From Juliet.VanEenwyk@DOH.WA.GOV Tue Nov 16 10:12:28 1999 Received: from mxu2.u.washington.edu (mxu2.u.washington.edu [140.142.32.9]) by lists.u.washington.edu (8.9.3+UW99.09/8.9.3+UW99.09) with ESMTP id KAA30654 for ; Tue, 16 Nov 1999 10:12:27 -0800 Received: from wagov-exchange1.wa.gov (hub1.dis.wa.gov [147.55.104.40]) by mxu2.u.washington.edu (8.9.3+UW99.09/8.9.3+UW99.08) with ESMTP id KAA17508 for ; Tue, 16 Nov 1999 10:12:26 -0800 Received: by hub1.dis.wa.gov with Internet Mail Service (5.5.2448.0) id ; Tue, 16 Nov 1999 10:12:54 -0800 Received: from mail1.doh.wa.gov ([192.230.11.132]) by wagov-exchange1.wa.gov with SMTP (Microsoft Exchange Internet Mail Service Version 5.5.2448.0) id WNGPCXPR; Tue, 16 Nov 1999 10:12:51 -0800 Received: by mail1.doh.wa.gov with Internet Mail Service (5.5.2448.0) id ; Tue, 16 Nov 1999 10:11:50 -0800 Message-ID: <213895AE8149D3118D9500508B0F20A01B2983@mail2.doh.wa.gov> From: "VanEenwyk, Juliet" To: "PH-ASSESS (E-mail)" Cc: "Bowman, Steve" , "Davies, Jac" Subject: November Rounds Date: Tue, 16 Nov 1999 10:11:43 -0800 MIME-Version: 1.0 X-Mailer: Internet Mail Service (5.5.2448.0) Content-Type: multipart/mixed; boundary="----_=_NextPart_000_01BF305E.0CB11D3A" This message is in MIME format. Since your mail reader does not understand this format, some or all of this message may not be legible. ------_=_NextPart_000_01BF305E.0CB11D3A Content-Type: text/plain; charset="iso-8859-1" Below are the rounds for November. I have also included them as attachments in WORD and RTF formats. PLEASE NOTE NEW E-MAIL ADDRESS: juliet.vaneenwyk@doh.wa.gov Juliet VanEenwyk Acting State Epidemiologist Director, Non-Infectious Conditions Epidemiology 360-236-4250 ****This message may be confidential. If you received it by mistake, please notify the sender and destroy the message. All messages to and from the Department of Health may be disclosed to the public.**** ____________________________________________________________________________ _______________ AOG Rounds November 1999 LHJ Assessment Report for Nov. Currently Regional Assessment Meetings are underway. This report will address only information from the N. W. Regional meeting. Sea-King has completed its report, Healthy Youth in King County, which provides a wide range of information on the health of youth and young adults living in King County. This report is unlike most health reports. It takes an "upstream" approach, focusing on the factors in society, communities and families that shape health behaviors and health outcomes. They are also working on an Indian Health report and an access to care survey. Contact David Solet at david.solet@metrokc.gov for a copy of the Health Youth report. Snohomish Health District has a number of projects in progress. They are in the midst of analyzing 1998 BRFSS data and will have a report by the end of the year. Also they are working analyzing YRBS data from their middle and high schools and that information will be out shortly. Donald Oliver Health Service Administrator Office of the Assistant Secretary Environmental Health Programs Health Services & Quality Assurance Rounds . . . Facilities and Services Licensing - Nothing to Report Rural Health - Nothing to Report Emergency Medical & Trauma Prevention - Progress is underway to develop a web-based data entry option for EMS. This is a joint project with the state fire chiefs. In addition, using a middleware product (Visionsoft), we are accessing data from large EMS data systems (e.g., Seattle Fire Department). This data was previously unavailable due to data system compatibility constraints. The Office of EMTP is currently completing a legislative report on epinephrine administration by EMTs to address anaphylaxis. Steve Bowman, Manager Trauma Services Designation, Registry and QA Section Office Emergency Medical and Trauma Prevention (360) 705-6730 email: smb0303@doh.wa.gov Community and Family Health Rounds . . . Community Wellness & Prevention (CWP) The 1997 cancer registry report was released last week. Two press releases were prepared and disseminated, highlighting findings from the report and showing connections to other CWP activities such as tobacco prevention, breast cancer screening, physical activity, and eating fruits and vegetables. Contact Mary LeMier for additional information The findings of the 1999 checks for tobacco sales to minors have been summarized. Washington's sales rate continues to meet federal requirements. The rate of sales to minors for 1999 (based on # sales/#purchase attempts) was 12% The report and a press release will be dissminated within the next couple of weeks. Contact Julia Dilley for additional information The plan for a comprehensive, tobacco prevention program is nearly complete. The deadline for submitting the plan to the legislative is later this month. The plan calls for an extensive amount of surveillance and evaluation work. Hopefully, there will be adequate funds to cover all the work that needs to get done. Contact Julia Dilley for additional information. Maternal and Child Health (MCH) The "final draft" of a paper entitled: Assessment of Two "Low-Tech" Genetic Health Care Procedures Performed by Prenatal Care Providers in Washington State: Implications for Future Policy Development Activities. By Bob Fineman and Tom Bell, using PRAMS data, was sent to a journal called "Community Genetics". The Washington State DOH's Immunization Program, PRO-West (the state's Medicare peer review organization) and the Immunization Action Coalition of Washington are collaborating on a statewide project to assess pneumococcal vaccination practices in licensed nursing homes and coverage rates among their residents. Occurring in several phases, the project will initially assess residents' pneumococcal vaccination status, will implement a vaccination intervention encouraging the use of vaccine standing orders, and will follow-up with a reassessment of coverage. All of the 274 licensed nursing homes in Washington State will be invited to participate in the project. A sample of residents will be selected to secure vaccine coverage data for residents that can be generalized statewide. Perinatal Regionalization Data Reports: Two 1997 Perinatal Data Reports were disseminated to the statewide regional contractors. The titles of the reports were: 1) 1997 Births by Birthweight by Washington State Perinatal Catchment Area and Facility of Birth; and 2) 1997 Perinatal and Neonatal Mortality by Washington State Perinatal Catchment Area and Facility of Birth. At the Nov. '99 Perinatal Regional Contractors meeting, the MCH Assessment Section will distribute several other perinatal data reports on maternal and infant morbidity. Topics to be featured are as follows: 1) Length of Stay by Gestational Weeks by Washington State Perinatal Catchment Area and Facility of Birth; 2) Neonatal Transfers by Washington State Perinatal Catchment Area and Facility of Birth; 3) Percent of Cesarean Sections by Washington State Perinatal Catchment Area and Facility of Birth; and 4) Percent of Vaginal Births After Cesarean by Washington State Perinatal Catchment Area and Facility of Birth. "Spokane HD, with funding and technical support from MCH/Immunization Program staff, continues to make progress on its Birth Certificate Follow-back Survey of 19-35 month old children to assessment pre-school child immunization coverage and risk and protective factors. This is part of the State's Immunization Program's Local and State Childhood Immunization Assessment Capacity Building Project (now in its 2nd year). Several other related projects are also now underway with Southwest WA HD and Seattle King County . SW is using similar methodology after deciding to conduct a survey of Clark Co. residents. SK will try out a modified, previously untested methodology to identify its sample of children to survey using RDD methods." Infectious Disease and Reproductive Health (IDRH) Mark Stenger, one of our new AIDS epidemiologists, has begun re-evaluating previous research on current methods for estimating HIV prevalence in order to develop a new set of estimates and future projections. Last projections were done in 1996 by Maggie Ryland. Todd Rime continues to analyze AIDS Prescription Drug Program client chart abstract data for antiretroviral therapy prescription and adherence. Todd Rime is also in the planning stages, with the federal Region X for family planning, of piloting new data collection and data analysis procedures at four local family planning agencies to assess client behavior, risk, and pregnancy change with clinical and counseling interventions. Kristen Janusz, our other new epidemiologist, is working on a multi-faceted evaluation of the new HIV reporting system by which those who are HIV infected who tested confidentially or receive care are reported to local health jursidictions by name. The LHDs are given 90 days to investigate cases that are missing necessary information (such as risk of transmission), and at that point are required to change the name to a unique code. LHDs report unique codes to the state. Pieces of the evaluation include evaluation of the actual process of reporting, evaluation of how representative the reported cases are of those who are HIV-infected in Washington State, and evaluation of whether HIV reporting is having an impact on counseling and testing behaviors. Scott LaMontagne, in coordination with STD staff, just finished a report on geographic access to STD care in Washington that represents our office's initial foray into GIS technology. Reports are for LHJs only and will be distributed in two weeks. Mary LeMier CWP Assessment Coordinator Department of Health, Mail Stop 47835 Olympia, WA 98504 Internet Address: MKL0303@hub.doh.wa.gov Voice: (360) 236-3693 FAX: (360) 664-2619 Epidemiology, Health Statistics, and Public Health Lab Rounds . . . Center for Health Statistics -- Teresa Jennings and Ann Lima gave a presentation at the annual conference of the Washington Association of Coroners and Medical Examiners. The presentation included information about CHS policies and procedures, uses of cause-of-death information, sources of information on how to fill out death certificates, possible solutions to common problems in death certification, and a discussion on how we can work together to support each other. The annual summary of vital statistics and annual report on pregnancy and abortion statistics for 1998 were completed and will be released the second week of November. Vista/PH version 9.2 (software for community health assessment) was released with all of the 1998 datasets, abortion data from 1981-1990, and a new option to restrict birth weight factors to single births. The federal privacy regulations related to HIPAA were released in a 600+ page draft on 10/29/99. DOH is convening an agency workgroup to review and comment on the regulations within the 60 day comment period. The "Invitation to Bid" for the mandatory state-wide telephone interview contract for the Behavioral Risk Factor Survey opened for bidding on October 9, 1999. Bids are due November 9 to the Office of State Procurement. See the General Administration website (below) and click on the text "Bid document." http://www.ga.wa.gov/pca/bids/09499b.htm Communicable Disease Epidemiology About 1,000 copies the 1998 Communicable Disease Summary were printed and distributed to local health departments, interested health care providers and state officials. Narrative summaries, maps, tables and graphs are provided for reportable communicable diseases. Copies may be obtained from EHSPHL, Communicable Disease Epidemiology, MS K17-9, 1610 NE 150th St, Shoreline, WA 98155, 206-361-2914. In cooperation with Public Health Seattle-King County and the California State Health Department we investigated an outbreak of E. coli O157:H7 related to contaminated romaine. We are working with multiple federal, state and local agencies in Seattle in preparation for the World Trade Organization conference to be held from November 30-December 4. About 5,000 government officials from over 130 countries are expected, along with a large number of demonstrators. Illness surveillance during this period will be performed. While not expected to be a high risk event, work is being done to improve preparedness for biochemical terrorism. We expect this work to have long term benefits for preparedness in Washington State. Non-Infectious Conditions Epidemiology The Childhood Lead and Health Study is in the final week of data collection. As of November 3, we anticipate enrolling approximately 540 children. We hope to have a preliminary analysis of the data by November 9th to help the Advisory Group develop a policy for targeted childhood lead screening in Washington. Contact: Eric Ossiander We are working with Trina Wynkoop-Simmons and other DOH epidemiologists to pilot test proposed state-added questions for BRFSS 2000. Cognitive testing will be done by telephone survey in the next few weeks, and the questions will be finalized by Dec. 1. Contact: Angela Zechmann We are coordinating a volume purchase of Stata statistical software, which, due to economy of scale from combining four DOH licenses and some LHJ licenses, means that each additional license will cost us only $250 each. Contact: Steve Macdonald All of the local health jurisdictions that did local Youth Risk Behavior Surveys have received their data. CDC has scanned, but not cleaned the state data. CDC did not include the Seattle questionnaires and so we need to combine the two datasets. We hope to have a dataset we can work with by the end of November. One of the first sets of analyses we will do is to look at bias by comparing YRBS frequencies to those obtained through OSPI for the four questions that are asked on both the YRBS and the OSPI student assessment questionnaire. DASA and Kids Count are also asking for data to be used in their November and December reports, respectively. At this point, we are not optimistic about meeting the DASA November deadline. Contact: Lillian Bensley A report by the Climate Impacts Group at the University of Washington will be released on November 9. The report addresses issues such as whether warmer and wetter weather in the Pacific Northwest is part of global climate change; what will happen in the next century; how would climate change affect our water, forests, salmon, and coasts; are the region's government agencies prepared for dealing with a changing climate. Members of the Climate Impacts Group will travel to several cities in the Northwest to discuss the report at a series of public meetings. To order a copy of the report or to learn more about the public meetings, please see: http://tao.atmos.washington.edu/PNWimpacts/report.html. Contact: Dick Hoskins CDC's 10/15 MMWR contained our article "Self-reported asthma in adults and proxy-reported asthma in children -- Washington 1997-98". In it we reported BRFSS data showing: persons with asthma reported significantly lower health status than other respondents; a substantial proportion (one in six) of households with children reported having a child with asthma; lifetime prevalence in adults is estimated at 10.8% (totaling 450,000 affected individuals), and in children at 10.1% (totaling 151,000 affected individuals). KING 5 TV news covered the story on 10/14 5pm and 11pm shows. Steve Macdonald also attended a news event on 10/26 sponsored by Am. Lung Assoc. WA announcing their new statewide community asthma education and outreach program. Contact: Steve Macdonald The report on the study of the availability and comparability of federal (military and veterans) hospital data, conducted by two UW MPH students, was released to LHJs just prior to the JCH meeting in Spokane, and we are waiting for feedback from the six counties as input into development of the next phase. Contact: Steve Macdonald The number of fetal deaths in Cowlitz County continues to be more than expected. We are working with the LHJ, continuing the investigation and drafting a plan for action. 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\f2\fs20\cgrid = {\b\f16\fs24 AOG Rounds \par November 1999 \par }\pard \s15\widctlpar\adjustright {\b\f16\fs24\ul=20 \par }\pard\plain \widctlpar\adjustright \fs20\cgrid {\f1\fs24=20 \par }{\b\f16\fs24 LHJ Assessment Report for Nov. \par }{\f16\fs24=20 \par Currently Regional Assessment Meetings are underway. This report = will address only information from the N. W. Regional meeting. \par=20 \par Sea-King has completed its report, Healthy Youth in King County, = which provides a wide range of information on the health of youth and = young adults living in King County. This report is unlike most health = reports. It takes an \ldblquote upstream \rdblquote approach, focusing on the factors in society, communities = and families that shape=20 health behaviors and health outcomes. They are also working on an = Indian Health report and an access to care survey. Contact David Solet = at david.solet@metrokc.gov for a copy of the Health Youth report. \par=20 \par Snohomish Health District has a number of projects in progress. They are in the midst of analyzing 1998 BRFSS data and = will have a report by the end of the year. Also they are working = analyzing YRBS data from their middle and high schools and that = information will be out shortly. \par=20 \par Donald Oliver \par Health Service Administrator \par Office of the Assistant Secretary \par Environmental Health Programs \par }{\f1\fs24 =20 \par }\pard\plain \s15\widctlpar\adjustright \f2\fs20\cgrid = {\b\f16\fs24\ul Health Services & Quality Assurance Rounds . = ..}{\b\f16\fs24 . \par=20 \par Facilities and Services Licensing}{\f16\fs24 - Nothing to Report \par }{\b\f16\fs24 Rural Health}{\f16\fs24 - Nothing to Report \par=20 \par }{\b\f16\fs24 Emergency Medical & Trauma Prevention}{\f16\fs24 - = Progress is underway to develop a=20 \par web-based data entry option for EMS. This is a joint project with = the=20 \par state fire chiefs. In addition, using a middleware product = (Visionsoft),=20 \par we are accessing data from large EMS data systems (e.g., Seattle = Fire=20 \par Department). This data was previously unavailable due to data = system=20 \par compatibility constraints. =20 \par=20 \par The Office of EMTP is currently completing a legislative report on = \par epinephrine administration by EMTs to address anaphylaxis.=20 \par=20 \par }\pard \s15\qj\widctlpar\adjustright {\f16\fs24 Steve Bowman, = Manager \par Trauma Services Designation, Registry and QA Section =20 \par Office Emergency Medical and Trauma Prevention \par (360) 705-6730 \par email: }{\cs16\f16\fs24\ul\cf2 smb0303{\*\bkmkstart = _Hlt467039782}@{\*\bkmkend _Hlt467039782}doh.wa.gov}{\f16\fs24=20 \par }\pard \s15\widctlpar\adjustright {\f16\fs24=20 \par }\pard\plain \widctlpar\adjustright \fs20\cgrid {\b\f16\fs24\ul = Community and Family Health Rounds . . . \par=20 \par }{\b\f16\fs24 Community Wellness & Prevention (CWP) \par=20 \par }{\f16\fs24 The 1997 cancer registry report was released last = week. Two press=20 \par releases were prepared and disseminated, highlighting findings = from the=20 \par report and showing connections to other CWP activities such as = tobacco=20 \par prevention, breast cancer screening, physical activity, and eating = fruits=20 \par and vegetables. Contact Mary LeMier for additional information=20 \par=20 \par The findings of the 1999 checks for tobacco sales to minors have = been=20 \par summarized. Washington's sales rate continues to meet federal=20 \par requirements. The rate of sales to minors for 1999 (based on #=20 \par sales/#purchase attempts) was 12% The report and a press release = will be=20 \par dissminated within the next couple of weeks. Contact Julia Dilley = for=20 \par additional information \par=20 \par The plan for a comprehensive, tobacco prevention program is nearly = \par complete. The deadline for submitting the plan to the legislative = is=20 \par later this month. The plan calls for an extensive amount of = surveillance=20 \par and evaluation work. Hopefully, there will be adequate funds to = cover=20 \par all the work that needs to get done. Contact Julia Dilley for = additional=20 \par information. =20 \par }{\b\f16\fs24=20 \par Maternal and Child Health (MCH) \par=20 \par }{\f16\fs24 The "final draft" of a paper entitled: Assessment of = Two "Low-Tech" Genetic Health Care Procedures Performed by Prenatal = Care Providers in Washington State: Implications fo r Future Policy Development Activities. By Bob Fineman and Tom Bell, = using PRAMS data, was sent to a journal called "Community Genetics". \par=20 \par The Washington State DOH's Immunization Program, PRO-West (the = state's=20 \par Medicare peer review organization) and the Immunization Action = Coalition=20 \par of Washington are collaborating on a statewide project to assess=20 \par pneumococcal vaccination practices in licensed nursing homes and = coverage=20 \par rates among their residents. Occurring in several phases, the = project=20 \par will initially assess residents' pneumococcal vaccination status, = will=20 \par implement a vaccination intervention encouraging the use of = vaccine=20 \par standing orders, and will follow-up with a reassessment of = coverage. =20 \par All of the 274 licensed nursing homes in Washington State will be = invited=20 \par to participate in the project. A sample of residents will be = selected to=20 \par secure vaccine coverage data for residents that can be generalized = \par statewide. \par=20 \par Perinatal Regionalization Data Reports: \par=20 \par Two 1997 Perinatal Data Reports were disseminated to the statewide = \par regional contractors. The titles of the reports were: 1) 1997 = Births by=20 \par Birthweight by Washington State Perinatal Catchment Area and = Facility of=20 \par Birth; and 2) 1997 Perinatal and Neonatal Mortality by Washington = State=20 \par Perinatal Catchment Area and Facility of Birth. =20 \par=20 \par At the Nov. '99 Perinatal Regional Contractors meeting, the MCH=20 \par Assessment Section will distribute several other perinatal data = reports=20 \par on maternal and infant morbidity. Topics to be featured are as = follows:=20 \par 1) Length of Stay by Gestational Weeks by Washington State = Perinatal=20 \par Catchment Area and Facility of Birth; 2) Neonatal Transfers by = Washington=20 \par State Perinatal Catchment Area and Facility of Birth; 3) Percent = of=20 \par Cesarean Sections by Washington State Perinatal Catchment Area and = \par Facility of Birth; and 4) Percent of Vaginal Births After Cesarean = by=20 \par Washington State Perinatal Catchment Area and Facility of Birth. \par=20 \par "Spokane HD, with funding and technical support from = MCH/Immunization=20 \par Program staff, continues to make progress on its Birth Certificate = \par Follow-back Survey of 19-35 month old children to assessment = pre-school=20 \par child immunization coverage and risk and protective factors. = This is=20 \par part of the State's Immunization Program's Local and State = Childhood=20 \par Immunization Assessment Capacity Building Project (now in its 2nd = year). =20 \par Several other related projects are also now underway with = Southwest WA=20 \par HD and Seattle King County . SW is using similar methodology = after=20 \par deciding to conduct a survey of Clark Co. residents. SK will try = out a=20 \par modified, previously untested methodology to identify its sample = of=20 \par children to survey using RDD methods." \par =20 \par }{\b\f16\fs24 Infectious Disease and Reproductive Health (IDRH) \par=20 \par }{\f16\fs24 Mark Stenger, one of our new AIDS epidemiologists, has = begun=20 \par re-evaluating previous research on current methods for estimating = HIV=20 \par prevalence in order to develop a new set of estimates and future=20 \par projections. Last projections were done in 1996 by Maggie Ryland. = Todd=20 \par Rime continues to analyze AIDS Prescription Drug Program client = chart=20 \par abstract data for antiretroviral therapy prescription and = adherence. =20 \par Todd Rime is also in the planning stages, with the federal Region = X for=20 \par family planning, of piloting new data collection and data analysis = \par procedures at four local family planning agencies to assess client = \par behavior, risk, and pregnancy change with clinical and counseling=20 \par interventions. =20 \par=20 \par Kristen Janusz, our other new epidemiologist, is working on a=20 \par multi-faceted evaluation of the new HIV reporting system by which = those=20 \par who are HIV infected who tested confidentially or receive care are = \par reported to local health jursidictions by name. The LHDs are = given 90=20 \par days to investigate cases that are missing necessary information = (such as=20 \par risk of transmission), and at that point are required to change = the name=20 \par to a unique code. LHDs report unique codes to the state. Pieces = of the=20 \par evaluation include evaluation of the actual process of reporting,=20 \par evaluation of how representative the reported cases are of those = who are=20 \par HIV-infected in Washington State, and evaluation of whether HIV = reporting=20 \par is having an impact on counseling and testing behaviors.=20 \par=20 \par Scott LaMontagne, in coordination with STD staff, just finished a = report=20 \par on geographic access to STD care in Washington that represents our = \par office's initial foray into GIS technology. Reports are for LHJs = only=20 \par and will be distributed in two weeks. \par=20 \par Mary LeMier \par CWP Assessment Coordinator \par Department of Health, Mail Stop 47835 \par Olympia, WA 98504 \par Internet Address: MKL0303@hub.doh.wa.gov \par Voice: (360) 236-3693 \par FAX: (360) 664-2619 \par }\pard \nowidctlpar\adjustright {\b\f16\fs24\ul=20 \par Epidemiology, Health Statistics, and Public Health = Lab}{\f16\fs24\ul }{\b\f16\fs24\ul Rounds . . .}{\f16\fs24\ul=20 \par }{\f16\fs24=20 \par }{\b\f16\fs24 Center for Health Statistics -- \par }{\f16\fs24=20 \par Teresa Jennings and Ann Lima gave a presentation at the annual = conference of the Washi ngton Association of Coroners and Medical Examiners. The presentation = included information about CHS policies and procedures, uses of = cause-of-death information, sources of information on how to fill out = death certificates, possible solutions to common p roblems in death certification, and a discussion on how we can work = together to support each other. \par=20 \par The annual summary of vital statistics and annual report on = pregnancy and abortion statistics for 1998 were completed and will be = released the second week o f November. Vista/PH version 9.2 (software for community health = assessment) was released with all of the 1998 datasets, abortion data = from 1981-1990, and a new option to restrict birth weight factors to = single births.}{\f16\fs24\cf2=20 \par }{\f16\fs24=20 \par The federal privacy regulations related to HIPAA were released in = a 600+ page draft on 10/29/99. DOH is convening an agency workgroup to = review and comment on the regulations within the 60 day comment period. = \par=20 \par }\pard \nowidctlpar\tx576\tqr\tx9360\adjustright {\f16\fs24 The = "Invitation to Bid" for the mandatory state-wide telephone interview = contract=20 for the Behavioral Risk Factor Survey opened for bidding on October 9, = 1999. Bids are due November 9 to the Office of State Procurement. See = the General Administration website (below) and click on the text "Bid = document." http://www.ga.wa.gov/pca/bids /09499b.htm=20 \par }\pard \widctlpar\adjustright {\f16\fs24=20 \par }\pard \sb100\sa100\widctlpar\adjustright {\b\f16\fs24 = Communicable Disease Epidemiology=20 \par }{\f16\fs24 About 1,000 copies the 1998 Communicable Disease = Summary were printed and distributed to local health departments, = interested health care providers and state officials. Narrative = summaries, maps, tables and g raphs are provided for reportable communicable diseases. Copies may be = obtained from EHSPHL, Communicable Disease Epidemiology, MS K17-9, 1610 = NE 150th St, Shoreline, WA 98155, 206-361-2914.=20 \par In cooperation with Public Health Seattle-King County and the = California State Health Department we investigated an outbreak of E. = coli O157:H7 related to contaminated romaine.=20 \par We are working with multiple federal, state and local agencies in = Seattle in preparation for the World Trade Organization conference to = be hel d from November 30-December 4. About 5,000 government officials from = over 130 countries are expected, along with a large number of = demonstrators. Illness surveillance during this period will be = performed. While not expected to be a high risk event, work i s being done to improve preparedness for biochemical terrorism. We = expect this work to have long term benefits for preparedness in = Washington State. \par }\pard \widctlpar\adjustright {\b\f16\fs24=20 \par Non-Infectious Conditions Epidemiology=20 \par }{\f16\fs24=20 \par The Childhood Lead and Health Study is in the final week of data c ollection. As of November 3, we anticipate enrolling approximately 540 = children. We hope to have a preliminary analysis of the data by = November 9th to help the Advisory Group develop a policy for targeted = childhood lead screening in Washington. Contact: Eric Ossiander \par=20 \par We are working with Trina Wynkoop-Simmons and other DOH = epidemiologists to pilot test proposed state-added questions for BRFSS = 2000. Cognitive testing will be done by telephone survey in the next = few weeks, and the questions will be finali zed by Dec. 1. Contact: Angela Zechmann \par=20 \par We are coordinating a volume purchase of Stata statistical = software, which, due to economy of scale from combining four DOH = licenses and some LHJ licenses, means that each additional license will = cost us only $250 each. Contact: Steve Macdonald \par=20 \par All of the local health jurisdictions that did local Youth Risk = Behavior Surveys have received their data. CDC has scanned, but not = cleaned the state data. CDC did not include the Seattle questionnaires = and so we need to=20 combine the two datasets. We hope to have a dataset we can work with = by the end of November. One of the first sets of analyses we will do = is to look at bias by comparing YRBS frequencies to those obtained = through OSPI for the four questions that are ask e d on both the YRBS and the OSPI student assessment questionnaire. DASA = and Kids Count are also asking for data to be used in their November = and December reports, respectively. At this point, we are not = optimistic about meeting the DASA November deadline. Contact: Lillian Bensley \par=20 \par A report by the Climate Impacts Group at the University of = Washington will be released on November 9. The report addresses issues = such as whether warmer and wetter weather in the Pacific Northwest is = part of global climate change; what will happen in the next century; how would climate change affect = our water, forests, salmon, and coasts; are the region's government = agencies prepared for dealing with a changing climate. Members of the = Climate Impacts Group will travel to several c ities in the Northwest to discuss the report at a series of public = meetings. To order a copy of the report or to learn more about the = public meetings, please see: \par http://tao.atmos.washington.edu/PNWimpacts/report.html. Contact: = Dick Hoskins \par=20 \par CDC's 10/15 M MWR contained our article "Self-reported asthma in adults and = proxy-reported asthma in children -- Washington 1997-98". In it we = reported BRFSS data showing: persons with asthma reported significantly = lower health status than other respondents; a substan t ial proportion (one in six) of households with children reported having = a child with asthma; lifetime prevalence in adults is estimated at = 10.8% (totaling 450,000 affected individuals), and in children at 10.1% = (totaling 151,000 affected individuals). KI NG 5 TV news covered the story on 10/14 5pm and 11pm shows. Steve = Macdonald also attended a news event on 10/26 sponsored by Am. Lung = Assoc. WA announcing their new statewide community asthma education and = outreach program. Contact: Steve Macdonald \par=20 \par The re port on the study of the availability and comparability of federal = (military and veterans) hospital data, conducted by two UW MPH = students, was released to LHJs just prior to the JCH meeting in = Spokane, and we are waiting for feedback from the six countie s as input into development of the next phase. Contact: Steve = Macdonald \par=20 \par }\pard\plain \s17\widctlpar\adjustright \f16\cgrid {The number of = fetal deaths in Cowlitz County continues to be more than expected. We = are working with the LHJ, continuing the investigation and drafting a = plan for action. Contact: Steve Macdonald \par }\pard\plain \widctlpar\adjustright \fs20\cgrid {\f16\fs24=20 \par Jac Davies, MS, MPH \par Acting Assistant Secretary, EHSPHL \par Washington Department of Health=20 \par 1610 NE 150th St. \par Seattle, WA 98155 \par 206-361-4883 (Seattle), 360-236-4204 (Olympia) \par 206-361-2904 (fax), 360-971-9601 (pager) \par email: jac.davies@doh.wa.gov \par=20 \par }} ------_=_NextPart_000_01BF305E.0CB11D3A-- .