There is a correlation
between strains and hosts in an evolutionary sense. This is surprising,
because a virus is expected to evolve too fast to be host specific.
The Institute of Medicine factors in emergence of diseases are:
- human demographics and behavior
- technology and industry
- economic development and land use
- international travel and commerce
- microbial adaptation and change
- breakdown of public health measures
- and more...
This shows, in conclusion, that there is a necessity for multidisciplinary
and longer term studies among the sciences of biological and human health.
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Center for Disease Control Representative
Dr. Chet Moore
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Division of Vector-Borne & Infectious Diseases, Ft. Collins, CO
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Emerging infections have gained a lot of attention
from the public. The Institute of Medicine defines emerging infections
as new, re-emerging or drug-resistant infection whose incidence
in humans has increased within the past two decades or whose incidence
threatens to increase in the near future. There are lot of active
infectious diseases all over the world (hantavirus, dangi, ebola,...).
In the South-East there is an increase in the number
of Lacrosse encephalitis cases, an arthropod born virus (arbovirus)
part of the California serogroup.
This could be due to:
- increased awareness in the medical community
- specific diagnostic tests are required
- increased exposure
- more people living in areas where the virus is active
The cycle of the virus is as follows:
vertebrate host
(birds)
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virus
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vector
(mosquito)
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dead end host
The virus cannot bind to high enough level to become
infective to the mosquitoes
A lot of factors are influencing the life cycle of
the virus:
- Influence on the vector and the host:
- weather and climate
- predator and parasites
- food resources
- space
- Influence on the host:
- immune status for vertebrate hosts
Spatial and temporal scales are different for each
step of the virus cycle:
- Virus
- Spatial: one or few organ systems
- Temporal: minutes to hours to reproduce
- Vector
- Spatial: meters to kilometers
- Temporal: multiple generations in a single season
- Host
- Spatial: kilometers to continental or global
- Temporal: years for generations
Lacrosse in the Eastern U.S. is usually associated
with wooded areas. An average of 75 cases are reported each year,
with a number varying between 60 and 120 a year. Lacrosse is the
mildest of the 4 major encephalitis of human importance.
The symptoms are not very specific (headache, fever, nausea, vomiting) and
death rate is under 1 percent.
Sequeliae nevertheless have included in some cases residual
neurologic damage lasting from a couple of weeks to months or longer.
An increase in reporting peaked the interest of the CDC
(Center for Disease Control and Prevention).
The California serogroup project group goals are:
- Define geographic range of Lacrosse and other California
serogroup viruses in South-Eastern and Gulf Coastal states
- Determine the public health importance of Lacrosse
and other California encephalitis in these states
- Revisit/re-evaluate selected traditional endemic
Lacrosse foci (Upper Midwest)
There was an increase in the reporting of cases in
West Virginia (Nicholas County) beginning in 1987. Increase in
awareness was not the only explanation for the increase in reporting.
Lacrosse has mammals as vertebrate hosts as opposed to the important
arbovirus. These hosts are: the eastern chipmunk, the gray squirrel,
the fox squirrel, and maybe foxes too in certain areas.
The insect vector is the treehole mosquito (aedes
triseriatus). Its life cycle involves water and air stages: the
egg is laid near water, the larva and pupa are in water and the
adult lives in the air. It is highly specialized: it is found
only in rot holes in some species trees (not oaks, not conifers,...),
as well as in tires or artificial containers. The female
mosquito can transmit the disease to her progeny.
Study design:
- Epidemiology of Lacrosse encephalitis
- Improved case detection
- Sero-survey and case-control study
- Ecology of Lacrosse virus in West Virginia
- Vector biology
- Virus infection rate
- Seasonal and multi-year population dynamics
- Relation to temperature, rainfall
- Vertebrate biology
- Species abundance and activity patterns
- Virus infection rates
- Human ecology and behavior
- GIS and remote sensing
- Identify appropriate scale(s) of study
- Plant cover/forest type as predictor of Lacrosse risk
- Impact of elevation, slope and aspect on Lacrosse activity
- Social economics and related factors from census data
- Validation through field study results
- Risk prediction
- Predict selected high- and low- risk areas
- Test predictions through field studies and epidemiology
- Extend to neighboring states
- Prevention and control of Lacrosse encephalitis
- Public education
- Source reduction
- Chemical control
It would take about 5 years to complete the project.
So far, after one year:
- The cases that happened have been located
- The areas of substantial number of cases and those
with no cases have been located
Various data are available for GIS studies to find
correlation on mosquito vectors, demographic data, vertebrate
data, and environmental data.
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State/Regional Perspective
Dr. Paul Erwin
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State of Tennessee Department of Health, East Tennessee Regional Health Director
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There are 4 major topical areas:
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Table of Content
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Water Related Health Problems
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In Del Rio, half of the hepatitis A cases happened among
people with an education level below 9th grade, and one-fourth among
people below the federal poverty level.
Epidemic:
4 children, 1 adult, 3 households, 1 child and 1
adult in the same household linked to the Knox County cases. No
other recent travel to endemic/epidemic areas. Children not in
day care. No increase in elementary school absenteism
The cases are spatially close
Children were presented with initial symptoms within
one week of each other
It was concluded that there was a common exposure
(common vehicle epidemic) rather than exposure to each other or
single individuals. It had to be foodborne or waterborne. Nevertheless
there was no common meal. But the initial 3 households had positive
fecal coliform in the water due to inadequate or unsafe waste
water disposal. These households were also in close proximity
to streams.
3 new cases happened: 2 children in one family and
one child in another. Both had positive fecal coliform in the
drinking water. The 3 new cases were new to each other, downstream
from the first 3 cases.
19 houses close to the cases were sampled, 6 with
document cases, 13 with no cases. 5/6 (83%) of the case houses
had positive fecal coliform, 6/13 (46%) of the non-case houses
had positive fecal coliform. The drinking wells were not safe,
there was inadequate septic drain fields, and the gray water was
sprayed on ground or dumped in the river.
The stream was sampled at 14 sites, 10 samples/site
over 30 days. The standard for recreation is a geometric mean
of 200 fecal coliform colonies per 100 ml of water. 8 sites out
of 14 (57%) were above the standard.
In summary:
- Clusters of cases in children in a small geographic area
- The timing of the cases implies a common source
- Water at household level tested positive for fecal coliform
- Septic systems are often inadequate
- Sampling of streams showed widespread contamination
of streams in general areas where the cases were located
As a follow-up, vaccination and legal measures for
improper septic fields were taken.
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Table of Content
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Health risks via atmospheric dispersion
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The Oak Ridge health agreement studies a site which is part
of the 1942 Manhattan project. In July of 1991 the State of Tennessee
and the U.S. Department of Energy agreed for the State to conduct
independent assessment of off-site human health risks. 5 goals
were:
- Design a dose reconstruction feasibility study
- Complete a dose reconstruction feasibility study
- Assemble a panel to oversee all health studies agreement
activities (ORSHAP)
- Enhance Tennessee cancer registry and develop a state
birth defect registry
- Review the U.S. Department of Energy worker health
program
OR Dose reconstruction feasibility study - technical tasks:
- Describe historical operations and releases
- Identify available environmental data
- Identify complete exposure pathways
- Identify environmental exposure pathways
- Characterize potentially exposed populations
- Describe hazards of important contaminants
- Compile and index project documents
Preliminary findings regarding X-10 and Y-12
production of radioactive barium/lanthanum
(RaLa process) and release of I-131 as by-product.
X-10 -> air -> air inhalation
deposition on green leafy -> vegetables
deposition to grass -> dairy cows -> dairy milk
I-131 was found at 2.7 Bequerel/m3 at the nearest
site of residence, 4000 m away, the dose equivalent to health
risk if fatal and non-fatal cancer (thyroid especially) and severe
hereditary effects. The highest risk is to women children drinking
goat milk. There is a health risk of 1/1000 per year of exposure.
lithium enrichment operation and release of mercury
Y-12 -> air -> inhalation of inorganic mercury
-> deposition to vegetables
-> water -> livestock/game
-> soil -> vegetables -> ingestion
Y-12: 11,000,000 kg of mercury used. An estimated 330,00 kg
are lost to the environment. An additional 590,000 kg are not
accounted for. Of the 330,000 kg lost to the environment, 15,000
kg went to the air.
2.3x10-5 mg/m3 were found at 500 m which represents
59% of USEPA inhalation reference dose. At the surface water the
dose was 2.9 times the ingestion reference dose, 1,400 times in
the soil.
We see that we can face high-tech (radiation) versus old-tech problems
(hepatitis A).
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Table of Content
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Man encrochement in wildlife habitat
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Erlichiosis (lyme disease) outbreak in a golf oriented retirement
community on cumberland plateau in East Tennessee in 1993.
Ehliciosis is similar to RMSF both in its etiology
and clinical impact. It is caused by ehrlichia chaffeeensis. It
was first reported in 1987. There are usually 3-5 cases/100,000
people with peaks in the summer. The vector is the lone star tick
(amblyomma americanum). The symptoms are severe headache, vomiting
and abdominal pain. The signs are fever, low white blood cells
and platelets, mild hepathitis. The diagnosis is clinical, elevated
IgG and positive PCR. The treatment is achieved through doxycycline
and prognosis is excellent with early treatment.
In June of 1993, 4 men developed RMSF without rash.
All lived in a golf retirement community in East-Central Tennessee.
3 were golfers and all reported recent tick bites.
Out break investigation
Community A - where cases happened
Community B - control community
- Identification of cases
- Retrospective
- Prospective
- Case-control study
- Households sero-survey
- 10% random survey of all households in A & B
- Collection of ticks
- Dragging
- Animal collection
- 16 white tailed deers
- 20 other mammals
Results of investigation
Out of 11 cases, 10 occurred in the community A.
The attack rate there was 330/100,000. Serosurveys showed 12.5%
positive in the community A, and 3.3% in community B. As far as
ticks are concerned, thousands of Lone Star Tick were found in
community A, and only 3 in community B.
Risks of infection
- 4 or more tick bites
- never using repellent
- golfing
- golf scores greater than 100
The community A was made of newly constructed golf
residence on the border of a wild life reserve.
Man + new environment + appropriate vector provide the perfect
conditions for a new disease.
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Table of Content
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Environmental poverty and its cohorts educational deprivation in geographical isolation
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More isolated, low education and poverty constitute
the elements of locations with poor health performance.
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Table of Content
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Demonstration of the Southern Appalachian Assessment
Dr. Cory Berish
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Environmental Protection Agency, Atlanta, GA
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Dr. Rick Dubrow
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Environmental Protection Agency, Atlanta, GA
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Dr. Karl Hermann
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Environmental Protection Agency, Denver, CO
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This presentation aimed at showing how data are collected and stored.
The data usually come from all the member agencies and state participants,
the private and the public sector, and the universities.
Once collected, they were put on a CD, and used to put together ArcView presentations.
Each view is called a scene. We have:
- the atmospheric scene
- the water quality scene
- the population trend scene
Dr. Berish demonstrated how the SAA contains variables such as:
- the bear population; suitable habitat
- the counties boundaries
- the federal lands
- the population density
- the toxic release inventory sites
- the particulates atmospheric release
- the NPDS permits indicating the types of municipal sewage systems
- the streams
- the index of biological integrity, an index indicating the gravity
of the impact in terms of organisms in streams
- campground sites
- fecal coliform levels
- mines
Geographical Information Systems allow:
- to overlap layers of different data
- to add new layers of information later
- to put in queries such as showing the relationship between two factors
(income and population for example)
- to identify sites of interest and accessing the full record of data
The boundaries considered on the screen can be set freely and can represent such thing as
state boundaries, counties boundaries, watershed boundaries,...
The data are mapped on a high to low scale, and a present or absent basis.
Such a system allows, for example, to manage the black bear population as a whole instead
of doing management on each unit. It would also be the perfect tool for the Del Rio
case-study presented by .... It can answer specific questions one may ask such as
'Is the excess acid deposition related to childhood asthma?', and can also show
the relation between level of poverty, ethnicity and water sources, and allow to make pro-active decisions.
The effort to gather data has to continue and more people need to learn this technology.
The future orientation is now to work with gap analysis groups.
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Facilitated Discussion: Identify priority issues
Patrick Bohan
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Center for Disease Control, National Center for Environmental Health
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A program based on the RAMBO model should be used for known and unknown infectious diseases.
The task now is to get more practical with health specialists instead of putting the stress on the research.
There is a great need for bridging the gap between environmental quality and public health.
We should aim at producing material indicating the
health procedures that prevent environmental problems and making
sure the 'right' people get it.
Public education is necessary to motivate people from other fields.
It is also important to make sure that the info goes both ways and
it is necessary to identify the institutions that
have resources/expertise in problems and interest in solving those
problems by building inventory databases.
There is a need for cooperation between states so that one state
facing or planned to be facing a certain problem may get information
and advice from other states that have already faced and handled this
particular problem (such as rabbies carried by raccoons that went
through North Carolina and is now coming to Tennessee).
Some problems such as straightpiping will not be solved by regulatory measures
and therefore there is a need for a private groups to act locally.
Human behaviors expose individuals to organisms or toxic
contaminants but humans are also promoters of risk:
they are encouraging the raccoon population,
man changing the landscape results in an increase
in vector population (clearcut,...).
Human actions are two-sided though: clearcutting removes
the habitat for birds that are vectors of EDE but also
increases the number of cases of tick related diseases.
The same thing is true with introduction programs.
The red wolf reintroduction program shows that the problems created
can be double-sided: on the one hand, red wolves may kill the red
raccoons, but on the other end they may chase them to urban areas.
Ethnoepidemiology, the study of how human behaviors expose
people to diseases, should be part of the risk assessment process.
If an introduction program is conducted, the ethnography/anthropology field
could also help better understand how people can contribute or can
be affected by the changes rather than just relying on statistics.
Outbreaks result of a factor getting out of balance:
potential predictive models should be emphasized and
occuring incidences cannot be the only guideline.
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