Can lessons from public health disease surveillance be applied to environmental public health tracking?

Abstract

Disease surveillance has a century-long tradition in public health, and environmental data have been collected at a national level by the U.S. Environmental Protection Agency for several decades. Recently, the CDC announced an initiative to develop a environmental public health tracking (EPHT) networkwith "linkage" of existing environmental and chronic disease data. On the basis of experience with established disease surveillance systems, we suggest how a system capable of linking routinely collected disease and exposure data should be developed. The primary operational goal of EPHT has to be the "treatment" of the environment to prevent and/or reduce exposures and minimize population risk for developing chronic diseases. Thus, EPHT should be synonymous with a dynam icprocess requ iring regular system updates to a) incorporate new technologies to improve population-level exposure and disease assessment, b) allow public dissemination of new data that become available, c) allow the policy community to address new and emerging exposures and disease "threads," and d) evaluate the effectiveness of EPHT over some tim e interval. It will be necessary toweigh the benefits of surveillance against its costs, but the major challenge will be to maintain support for this important new system.