Assessing the Effects of the Gulf of Mexico Oil Spill on Human Health A Summary of the June 2010 Workshop (2010) / Chapter Skim
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6 Data-Collection, Surveillance, and Research Methodologies
6 Data-Collection, Surveillance, and Research Methodologies
Pages 105-122
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From page 105... ...
Moreover, these efforts help identify at-risk individuals and preventive actions that may better protect individuals in the event that a disaster of this magnitude occurs again in the future, said Lynn Goldman. Panelists considered methodologies and available data sources (including ongoing health surveillance and surveys)
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From page 106... ...
in assessing the health impacts of disasters in general. He also recommended creating a Gulf Region Health Information Exchange to pool health data from practice-based EHRs across the region so that health effects can be more effectively monitored.
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From page 107... ...
Syndromic Surveillance Matte stated that syndromic surveillance involves tracking nondiagnostic health indicators. (See Chapter 4 for descriptions of state-level syndromic surveillance systems that are already in place for monitoring the potential health outcomes of the Gulf oil disaster.)
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From page 108... ...
Registries, Cohorts, and Panels Matte discussed the World Trade Center Health Registry, which allowed for longitudinal follow-up of populations impacted by the World Trade Center attack. The registry included more than 70,000 of an estimated 400,000 eligible residents, employees, students, passers-by, and others enrolled between 2003 and 2004.
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From page 109... ...
funded World Trade Center Medical Monitoring and Treatment Program. From 2002 to 2007, more then 20,000 responders received standardized initial exams.
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From page 110... ...
AN OVERVIEW OF METHODOLOGIES AND DATA SOURCES FOR USE IN HEALTH SURVEILLANCE AND ENVIRONMENTAL MONITORING ACTIVITIES Lynn R Goldman, Johns Hopkins University According to Lynn Goldman, the reality that unknown numbers of individuals are being exposed to unknown hazards poses a major challenge to developing health surveillance and environmental monitoring systems for the Gulf oil disaster.
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From page 111... ...
The more that health departments communicate information about syndromic surveillance and other data in ways that are sensitive to local cultures and values, the more useful the information. Finally, Goldman emphasized the importance of environmental public health monitoring and listed the various types of data that should be collected, including both health surveillance and environmental monitoring data: x Health surveillance data o Baseline health status o Change in health, both in the immediate aftermath of the dis aster and over time o Biomonitoring-based changes that are indicative of expo sures or increased risks of adverse health outcomes x Environmental monitoring data o Immediate environmental monitoring o Collection and archiving of samples for later, more sophisti cated analyses o Use of all possible sources of data
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From page 112... ...
Depending on those two variables, exposure may ultimately overcome the body's natural coping mechanisms, leading to adverse effects. According to Farland, although a primary goal of the public health response to the Gulf oil spill should be to prevent exposure, it may nonetheless be possible to manage and mitigate adverse effects when exposures do occur by gaining a better understanding of "source-toreceptor" pathways (i.e., the multiple pathways and environmental fates of potential toxins)
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From page 113... ...
Osofsky, Louisiana State University Health Sciences Center Howard Osofsky addressed several key issues to consider when evaluating mental health surveillance and research methodologies. Disasters have typically limited the ability to conduct longitudinal and cross-sectional research.
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From page 114... ...
can help ensure that the research instruments used in larger quantitative studies are culturally sensitive and that the research "makes sense" to the affected communities and encourages ongoing collaboration. Osofsky also described quantitative methodologies that have been used in past disasters and which NIOSH and others use today to assess mental health responses to disasters, as well as how those assessments are being modified to include measures of cumulative trauma for use in a Deepwater Horizon mental health response assessment.
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From page 115... ...
Masys, Vanderbilt University Medical Center Daniel Masys addressed biomedical informatics, the application of the principles of computer and information science to problems in medical research and health care education. He explored lessons learned from past disasters and possible applications to enhance surveillance activities related to the oil spill disaster.
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From page 116... ...
The CTSA has in turn supported the development of REDCap, the Research Electronic Data Capture system, a secure webbased tool for acquiring and analyzing data. REDCap is available free of charge and allows users to define a set of variables, acquire data from previous studies, and to merge data from multiple sources in a matter of minutes.
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3. Create a Gulf Region Health Information Exchange that pools health data from practice-based EHRs across the region.
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From page 118... ...
Bailar opined that research should be a highly centralized effort so that the various data collected by separate groups can be brought together to "tell a convincing story." For the Gulf oil disaster, he envisioned a single organization headed by a single person who has the responsibility and the authority to conduct the research operation. While he was hesitant to suggest who that organization might be, he mentioned CDC or perhaps a new organization created by the affected states' health departments or a consortium of regional universities.
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From page 119... ...
Bailar also thought that there will be a need for a substantial, dedicated staff to manage the surveillance activities and to learn what can be learned from other long-term followup programs, such as the National Cancer Institute's Surveillance Epidemiology and End Results Program, the Radiation Effects Research Foundation in Japan, the Framingham Study, the Nurses Health Study, and the World Trade Center follow-up. QUESTIONS AND COMMENTS FROM THE AUDIENCE What must be done to implement an active surveillance system so that preventive measures can be instituted quickly to protect workers from adverse effects?
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From page 120... ...
Matte added that efforts to study the physical and mental health outcomes as a result of exposures during the Deepwater Horizon event should not be conducted separately, given how much is known about how the two domains of health influence each other. Osofsky agreed that it is very crucial for the two types of outcomes to be studied in an integrated manner, given expanding knowledge about the interface and influences between physical and mental health.
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From page 121... ...
What authoritative, web-based resources does the panel suggest for the public to access Gulf oil-spill-related information? Matte said that, although the richness of available data will "gradually get better" over time, there is already "pretty good" information online at several federal agency websites (e.g., the CDC, the EPA, OSHA, National Library of Medicine)
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From page 122... ...
For example, researchers were not able to communicate results back to the affected communities. Palinkas's story prompted Goldman to comment that protecting researchers from those types of legal barriers is an important public policy issue that needs to be addressed.
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