A Regional, Multi-Institutional Academic Partnership for Excellence in EPHT

描述（由申请人提供）：环境公共卫生跟踪（EPHT）是一种公共卫生或流行病学监测，是对可归因于环境危害的当地疾病或伤害过度进行持续监测和识别，并传播这些数据，以制定干预措施，以预防和/或减少这些事件的频率和严重程度。这一建议寻求开展一个区域性多机构的EPHT项目，在美国东北部（如缅因州、新罕布什尔州、马萨诸塞州、康涅狄格州、纽约和纽约市）的邻近EPHT伙伴之间开展合作，进行监测和流行病学研究，展示数据联系、模式检测和暴露-疾病关联评估方法的新应用和新发展。并训练学生和其他研究人员使用和解释这些方法来研究疾病可能的环境原因。具体来说，除了对当前的监测方法进行审查外，我们还计划调查和验证在当前的报告系统中添加与环境问题相关的新数据字段，例如出生证明。我们将回顾目前生态分析方法在EPHT中的应用，指出局限性和改进的机会，开发培训材料，用具体的、非数学的逻辑和例子说明要点，并提供实施的实际指导。我们还将探索利用局部环境暴露的空间一致性的新方法，如地理加权回归（GWR）和多元方法，并进行具体分析，以证明它们在EPHT中的优势和劣势。我们将与环境污染监测计划的伙伴合作，确定并开展一项区域环境污染监测计划流行病学研究，重点关注一个具有地方重要性的问题，例如饮用水或空气污染中砷的暴露对生殖的影响，或评估儿童癌症的空间格局和相关环境暴露。最初，我们的重点将是促进协作和数据共享，同时兼顾对保密性的担忧。为了提供指导，我们将召集一个咨询委员会，由伙伴卫生机构、伙伴环境机构、工业界、非政府组织和公众的代表组成。我们将这些努力视为从个别EPHT伙伴项目向国家EPHT网络和合作迈出的重要一步。

DESCRIPTION (provided by applicant): Environmental public health tracking (EPHT), a type of public health or epidemiologic surveillance, is the ongoing monitoring for and identification of local disease or injury excesses attributable to environmental hazards and the dissemination of these data for development of interventions to prevent and/or reduce the frequency and severity of these occurrences. This proposal seeks to undertake a regional, multi-institutional EPHT project to develop collaborations among neighboring EPHT Partners in the northeast US (e.g., Maine, New Hampshire, Massachusetts, Connecticut, New York and New York City) for surveillance and epidemiologic research, to demonstrate new applications and developments in methods for data linkage, pattern detection and assessment of exposure-disease associations, and to train students and other researchers in the use and interpretation of these approaches for the study of the possible environmental causes of disease. Specifically, in addition to conducting a review of current surveillance methodology, we plan to investigate and validate the addition of new data fields relevant to environmental problems to current reporting systems, such as birth certificates. We will review the current applications of ecologic analysis methods to EPHT, noting limitations and opportunities for improvement, develop training materials illustrating key points with concrete, non-mathematical logic and examples, and provide practical guidance for implementation. We also will explore new methods that exploit the spatial coherence of local environmental exposures, such as geographically weighted regression (GWR) and multivariate methods, conducting specific analyses to demonstrate their strengths and weaknesses for EPHT. We will work with EPHT partners to identify and develop a regional EPHT epidemiologic study focusing on a problem of local importance, such as the reproductive effects of exposure to arsenic in drinking water or air pollution, or assessment of the spatial pattern of childhood cancers and related environmental exposures. Initially, our focus will be on facilitating collaboration and data sharing while accommodating concerns about confidentiality. To provide guidance, we will convene an advisory committee of representatives from partner health agencies, partner environmental agencies, industry, NGOs and the public. We see these efforts as an important step from individual EPHT partner programs towards national EPHT network and collaboration.