Surveillance systems health

In 1985, Berteau and Mengle (1985) of the California Department of Health Services and Maddy of the Department of Food and Agriculture conducted a preliminary review of pesticides used indoors. They noted several cases (six) from the Pesticide Illness Surveillance system in which illness was reported after structural pest control. Hypothetical exposure estimates for infants, children, and adults following label use for propoxur, DDVP, and chlorpyrifos were sometimes greater than toxic levels. In 1987, Berteau et al. (1989) reiterated the concern about the potential magnitude of indoor exposures, particularly for children. 

California State Department of Health Services, Behavioral Risk Factor Surveillance System (BRFSS) study of 4,000 randomly selected adults statewide, first in 1995 and replicated in 1996, in press with American Journal of Epidemiology, 1999. 

The monitoring system was a stimulated passive surveillance system. In other words, when vaccines purchased with federal funds were administered in the public sector, Important Information forms were given to recipients or their parents or guardians instructing them to report any illnesses requiring medical attention that occurred within four weeks of vaccination. System coordinators at each immunization project or grantee site and the state health department completed standardized forms that were reviewed for consistency and completeness and then forwarded to the CDC for data entry and analysis. 

The United States is one of the only countries that has established a formal surveillance system for post-approval monitoring of adverse reactions to food additives. Despite the obvious limitations of a passive surveillance system, ARMS provides an important venue for the public and others to report health problems perceived to be related to food additives. It provides a means of spotting potential longer-term problems with additives which can then be investigated further. 

Zeitz, P., Orr, M. F. and Kaye, W. E. (2002). Public health consequences of mercury spills Hazardous Substances Emergency Events Surveillance system, 1993-1998. Environ Health Perspect, 110(2), 129-132. 

According to the Drug Abuse Warning Network (DAWN), a public health surveillance system, in the second half of 2003, there were 627,923 drug-related visits to the emergency rooms of hospitals. Of these visits, 141,343 involved alcohol alone or alcohol along with other drugs. Of all the alcohol-related visits, 16,770 were made by 12-to 17-year olds in a ratio of about 2 1, males to females. ... 

Periodic medical surveillance. The health status of employees should be reviewed periodically to ensure that no work-related illnesses have developed. Reviews may be limited to appropriate organ(s) or organ system(s). The frequency of reviews is related to the potential hazard(s). 

Continue to develop and enhance population-based surveillance systems for the real-time capture of sentinel health end-points. This includes current surveillance systems such as vital registration for birth size and gestation and birth defects registries for capture of major malformations. Consideration of emerging sentinel end-points such as fecundability, as measured by time to pregnancy and sex ratios, should receive added research consideration. 

Nearly simultaneously with the U. S. success in reducing urban S02 levels, the Community Health and Environmental Surveillance System (CHESS) reported that adverse health effects result not from S02 itself, but from the secondaiy sulfates and... 

Report prepared for the Committee on Science and Technology, U. S. House of Representatives, "The Environmental Protection Agency s Research Program with Primaiy Emphasis on the Community Health and Environmental Surveillance System." U. S. Govt. Printing Office, Washington, D. C., 1976. 

Community service organizations can contribute to public health surveillance systems as formal or informal surveillance partners. 

In the field of public health, the term surveillance refers to the ongoing, systematic collection, analysis, interpretation, and dissemination of health data (CDC, 2001b, p. 2). The data collected and analyzed through surveillance systems provide information about patterns of disease occurrence in a population. In turn, this information forms the basis of action by public health officials in designing, implementing, and evaluating interventions to control or prevent disease (CDC, 1992). The activities carried out in a surveillance system are described briefly in the following. 

Several types of data are routinely collected related to infectious disease surveillance, including morbidity, mortality, and health indicator data (CDC, 1992). Each state has requirements for mandatory reporting by health care providers and facilities, including laboratories, of cases of notifiable infectious diseases. There is a national notifiable disease list as well, for which reporting is voluntary, with data compiled through the National Notifiable Disease Surveillance System (CDC, 2004d, 2006). 

The first indicator of a biological event may come from routine public health surveillance systems (Institute of Medicine [lOM] National Research Council [NRC], 1999). Tfaditional systems for surveillance fall into four general categories ... 

Passive in a passive system, health care providers or institutions initiate case reports, which are compiled at the local level and subsequently at state and national levels (CDC, 1992). The National Notifiable Disease Surveillance System (NNDSS) in an example. An important point is that it is only after individual case reports are compiled that an outbreak may be apparent (Bres, 1986), so timely reporting is essential for effective control. 

Active With active surveillance, the health department actively searches for cases (CDC, 1992). As this process typically requires many more resources than a passive system, its use is usually limited to outbreak situations. For example, the New York Department of Health used an active case finding approach during the 1999 West Nile virus outbreak (Fine Layton, 2001). 

THE ROLES OF STATE AND LOCAL HEALTH DEPARTMENTS IN DISEASE SURVEILLANCE SYSTEMS... 

Syndromic surveillance refers to surveillance using health-related data that precede diagnosis and signal a sufficient probability of [a] case or an outbreak to warrant further public health response (CDC, 2004a, p. 1). Such surveillance occurs in real-time or near real-time to achieve what has been termed pre-emptive surveillance (Teich, Wagner, Mackenzie, Schafer, 2002, p. 6). The primary purpose of syndromic surveillance systems is earlier and more complete detection of outbreaks (CDC, 2004b), although systems to monitor other health... 

Syndromic surveillance systems have developed in tandem with advances in information technology. A major component of many syndromic systems is the use of available electronic databases to capture health indicator data. With such computerized data, automated search algorithms can he applied to detect unusual patterns that may signal an outbreak and can provide that signal earlier than is feasible using traditional surveillance methods (CDC, 2000 Lazarus et al., 2002 Polyak, Elbert, Pavlin, Kelley, 2002 Teich et al., 2002). 

Syndromic surveillance is a work in progress. There is a need for continued development of standardized signal detection methods and signal response protocols (Henning, 2004). Also, whereas reporting of patient information as part of traditional public health surveillance has been deemed exempt from the confidentiality guidelines in the Health Insurance Portability and Accountability Act of 1996 (HIPAA), how those guidelines may be applicable to syndromic surveillance systems remains unclear (Buehler, 2004). 

New York City. The New York City Department of Public Health and Mental Hygiene collects health indicator data on emergency department visits, retail pharmacy sales, and ambulance dispatch logs, along with one employer s worker absenteeism rates, as part of an integrated, citywide surveillance system (Heffer-nan et al., 2004). 

Community service organizations can play a direct role in providing specific health indicator data that would contribute to a syndromic surveillance system. Worksite absenteeism or patterns of health care behavior among clients are examples of potential indicators, but issues related to the confidentiality of such information under HIPAA have yet to be fully addressed. Even if no formal surveillance partnership to provide data exists, community service organizations should still consider themselves as stakeholders in the overall community response plans for biological events. They should also publicize the emergency public health contact information within their organizations. Table 20.3 lists several specific actions that community service... 

Public health surveillance is an essential process for detection of biological events. The traditional notifiable disease reporting system remains an important component of infectious diseases surveillance however, new approaches are being implemented that may enhance capabilities for early detection of events. The increasing availability of electronic health data and advances in information technologies provide opportunities for active, real-time surveillance systems (Teich et al., 2002). Syndromic surveillance systems that rely on alternative health indicators and detection of unusual patterns have... 

Centers for Disease Control and Prevention. (2001b). Updated guidelines for evaluating public health surveillance systems Recommendations from the Guidelines Working Group. Morbidity andMortality Weekly Report, 50(RR-13), 1-35. 

Centers for Disease Control and Prevention, (n.d.). National Electronic Disease Surveillance System The surveillance and monitoring component of the Public Health Information Network. Retrieved November 30, 2004, from http //www.cdc.gov/nedss/ About/overview.html... 

Developing a system to share data may turn out to be one of the biggest—and most complex—goals of the grant. The goal is to create an interoperable disease surveillance system that health care workers on both sides of the border can access. It would provide an alert system and a database with common coding and commonly reported diseases. Though it may sound simple. 

Recognition by routine surveillance systems (local, state, and federal) may be the first indicator of a bioterror event (Institute of Medicine [lOM] National Research Council, 1999). Background data on disease occurrence are needed so that an unusual pattern can be detected above the endemic (i.e., usual noise ) level. Current public health surveillance systems related to bioterrorism preparedness, including syndromic surveillance systems, are discussed in detail in chapter 20. 

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