Disaster Epidemiology: From Fukishima to Super Storm Sandy
Sunday, June 9, 2013: 8:30 AM-5:00 PM
107 (Pasadena Convention Center)
This workshop will address environmental epidemiology response during disasters, including sessions addressing manmade and extreme weather events. The goal and purpose of this workshop will be to discuss the role of environmental epidemiology in preparing for responding to and recovering from disasters. It is anticipated that discussion of natural disasters such as super storm Sandy (summary of the storm effects, illness and injury, surveillance efforts, environmental health response and the challenges which followed) will be prominent. Panel members representing states that have recent experience with hurricanes, ice storms and possibly large wild fires are also anticipated. Resources to be shared and presented include current approaches and tools that are in place for interview surveys and assessments (such as EHRMS, CASPER and ACE); tracking tools developed by the Environmental Public Health Tracking program; and best field use of these. The role of tracking data in disaster planning and response (baseline, assessing long term recovery, etc.) will be discussed as well as the use of syndromic surveillance in this novel situation.

The final half-day will include an interactive discussion of the role of environmental epidemiology in responding to radiation emergencies such as what occurred in the Fukushima Japan incident will also be presented as the case study (or as the basis of our discussion). A summary of this event, after action recommendations, guidance and population monitoring tools related to radiation that were recently developed, and new radiation guidelines will be shared. Current state activities related to response and monitoring (debris washing on shore, etc.) will be also discussed.

CSTE Staff Contact:
Erin Simms
esimms@cste.org

8:30 AM
Introductions
Michael Heumann
8:40 AM
Welcome/Opening Remarks
Dan Smith, California Dept of Public Health
8:50 AM
Syndromic Surveillance and Disaster Response
Moderator: Betsy Kagey, Georgia Department of Public Health

Speakers:

8:50-9:05 am       

Use of Florida’s Syndromic Surveillance System (ESSENCE) during Disasters and for Novel Events

Sharon Watkins, Florida Department of Health

9:05-9:20 am       

Disaster-related surveillance using NC DETECT

Grace Oguntebi and Amy Ising, North Carolina Division of Public Health

9:20-9:30 am      

Discussion

9:30 AM
The Impact of the Fukushima Accident in Washington State (Or, the Emergency That Wasn’t)
Moderator: Sharon Watkins, Florida Department of Health

Shortly after the Japanese earthquake and tsunami occurred on March 11, 2011, the headlines began reporting: “deadly radiation cloud heading to the United States.” The media seemed to be competing to see who could scare the public the most, with internet bloggers doing the same. Along with the radiation protection programs in other states, the Washington Department of Health geared up to respond to public concerns, recognizing that an accident 5,000 miles away would have minimal health impact on our citizens. We responded to questions, fears and concerns, while collecting and analyzing environmental data to provide the proof of our statements. Although never a radiological emergency, this accident proved to be a public information emergency, requiring the establishment of a modified incident command structure to effectively respond. This presentation will describe our response to, and education of, our frightened and distrustful public.

Speaker:

9:35-10:05 am    

Al Conklin, Washington Department of Health

10:05-10:15 am  

Discussion

10:15 AM
Break

10:30 AM
Disaster epidemiology tools for improving all-hazard disaster preparedness and response capacities:
Community Assessment for Public Health Emergency Response (CASPER), Emergency Responder Health Monitoring & Surveillance (ERHMS) system, and Assessment of Chemical Exposure (ACE)

Facilitator:  Mary Anne Duncan, Agency for Toxic Substances and Disease Registry

To respond appropriately to the public health threats from disasters, timely and accurate information concerning community needs is required. Epidemiologic activities provide information to identify health problems and establish priorities for decision-makers.  To assist state, local, tribal, and territorial (SLTT) health departments in conducting epidemiologic activities in response to all phases of the disaster life cycle, CDC’s National Center for Environmental Health (NCEH), CDC’s National Institute of Occupational Safety and Health (NIOSH), and the Agency for Toxic Substances Disease Registry (ATSDR) developed the Community Assessment for Public Health Emergency Response (CASPER) methodology, Emergency Responder Health Monitoring and Surveillance (ERHMS), and Assessment of Chemical Exposures (ACE) respectively.  These epidemiologic tools assist emergency preparedness and response by describing the distribution of exposures and outcomes; rapidly detecting hazards, outbreaks or clusters; identifying and implementing timely interventions; evaluating the impacts of public health efforts; and improving public health preparedness planning.  The Council of State and Territorial Epidemiologists (CSTE) disaster epidemiology subcommittee has been working closely with CDC/ATSDR to increase awareness and provide training on these tools.  We will provide an overview of CASPER, ERHMS, and ACE; describe when they are most appropriate to be used; and identify how state, tribal, local, territorial, and regional public health practitioners can work with federal partners to use these tools. Data collection methods and analytic considerations will be discussed as well as examples of instances when they have been used and the applications of the information gathered by these tools:

  • CASPER is an epidemiologic technique for public health practitioners and emergency management officials designed to provide quickly and at low cost, household-based information about an affected community’s needs after a disaster. Public health officials and emergency managers can make informed decisions to prioritize their response activities and match available resources with identified needs.
  • ERHMS was developed to close gaps that existed in health monitoring and surveillance afforded to emergency responders and the need for both a comprehensive approach to protect responders and a practical guide on implementing such an approach.  The ERHMS guidance was created by an interagency workgroup coordinated by NIOSH and published as a National Response Team Technical Assistance Document.
  • ACE was developed to be a resource to help SLTT health departments respond quickly and effectively to the emergency health challenges of chemical incidents. The ACE toolkit contains English/Spanish language surveys tools; forms for medical record abstraction and consent; a database to enter the data; and training materials. 

Speakers:

10:30-11:00 am                                  

CASPER

Amy Wolkin, National Center for Environmental Health, Health Studies Branch

11:00-11:30 am                                 

ERHMS

Renée Funk, Epidemiologist, Emergency Preparedness and Response Office, National Institute for Occupational Safety and Health

11:30-12:00 pm                                  

ACE

Mary Anne Duncan, Epidemiologist, Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry

12:00 PM
Lunch on your own

1:30 PM
Storm Trackers: Role of Local Environmental Public Health Tracking Programs during Super Storm Sandy
Moderator: Ekta Choudhary, Centers for Disease Control and Prevention

Speakers:

1:30 – 1:50 pm                  

EPHT as part of a collaborative storm response

Patricia Przysiecki, Connecticut Department of Public Health

1:50 – 2:10 pm                   

Hurricane Sandy and the NYC Tracking Program’s Response

Sarah Walters and Nancy Loder Jeffery, New York City Department of Health and Mental Hygiene

2:10 – 2:30 pm                   

Tracking Hurricane Sandy-Related Health Impacts in New Jersey with a Syndromic Surveillance System

Jerald A. Fagliano, New Jersey Department of Health

2:30 – 3:00 pm                   

Question & Answer

3:00 PM
Break

3:15 PM
Description of Federal Response to Hurricane Sandy

Hurricane Sandy made landfall across the U.S. northeastern coastline on October 29, 2012 causing widespread infrastructure destruction and large scale evacuations from flood zones. In addition to the tens of billions of dollars in damages, “super-storm” Sandy claimed many lives. The affected states and federal government initiated large scale response to the storm. This presentation will describe various disaster epidemiology efforts conducted in response to Hurricane Sandy.

Amy Wolkin, Centers for Disease Control and Prevention

3:45 PM
Discussion and Demonstration of Radiation and Earthquake Monitoring Equipment
Moderator: John Neuberger, The University of Kansas

Erin Burkett, U.S. Geological Survey

Josephine Ortego, Los Angeles County Department of Public Health

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