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Columns

Tracking chronic disease

October 31, 2001
The first confirmed death this year in the U.S. from the mosquito-borne West Nile virus occurred this past August. The virus has killed eight people since it first appeared in North America in 1999. Our nation will spend about $100 million this year to track and control the West Nile virus.

The rationale for tracking infectious disease is obvious. If we spot infectious disease outbreaks, or threats, at their onset, actions can be taken to prevent an epidemic. Huge savings in potential medical costs, deaths and suffering may be realized.

Although there is a nationwide system to track infectious diseases, there is no comparable system in the U.S. for tracking chronic diseases such as cancer, asthma and birth defects.

This past July, a collation of the most powerful public interest and health advocate groups in the U.S. urged the government to begin funding a Nationwide Health Tracking Network "that would monitor and track chronic diseases and their potential links to environmental factors."

The framework for the health tracking system would cost $60 million and would be directed by the U.S. Centers for Disease Control. A nationwide system would cost $275 million annually or "less than $1 for every American." This is a real bargain considering what the U.S. spends to track and control just the West Nile virus.

Merits for the health tracking system are very strong. More than one-third of the U.S. population suffers from chronic disease, chronic diseases are responsible for seven out of ten deaths in this country, and chronic diseases cost our nation more than $325 billion each year. And in less than 15 years, the estimated cost of chronic disease in the U.S. is predicted to rise to $1 trillion.

Support grows

But tracking is just the first part. The CDC estimates that 70 percent of chronic diseases are preventable. The system will provide data that all stakeholders can use to form prevention strategies.

There is overwhelming public support for the concept. Surveys show that 89 percent of registered voters support the creation of a health tracking system. Politicians notice the strong public support and they are taking action.

The health tracking system will build upon the existing infectious disease tracking and control network. It will create a national disease and exposures database as well as an early warning system to detect environmental threats. This activity is already underway as evidenced by the CDC's first annual "National Report on Human Exposure to Environmental Chemicals" that was released this past March.

Clueless in the workplace

Businesses have no idea how a nationwide health tracking system will impact their environmental health and safety programs. If you recall how the near passage of the proposed High Risk Occupational Disease Notification and Prevention Act scared the dickens out of industry back in 1988, then imagine what this tracking system will do. It will affect nearly every business and every American. But this system is not a proposed law (such as the ergonomics standard) that can be overturned. It's just a decision among politicians on how to spend taxpayers' dollars. And we know how 89 percent of the voters feel on this topic.

Elements of this system are present now. Here's an example of its use - and its potential effect on your EHS program:

Is it safe to have a baby in your county? I posed this question this past July to both industry and government employees, all from the same county, that attended a seminar I held on business EHS data and the Internet.

I asked the question because Internet data showed that the county's infant mortality rate was 9.9, while the rate for "peer" counties ranged from 4.9-8.8. "Why is your county's infant mortality rate so much higher than its peers?", I asked.

While the group considered a response, I presented Web data indicating that their county's ambient lead in air was recorded at 0.26 ug/m3, which is the second highest level among all counties in their state. And their county was ranked as one of the "Dirtiest/Worst Counties in the U.S." for "Non-Cancer Risk Score" with the score weighted heavily toward lead and lead compounds all coming from business activity.

I showed the group Web sites that addressed lead. I stressed the health effects and toxicity data that were highlighted online. I then inquired, "Could exposure to lead be a reason for the high infant mortality rate in your county?"

I asked the group, "Are there businesses in your county at risk from what I just showed you?" A Web report on one business was provided. The report showed that from 1997 to 1999 releases of "recognized reproductive and developmental toxicants to air (all from lead and lead compounds) increased 268 percent." And the company's EPA public contact told me he didn't feel his company needed to attend this seminar because they have things "under control."

You needed to be at the seminar to see how facial expressions told it all. Everyone was genuinely concerned and worried about the data I presented. No one had ever seen this Web information before. A county commissioner who attended the seminar, and who had worked in the county for more than 30 years as a science teacher, said he was "shocked" by what I presented.

Questions are coming

But the data was not unique to this county. I could play it out in almost any other county, and other related health issues could be explored. Businesses must learn to look beyond their walls to better manage their EHS programs.

A year ago, using the Web to examine business EHS data and its relationship to community health was comparable to a caveman hacking away with a stone ax to get meat from a felled Mastodon. You could get the meat but it was crude. When the health tracking system comes online, many people will be able to dissect business EHS data and its possible relationship to chronic disease like a modern surgeon uses a scalpel.

Some people are beginning to understand my high concern over business EHS data being on the Internet. They tell me, "I guess we have not being doing enough to anticipate the future." I tell them, "It's not that business has failed to anticipate the future, rather it is business failing to keep pace with the present."

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