# Presentation: 164740

## Environmental Health

**Environmental Health**
**Progress Review**
**March 19, 2003**

## Key Components of 

**Environmental Health**

-    Source: Department of Health and Human Services.  Healthy People 2010. 2nd edition. With understanding and improving health
-    and objectives for improving health. Vol. 1. Washington: U.S. Government Printing Office.  November 2000.

**Water Quality**

**Toxics and Waste**

**Outdoor Air Quality**

**Healthy Homes and Healthy Communities**

**Global Environmental Health**

**Infrastructure and Surveillance**

**Health of Individuals & Communities**

**Notes:**
EH objectives are organized into 6 topic areas.

This presentation highlights one to two objectives from each topic area.

Begin at one o’clock and progress clockwise.

## Outdoor Air Quality

**	****8-2. ****	****Alternative modes of transportation**
**	****8-3. ****	****Cleaner alternative fuels**
**	****8-4. ****	****Airborne toxins**
**	**

**Outdoor Air Quality**

**Notes:**
8-1 is a Leading Health Indicator.

## 8-1a. Persons living in areas that do not 

**meet EPA standards****†**** for ozone**

-     Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR.

**Total**

**American Indian/**
**Alaska Native**
**only**

**White only, **
**not Hispanic**

**Black only, **
**not Hispanic**

**Hispanic**

**Asian**
**only**

**Percent**

**2010 target****‡**** = 0%**

**1997**

**2001**

**Native Hawaiian/**
**Other Pacific **
**Islander only**

**Notes:**
Data are available for all years (1997-2001).

Between 1997 and 2000: No change in data point for any group in the template between (because regions keep their “non-attainment” designation for three years).  Thus, trend data not shown.  1997 and 2001 provide only point of comparison.

## 8-1b. Persons living in areas that do not 

**meet EPA standards****†**** for particulate matter**

**Total**

**American Indian/**
**Alaska Native**
**only**

**White only, **
**not Hispanic**

**Black only, **
**not Hispanic**

**Hispanic**

**Asian**
**only**

**Percent**

**2010 target****‡**** = 0%**

**1997**

**2001**

**Native Hawaiian/**
**Other Pacific**
**Islander only**

-    Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR.

**†**

- National Ambient Air Quality Standards for particulate matter.
- Target set to be consistent with the Clean Air Act (Public Law 101-549).

**‡ **

## meet EPA standards† for carbon monoxide  

**meet EPA standards****†**** for carbon monoxide****  **

-     Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR.

**2010 target****‡**** = 0%**

**1997**

**2001**

**Percent**

**American Indian/**
**Alaska Native**
**only**

**White only, **
**not Hispanic**

**Black only, **
**not Hispanic**

**Hispanic**

**Asian**
**only**

**Total**

**†**

- National Ambient Air Quality Standards for carbon monoxide.
- Target set to be consistent with the Clean Air Act (Public Law 101-549).

**Native Hawaiian/**
**Other Pacific **
**Islander only**

**‡ **

## 8-1d. Persons living in areas that do not 

**meet EPA standards****†**** for nitrogen dioxide**

-     Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR.

**2010 target****‡**** = 0%**

**Percent**

**American Indian/**
**Alaska Native**
**only**

**White only, **
**not Hispanic**

**Black only, **
**not Hispanic**

**Hispanic**

**Asian**
**only**

**Total**

**1997**

**2001**

**†**

- National Ambient Air Quality Standards for nitrogen dioxide.
- Target set to be consistent with the Clean Air Act (Public Law 101-549).

**Native Hawaiian/**
**Other Pacific**
**Islander only**

**‡**

- *

- *

- *

- *

- *

- *

- *

## meet EPA standards† for sulfur dioxide  

**meet EPA standards****†**** for sulfur dioxide****  **

-    Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR.

**2010 target****‡**** = 0%**

**1997**

**2001**

**Percent**

**American Indian/**
**Alaska Native**
**only**

**White only, **
**not Hispanic**

**Black only, **
**not Hispanic**

**Hispanic**

**Asian**
**only**

**Total**

**†**

- National Ambient Air Quality Standards for sulfur dioxide.
- Target set to be consistent with the Clean Air Act (Public Law 101-549).

**Native Hawaiian/**
**Other Pacific **
**Islander only**

**‡**

## 8-1a-f. Persons living in areas that do not meet 

**EPA standards****†**** for criteria pollutants, 2001**

-     Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR.

**2010 targets****‡**** = 0%**

**Percent**

**Ozone**

**Sulfur **
**dioxide**

**Nitrogen **
**dioxide**

**Carbon **
**monoxide**

**Particulate **
**matter**

- *

- *

**Lead**

**Outside MSA**

**Within MSA**

**Total**

- MSA: Metropolitan Statistical Area

## 8-1g. Persons living in areas that do not meet EPA 

**standards****† ****for criteria pollutants, by race/ethnicity**

-    Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR.

**American Indian/**
**Alaska Native only**

**White only, **
**not Hispanic**

**Black only, **
**not Hispanic**

**Hispanic**

**Asian**
**only**

**Number (thousands)**

**2010 target = 0**

**1997**

**2001**

**Native Hawaiian/**
**Other Pacific**
**Islander only**

## standards† for criteria pollutants, by age and 

**standards****† ****for**** ****criteria pollutants****, by age and **
**geographic location**

-    Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR.

**Less than 10**

**65 and over**

**10-64**

**Number (thousands)**

**Age in years**

**....................                        ....................**

**Within**

**Outside**

**..............            ..............**

**MSA**

**2010 target = 0**

**1997**

**2001**

- MSA: Metropolitan Statistical Area

## EPA-designated nonattainment areas,

**1990 and 2000**

-   Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR.

**1990**

**2000**

- * Criteria pollutants are ozone, carbon monoxide, nitrogen dioxide, sulfur dioxide, particulate matter, and lead.

- *

## EPA-designated nonattainment areas for 

**EPA-designated nonattainment areas for**** **
**criteria pollutants****†****, ****September 2001**

-      Source: Aeromatic Information Retrieval System (AIRS), EPA/OAR.

## Water Quality

**	****8-6. ****	****Waterborne disease outbreaks**
**	****8-7. ****	****Water conservation**
**	****8-8. ****	****Surface water quality (developmental)**
**	****8-9. ****	****Beach closings (developmental – proposed ****	****	****           baseline data shown)**
**	****8-10. ****	****Fish contamination (developmental)**

**Water Quality**

## Number of beaches in the 2001 National 

**Number of beaches in the 2001 National **
**Health Protection Survey of Beaches**

-   Source: EPA/OW.  *BEACH Watch Program: 2001 Swimming Season*.  May 2002.

## 8-9. Beaches experiencing one or more 

- <date/time>

**8-9. Beaches experiencing one or more **
**advisories or closings, 1997-2001**

-   Source: National Health Protection Survey of Beaches, EPA/OW.

**Number**

**Beaches surveyed**

**Beaches experiencing **_**>**_** 1 advisories/closings**

**23%**

**25%**

**24%**

**27%**

**27%**

-   Note: This objective is developmental.  A 2010 target has not yet been set.

## Sources of pollution causing beach 

**advisories and closings, 2001**

-   Source: EPA/OW.  *BEACH Watch Program: 2001 Swimming Season*.  May 2002.

**Unknown**
**52%**

**Storm water runoff**
**20%**

**Other**
**3%**

**Wildlife**
**10%**

**Combined sewer overflow**
**3%**

**Boat discharge**
**2%**

**Sanitary sewer overflow**
**2%**

**Sewer line blockage or break**
**4%**

**Publicly owned treatment works**
**1%**

**Septic system**
**3%**

## Toxics and Waste

**	****8-12.****	**** Risks posed by hazardous sites ****	**
**	****8-13.****	**** Health care visits due to pesticide ****	****	****	**** exposure ****	**
**	****8-14. ****	**** Toxic pollutants generated for energy ****	****	****	**** recovery (developmental)**
**	****8-15. ****	**** Recycled municipal solid waste**
**	**

**Toxics and Waste**

## 8-11. Children ages 1-5 years with 

**elevated blood lead levels****†**

-       Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.

**Percent **

**1988-1991**

**1999-2000**

**1976-1980**

**1991-1994**

**88.2%**

**8.9%**

**4.4%**

**2.2% ********

## Mean blood lead concentration 

**in children ages 1-5 years**

-     Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.

**†**  Geometric mean

**Mean****†**** blood lead concentration (ug/dL) **

- I  95% Confidence Interval

**1976-1980**

**1988-1991**

**1999-2000**

**1991-1994**

## Mean blood lead concentration in 

**children ages 1-5 years, by race/ethnicity**

-     Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.

**†**  Geometric mean

**Mexican **
**American***

**White, **
**not Hispanic**

**Mean****†**** blood lead concentration (ug/dL) **

- I  95% Confidence Interval

**Black, **
**not Hispanic**

- *  Can be of any race

**Total**

**1991-1994**

**1999-2000**

## Healthy Homes and Communities

**	****8-17.****	****   Office building air quality**
**	****8-18.****	****   Homes tested for radon ****	**
**	****8-19. ****	****   Radon-resistant new home construction**
**	****8-20. ****	****   School policies to protect against hazards**
**	****8-21.****	****   Disaster preparedness plans and protocols**
**	****8-22.****	****   Lead-based paint testing in pre-1950s homes**
**	****8-23.****	****   Substandard housing**
**	**

**Healthy Homes and Communities**

## 8-16. Indoor allergens: Dust mite 

**and cockroach allergens in bed dust**

-    Source: National Survey of Lead and Allergens in Housing, NIH/NIEHS; and U.S. Department of Housing and Urban Development (HUD).

**Group 1 dust mite **
**> 2 ug/g**

**Millions of homes **

**1998-99 level**

**2010 target**

**Direction desired**

**Group 1 dust mite **
**> 10 ug/g**

**German cockroach **
**> 0.1 unit/g**

**Allergen concentration in bed dust**

**...........................                                                                ...........................****.     **

**44.3**

**23.2**

**5.8**

## Homes with group 1 dust mite allergen 

**concentrations at or above threshold, 1998-1999**

-     Source: Arbes SJ, Cohn RD, Yin M, et al. House dust mite allergens in US beds: Results from the first National Survey of Lead and Allergens
-     in Housing. Journal of Allergy and Clinical Immunology. February 2003.

_**>**_** 0.025 ug/g**

**Percent of homes **

_**>**_** 2.0 ug/g**

_**>**_** 10.0 ug/g**

**Allergen concentration in bed dust**

** ........................                                                                    ........................     **

**Lower limit of detection**

**Threshold for **
**allergic sensitization**

**Threshold for **
**asthma sensitization**

- I  95% Confidence Interval* of any race.

**84.2%**

**46.2%**

**24.2%**

## Mean dust mite concentrations, by

**housing unit characteristics, 1998-1999**

-     Source: Arbes SJ, Cohn RD, Yin M, et al. House dust mite allergens in US beds: Results from the first National Survey of Lead and Allergens in  Housing.
-     Journal of Allergy and Clinical Immunology. February 2003.

**Construction Year**

-  _<_ 1939

- 1940-1959

- 1960-1977

- 1978-1998

**1990 census region**

- West

- Midwest

- South

- Northeast

**Household income**

- < $20,000

- $20,000-39,999

- $40,000-59,999

- _>_ $60,000

**Mean concentration (ug/g)**

- I  95% Confidence Interval* of any race.

## Infrastructure and Surveillance

**	****8-25.****	****   Exposure to heavy metals and other toxic ****	****	****   ****	****   chemicals (developmental – proposed ****	****	****	****   baseline data shown)**
**	****8-26.****	****   Information systems used for environmental ****	****	****   health****	**
**	****8-27. ****	****   Monitoring environmentally related diseases**
**	****8-28. ****	****   Local agencies using surveillance for vector ****	****	****   control**
**	**

**Infrastructure and Surveillance**

## 8-24a-d. Pesticide metabolites in the urine, 

**persons ages 6 and over**

- Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.  Data reported in the *Second National Report on Human *
*Exposure to Environmental Chemicals*, CDC/NCEH (January 2003).

**1-Napthol **
**(carbaryl)**

**Paranitrophenol**
**(methyl parathion/**
**parathions)**

**3,5,6-Trichloro-2-pyridinol**
**(chlorpyfifos)**

**Metabolite (pesticide)**

**Isopropoxyphenol**
**(propoxur)**

- Note: 1988-1994 data are for persons ages 6 and over.  1999-2000 data are for persons ages 6-59 years.

**< LOD**

**                †**  95th percentile
-  I  95% Confidence Interval

- LOD: Limit of detection

**Urine concentration (ug/g creatinine)****†**

**1988-94**

**1999-2000**

**2010 target**

- *

## 8-24a-c. Pesticide metabolites in the urine, 

**persons ages 6-59 years, by race, 1999-2000**

-       Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.  Data reported in the *Second National Report on Human *
*      **Exposure to Environmental Chemicals*, CDC/NCEH (January 2003).

**1-Napthol **
**(carbaryl)**

**Paranitrophenol**
**(methyl parathion/**
**parathions)**

**3,5,6-Trichloro-2-pyridinol**
**(chlorpyfifos)**

**Metabolite (pesticide)**

**†**  95th percentile
- ** Can be of any race.

**Urine concentration (ug/g creatinine)****†**

**Mexican American****

**Black, not Hispanic**

**2010 target**

**White, not Hispanic**

- *

## 8-24a-c. Pesticide metabolites in the urine, 

**persons ages 6-59 years, by age, 1999-2000**

-    Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.  Data reported in the *Second National Report on Human *
*   **Exposure to Environmental Chemicals*, CDC/NCEH (January 2003).

**1-Napthol **
**(carbaryl)**

**Paranitrophenol**
**(methyl parathion/**
**parathions)**

**3,5,6-Trichloro-2-pyridinol**
**(chlorpyfifos)**

**Metabolite (pesticide)**

**†** 95th percentile

**Urine concentration (ug/g creatinine)****†**

**6-11 years**

**12-19 years**

**2010 target**

**20-59 years**

- *

## 8-25b,c,e. Heavy metals in the blood, 

**persons ages 1 year and over, 1999-2000**

-      Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.  Data reported in the *Second National Report on Human *
*     **Exposure to Environmental Chemicals*, CDC/NCEH (January 2003).

-     Note: This objective is developmental.  A 2010 target has not yet been set.

**†**  95th percentile
- I  95% Confidence Interval

**Cadmium**

**Lead**

**Blood concentration (ug/dL)****†**

**Females & Males**
**1-5 years**

**Females**
**16-49 years**

- ..........            ..........

**Mercury**

##  8-25c. Mean blood lead concentrations, 

**persons ages 1 year and over, 1999-2000**

-      Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.  Data reported in the *Second National Report on Human *
*     **Exposure to Environmental Chemicals*, CDC/NCEH (January 2003).

**Total**

**1-5 years**

**Mexican American***

**Male**

**  ****Female**

**Black, not Hispanic**

**White, not Hispanic**

**6-11 years**

**12-19 years**

**20 years and over**

- *   Can be of any race
- I   95% Confidence Interval*

**Mean blood lead concentration (ug/dL)**

-      Note: This objective is developmental.  A 2010 target has not yet been set.

## 8-25f,g,i. Pesticide metabolites in the urine, 

**persons ages 6-59 years, 1999-2000**

-   Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.  Data reported in the *Second National Report on Human *
*  **Exposure to Environmental Chemicals*, CDC/NCEH (January 2003).

- LOD: Limit of detection.
- Note: This objective is developmental.  A 2010 target has not yet been set.

**2,4-Dichlorophenoxyacetic **
**acid**

***ortho*****-Phenlyphenol**

**2-Isopropyl-4-methyl-**
**6-hydroxypyrimidine**
**(Diazinon)**

**Metabolite (pesticide)**

**Urine concentration (ug/g creatinine)****†**

**< LOD**

**< LOD**

## 8-25m,o,p. Organochlorine compounds in the blood 

**serum, persons ages 12 years and over, 1999-2000**

-   Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.  Data reported in the *Second National Report on Human *
*  **Exposure to Environmental Chemicals*, CDC/NCEH (January 2003).

- Note: This objective is developmental.  A 2010 target has not yet been set.

**Oxychlordane**

**Dichlorodiphenyltrichloroethane**
**(DDE)**

**Beta-hexachlorocyclohexane**

**Organochlorine compound**

**Serum concentration (ng/g lipid)****†**

**†**

- I

-                  95th percentile
- 95% Confidence Interval*

## 8-25o. Dichlorodiphenyltrichloroethane (DDE) in the 

**blood serum, persons ages 12 and over, 1999-2000**

-    Source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.  Data reported in the *Second National Report on Human *
*   **Exposure to Environmental Chemicals*, CDC/NCEH (January 2003).

**Total**

**12-19**
**years**

**Mexican**
** ****American***

**Serum concentration (ng/g lipid)****†**

**20+**
**years**

**Males**

**Females**

**Black,**
**not**
**Hispanic**

**White,**
**not**
**Hispanic**

- *  Can be of any race

- Note: This objective is developmental.  A 2010 target has not yet been set.

## Global Environmental Health

**	****8-30.****	**** Water quality in the U.S.-Mexico border region ****	**
**	**

**Global Environmental Health**

## U.S.-Mexico border region

**U.S.-Mexico border region**

- Source: U.S.-Mexico Border Health Commission

## 8-30a-f. Wastewater sewer service in selected 

**U.S.-Mexico border communities   **

- Sources: EPA; Mexico’s Comision Nacional de Agua; State and local health departments; American Water Works Association; Rural Water
- Association; U.S.-Mexico Border Health Association.

**Ciudad **
**Acuna**

**Percent **

**1997**

**2002**

**2010 target**

**Mexicali**

**Piedras**
**Negras**

**Matamoros**

**Nogales,**
**Sonora**

**Reynosa**

**NA**

**NA**

- NA: Data not available.

- *

- *

- *

## 8-30g-l. Wastewater receiving treatment in  

**selected U.S.-Mexico border communities**

-   Sources: EPA; Mexico’s Comision Nacional de Agua; State and local health departments; American Water Works Association; Rural Water
-   Association; U.S.-Mexico Border Health Association.

**Ciudad **
**Acuna**

**Percent **

**1997**

**2002**

**2010 target**

**Mexicali**

**Piedras**
**Negras**

**Matamoros**

**Nogales,**
**Sonora**

**Reynosa**

**NA**

- NA: Data not available.

**NA**

- *

- *

- *

## For more information

**Progress Review data and slides **
**can be accessed on the web at:**
**http://www.cdc.gov/nchs/hphome.htm**