From Marie.Flake@DOH.WA.GOV Fri Nov 17 18:37:22 2000 Received: from mxu3.u.washington.edu (mxu3.u.washington.edu [140.142.33.7]) by lists.u.washington.edu (8.9.3+UW00.05/8.9.3+UW99.09) with ESMTP id SAA407808 for ; Fri, 17 Nov 2000 18:37:21 -0800 Received: from mail1.doh.wa.gov (mail1.doh.wa.gov [192.230.11.132]) by mxu3.u.washington.edu (8.9.3+UW00.02/8.9.3+UW99.09) with ESMTP id SAA09598 for ; Fri, 17 Nov 2000 18:37:20 -0800 Received: by mail1.doh.wa.gov with Internet Mail Service (5.5.2652.35) id ; Fri, 17 Nov 2000 18:35:52 -0800 Message-ID: <213895AE8149D3118D9500508B0F20A00200D6AE@mail2.doh.wa.gov> From: "Flake, Marie D" To: "Ph-Assess PH-ASSESS (E-mail)" Subject: AOG - November Rounds Date: Fri, 17 Nov 2000 18:35:51 -0800 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2652.35) Content-Type: text/plain; charset="iso-8859-1" Or see attached Word document. - marie Department of Health Assessment Operations Group ROUNDS November 14, 2000 COMMUNITY AND FAMILY HEALTH Maternal Child Health Program Please contact Jude Van Buren at (360) 236-3495 for more information regarding these topics: * Child Death Review Program * The Child Death Review (CDR) Program which began in SFY 1999, is completing its' first Progress Report. The report includes a description of the state CDR program and of local team activities in 1999, as well as aggregate data from 1999 deaths that were reviewed. CDR teams are composed of individuals from many disciplines, and exist in every part of the state. The role of these county-based teams is to review all unexpected deaths to children ages 0-17. Based on information gathered in the review process, teams develop recommendations to prevent future deaths of children. Issues may surface through the work of the teams and will be of interest to assessment people around the state. * * Enhancing Birth Defects Surveillance in Washington State: CDC Cooperative Agreement * The Office of Maternal and Child Health was selected to enter into a Cooperative Agreement with the CDC to carry out a project entitled Enhancing Birth Defects Surveillance in Washington State. Washington State was one of eight states funded. Our plan focuses on increasing the number of facilities reporting cases of eight structural birth defects and Down syndrome; designing and implementing a sustainable quality assurance strategy for the birth defects surveillance system; analyzing and disseminating birth defects surveillance data; and increasing the consumption of folic acid among women of reproductive age, in partnership with the March of Dimes Washington State Chapter. The first step will be to hire a Project Manager that will work in conjunction with the MCH Birth Defects Surveillance Planning Group to implement the strategies outlined in our plan. This opportunity will build off ongoing efforts to align birth defects reporting with other public health surveillance activities through the revised Notifiable Conditions statute. * * * ENVIRONMENT HEALTH PROGRAMS * * Assessment coordinator: Jim VanDerslice at (360)236-3183 * * Dr. Harriet Ammann will be reviewing the Spokane Waste to Energy Facility Risk Assessment as part of her role as a representative on the Technical Oversight Committee for the risk assessment. Dr. Ammann can be reached at (360)236-3171. * * * * * * EPIDEMIOLOGY, HEALTH STATISTICS AND PUBLIC HEALTH LABORATORY * * Assessment Coordinator: Vicki Hohner (360)236-4211 * * Communicable Disease Epidemiology * Please contact John Kobayashi (206)361-2831 for more information regarding these topics. * * Department epidemiologist assists in the global polio eradication effort * * On October 29, the World Health Organization (WHO) certified the Western Pacific Region as polio-free. This region includes 37 countries ranging in population from small countries in the South Pacific to China. In May 2000, Dr. Michael Bruce was involved in this effort. Bruce is an epidemiologist who was assigned by the Centers for Disease Control and Prevention to work in the Washington Department of Health Communicable Disease Epidemiology Section from 1999-2000. Because of his fluency in French and his epidemiological expertise, he was able to help certify New Caledonia as polio free. This was one of the last remaining countries in the Western Pacific Region to achieve certification. The WHO Western Pacific Region is now the second in the world to be certified as polio-free, after the WHO Region of the Americas in 1994. * * Bioterrorism field exercise * * The State Public Health Laboratory and Communicable Disease Epidemiology participated in a Seattle-King County bioterrorism field-exercise on October 25th. This field exercise, named "Sea-King 2000," complements last month's "table-top" exercise of the same name that involved public safety and elected officials from throughout the county. * * Surveillance for neonatal group B streptococcal disease * * James Heffelfinger, CDC Preventive Medicine Resident, in cooperation with Cathy Wasserman and others the MCH Program, CFH is developing a project to identify all cases of early-onset group B streptococcal (GBS) disease in newborns in Washington State during 1999-2000. The objectives of this project will to determine the incidence of laboratory-confirmed neonatal early-onset GBS disease in Washington State, to describe activities undertaken to prevent GBS disease in these newborns, to describe missed opportunities for prevention, to educate providers about the disease, to validate data on neonatal GBS disease obtained from Comprehensive Hospital Abstraction Reporting System (CHARS), and to determine how complete reporting of neonatal GBS disease is using CHARS. This project will help determine whether neonatal GBS disease should be recommended as a notifiable condition in Washington State. * * Non-Infectious Conditions Epidemiology * Please contact Juliet VanEenwyk (360)236-4250 for more information regarding these topics. * * On-going investigations: * * We have continued to work with the Pacific County Health Department to * develop a pregnancy monitoring system for the county. Surveillance dependent on provider participation has so far been unsuccessful. A second alternative, a telephone survey of Pacific county women of reproductive age, is being considered. Contact: Angela Zechmann * * We have continued to work with the citizens living in the SeaTac Airport area * by responding to a data request to assess learning disabilities in the Highline School District. We identified comparison schools and provided the data requested. As a response to a data request, we did not provide extensive interpretation of the data, but rather we provided guidance to the citizens on what additional work was necessary to interpret the data. Contact: Jennifer Sabel * * With the availability of 1999 fetal death data, we began the final phase of * the Cowlitz fetal death cluster investigation. An investigation late last year concluded that the apparent elevations in perinatal deaths were attributable to an elevation in late fetal deaths occurring in the category of 28+ weeks gestation, and we found no patterns, which could explain this elevation. Preliminary analysis does not suggest that the elevation continued through the year. Contact: Steve Macdonald * * Completed investigations: * * We recently concluded an investigation of a cluster of breast cancer among * clerical workers at the Clark County Sheriffs office. The number of women with breast cancer - five - was five times greater than the expected of one. Although we cannot rule out an unidentified carcinogen or chance as a cause of the cluster, further investigation is not likely to be fruitful because of the small numbers involved. Our revised non-infectious conditions cluster protocol proved helpful in decision making during this investigation. Contact: Angela Zechmann * * Childhood Lead Poisoning (Contacts Eric Ossiander and Marcia Mueller) * We have complete a draft of the recommendations for childhood blood lead testing. A final report will be completed by the end of November. The recommendations are consistent with the recommendations of an advisory group comprised of health care providers, representatives from state and local health departments, Medicaid, managed care and private insurance organizations, and community action groups. The recommendations are also consistent with guidance from CDC. DOH does not recommend universal or targeted screening in Washington. Health care providers should continue to use clinical judgement to identify children who should be tested. DOH should continue to monitor blood lead levels in children statewide and should conduct studies in central Washington to determine whether guidelines for targeted screening can be developed there. Based on input from DOH, the State Board of Health has decided to remove blood lead screening from the list of preventive services. * * On Oct 6 we trained the lab staff at Family Medical Clinic in Walla Walla on * the use of the portable blood lead analyzer and gave an in-service to 35 medical staff, including 5 providers, on childhood lead poisoning. The clinic will provide free screening to all their 1 and 2 year old pediatric patients and provide educational materials to families as part of our enhanced screening project in high-risk counties. FMC is the 6th clinic participating in this project. Since March, over 700 children have been tested as part of this project. Approximately 3% of tests are elevated. * * We continue to receive requests for addresses of children with elevated blood lead levels from local housing authority staff (most recently Grays Harbor County) because of the new HUD rules that were effective Sept. 15th. We are unable to release this confidential information. DOH has been invited by the HUD regional office in Seattle to participate in a meeting/conference call on Nov. 1st to discuss "Transition Assistance for Washington State communities impacted by HUD's new Lead-Based Paint regulations". * * We are working with the Dept. of Labor & Industries to identify laboratories that are no longer reporting to the registry because they incorrectly thought the state reporting WAC expired. We have already identified 3 labs that are not reporting. Although all labs were notified of the incorporation of blood lead testing into the notifiable conditions regulation in the ELABorations newsletter, it appears a separate mailing will be necessary to emphasize the blood lead reporting requirement. * * Center for Health Statistics * Please contact John Whitbeck (360)236-4321 for more information regarding these topics. * * Joint Conference on Health presentations: * Trina Wynkoop Simmons co-authored "Using Rural and Urban Classification * Systems in Public Health Assessment" with Vince Schueler, Rural and Community Health. She is also coordinator of "Five new topics in the Behavioral Risk Factor Surveillance System, 1999," discussing highlights of results on asthma surveillance, food insecurity, veterans' status, health differences among rural and urban people and family violence. Participants included Steve Macdonald, Lillian Bensley, Vince Schueler (all DOH staff) and Gayle Reiber (Veterans Administration and UW). * * Pat Starzyk, Ann Lima, Teresa Jennings, & Vicki Hohner made several presentations at the Joint Conference on Health in Tacoma. Topics covered: * data sharing and confidentiality around HIPAA, * birth and death certificate revisions, * ICD-10 cause of death coding, and * adding new data elements to the CHARS data under HIPAA. * * Statewide Presentations: * Ann Lima gave a presentation on "Improving Cause-of-Death Statistics" at the Washington Association of Coroners and Medical Examiners Conference on October 4. Some of the topics discussed were how cause-of-death statistics are used, referrals to coroners and medical examiners, importance of reporting information in all injury sections of the death certificate, reporting order of conditions on death certificates, and information needed for falls. * * Ann Lima wrote an article about cause-of-death reporting and referrals to * coroners which was published in the October issue of the Washington State Medical Association newsletter. The article emphasized that conditions such as pneumonia, cardiac arrest, or sepsis should not appear as the only condition on death certificates. * * Program Activity: * * Vital Statistics: * 1999 Birth tables are out on Web; CD's are being cut for distribution. * The 1999 birth data tables are now available on the DOH web page at www.doh.wa.gov/EHSPHL/CHS/default.htm#birth. * Tables with second quarterly preliminary counts of 2000 births and deaths were released to LHJ's and other interested parties. * Re: 1999 Death CD and final report: we are affected by our inability to accurately characterize the ICD-10 issues. We will either publish a preliminary Death Vital stats, and 'burn' in-house CD's, or publish a preliminary and then a final CD with NCHS information sometime in January or February, 2001. * * BRFSS: * Coordinated and compiled State Added Questions for BRFSs 2001 for approval by Assessment Operations Group and submitted draft questionnaire to Human Subjects Review Committee. * * CHARS: * Base data for use by the hospitals in undertaking market share studies was completed in * draft form. * Furnished a brief report on examining the use of regions within the CHS/DOH. * Began work with CHARS data rolling up diagnosis codes into disease groupings and displaying this by hospital and age group within regions. * * VISTA: Basic & Advanced Vista/PH Joint Conference Training (Two full classes) offered the Sunday of the Joint Conference. Basic Epidemiology Training : Offered to LHJ to fill previous requests. Marie Flake, Local Health Liaison Public Health Systems Planning and Dev. Washington State Department of Health 1102 SE Quince St / PO Box 47815 Olympia, WA 98504 Ph (360) 236-4063 / Fax (360) 236-4088 marie.flake@doh.wa.gov Required note: This message may be confidential. If you received it by mistake, please notify the sender and return the item. All message to and from the Dept. of Health may be disclosed to the public. .