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Suggested Citation:"Front Matter." Institute of Medicine. 1997. Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine. Washington, DC: The National Academies Press. doi: 10.17226/5496.
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Toxicology and Environmental Health Information Resources

The Role of the National Library of Medicine

Catharyn T. Liverman, Carrie E. Ingalls, Carolyn E. Fulco, and Howard M. Kipen, Editors

Committee on Toxicology and Environmental Health Information Resources for Health Professionals

Division of Health Promotion and Disease Prevention

INSTITUTE OF MEDICINE

NATIONAL ACADEMY PRESS
Washington, D.C.
1997

Suggested Citation:"Front Matter." Institute of Medicine. 1997. Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine. Washington, DC: The National Academies Press. doi: 10.17226/5496.
×

NATIONAL ACADEMY PRESS
2101 Constitution Avenue, N.W. Washington, DC 20418

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competencies and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy’s 1863 congressional charter responsibility to be an advisor to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

Support for this project was provided by the National Library of Medicine, National Institutes of Health, under Contract No. N01-OD-4-2139. The views presented are those of the Institute of Medicine Committee on Toxicology and Environmental Health Information Resources for Health Professionals and are not necessarily those of the funding organization.

International Standard Book No. 0-309-05686-1

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Copyright 1997 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America.

Suggested Citation:"Front Matter." Institute of Medicine. 1997. Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine. Washington, DC: The National Academies Press. doi: 10.17226/5496.
×

COMMITTEE ON TOXICOLOGY AND ENVIRONMENTAL HEALTH INFORMATION RESOURCES FOR HEALTH PROFESSIONALS

HOWARD KIPEN, (Chair), Associate Professor and Director,

Division of Occupational Health, Environmental and Occupational Health Sciences Institute, University of Medicine and Dentistry of New Jersey—Robert Wood Johnson Medical School, Piscataway, New Jersey

PAUL FRAME* Family Physician,

Tri-County Family Medicine, Cohocton, New York

MARK FRISSE, Associate Dean,

Washington University School of Medicine, St. Louis, Missouri

SHERRILYNNE FULLER, Acting Director,

Informatics, School of Medicine, and

Director,

Health Sciences Libraries and Information Center, University of Washington, Seattle, Washington

FRED HENRETIG, Pediatric Emergency Physician,

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

DAVID McNELIS, Chief Scientist,

Environmental Science and Engineering, Research Triangle Institute, Research Triangle Park, North Carolina

KATHLEEN REST, Associate Professor,

Department of Family and Community Medicine, Occupational and Environmental Health Program, University of Massachusetts School of Medicine, Worcester, Massachusetts

BARBARA SATTLER, Director,

Environmental Health Education Center, University of Maryland at Baltimore School of Medicine, Baltimore, Maryland

ROSE ANN SOLOWAY, Administrator,

American Association of Poison Control Centers, and

Clinical Toxicologist,

National Capital Poison Center, Washington, D.C.

ROBERT E. TAYLOR, Chairman,

Department of Pharmacology, Howard University College of Medicine, Washington, D.C.

P. IMANI THOMPSON, Behavioral Scientist,

Centers for Disease Control and Prevention, Atlanta, Georgia

Institute of Medicine Staff

CATHARYN T. LIVERMAN, Study Director

CAROLYN E. FULCO, Senior Program Officer

CARRIE E. INGALLS, Research Associate

THOMAS WETTERHAN, Administrative Assistant/Research Assistant

AMELIA MATHIS, Project Assistant

MICHAEL STOTO, Director,

Division of Health Promotion and Disease Prevention (through December 1996)

KATHLEEN STRATTON, Interim Director,

Division of Health Promotion and Disease Prevention (from January 1997)

Suggested Citation:"Front Matter." Institute of Medicine. 1997. Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine. Washington, DC: The National Academies Press. doi: 10.17226/5496.
×

This page is blank in original.

Suggested Citation:"Front Matter." Institute of Medicine. 1997. Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine. Washington, DC: The National Academies Press. doi: 10.17226/5496.
×

Preface

The environment is increasingly recognized as having an impact on human and ecological health, as well as on specific types of human morbidity, mortality, and disability. Since the publication of its landmark report in 1988, Role of the Primary Care Physician in Occupational and Environmental Medicine, the Institute of Medicine (IOM) has conducted two additional studies that have examined the need to integrate environmental and occupational health into the education and practices of nurses and physicians. The recommendations from these reports are currently being implemented.

In 1995, the National Library of Medicine (NLM) asked the IOM to explore a related topic by requesting a study of NLM's Toxicology and Environmental Health Information Program (TEHIP). Specifically, NLM was concerned that health professionals were not fully using the information available in the 16 online databases comprising the TEHIP program. The IOM formed the Committee on Toxicology and Environmental Health Information Resources for Health Professionals. One of the committee's first goals was to seek input from a wide range of health professionals to more thoroughly understand health professionals' toxicology and environmental health information needs. Several mechanisms were used to receive input, including a workshop, during which attendees participated in focus group sessions; a questionnaire, designed to solicit information about health professionals' information needs; and discussions with representatives from federal agencies, health care, and academia.

During the course of the study, the committee reached several conclusions that it viewed as pivotal in advising NLM on how best to provide health professionals with toxicology and environmental health information. First, the committee believes that as environmental health concerns continue to increase, it is important for health professionals and other communities to have ready access

Suggested Citation:"Front Matter." Institute of Medicine. 1997. Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine. Washington, DC: The National Academies Press. doi: 10.17226/5496.
×

to information resources in this field. The committee reaffirms the findings of the 1993 NLM Long Range Planning Panel on Toxicology and Environmental Health, which found that NLM's TEHIP program is an important information resource that needs to be strengthened.

Second, the committee believes that there is a large and diverse potential audience for toxicology and environmental health information. In attempting to understand the user communities, the committee discussed a broad spectrum of potential users ranging from emergency care personnel treating individuals affected by acute toxic exposures to local coalitions struggling to determine the environmental health hazards faced by their communities. Although each of the user communities in this broad spectrum has diverse information needs, there are methods of targeting training and outreach efforts and developing database interfaces that will more adequately meet those disparate needs.

Finally, the committee concluded that NLM, as the nation's premier biomedical library, can and should play a key role in organizing and providing pointers to all toxicology and environmental health information resources (including and beyond the TEHIP databases). NLM, given its library and medical informatics expertise, is well-positioned to further develop the tools that can link health professionals with the wide array of information resources that are available in this important field. Furthermore, this is an area where public-private-sector partnerships can play an important role as there are numerous sources of toxicology and environmental health information.

The committee is grateful to those who provided input to its deliberations including the individuals who contributed their ideas through the workshop and in discussions with the committee (see Appendixes A and C). Additionally, the committee thanks the individuals who took the time to respond to the committee's questionnaire (see Appendix B). The TEHIP program staff, including Jeanne Goshorn and Melvin Spann, provided thorough background materials, assisted in the committee's workshop, and responded promptly to the committee's many requests for additional information or clarification. The committee appreciates all of their efforts. The IOM staff of Cathy Liverman, Carrie Ingalls, and Carolyn Fulco are to be congratulated for their thorough research of the issues and for molding the committee's sometimes wandering deliberations into this report.

Although the committee has recommended some clear directions and mechanisms for implementation, much work remains to be done. The committee hopes that the conclusions and recommendations made in this report will prove to be useful as NLM moves forward in providing health professionals with toxicology and environmental health information.

Howard M. Kipen, M.D., Chair

Committee on Toxicology and Environmental Health Information Resources for Health Professionals

Suggested Citation:"Front Matter." Institute of Medicine. 1997. Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine. Washington, DC: The National Academies Press. doi: 10.17226/5496.
×
Suggested Citation:"Front Matter." Institute of Medicine. 1997. Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine. Washington, DC: The National Academies Press. doi: 10.17226/5496.
×

Tables, Figures, And Boxes

Tables

2.1

 

Timeline of Events and Changes in Computer Technology and Environmental Health

 

23

2.2

 

TEHIP Databases

 

31

2.3

 

Types of Information Available in the TEHIP Databases

 

35

2.4

 

TOXLINE Subfiles

 

48

3.1

 

Sample of Current Toxicology and Environmental Health Databases

 

59

6.1

 

Review Process for TEHIP Factual Databases

 

113

Figures

2.1

 

National Library of Medicine Organizational Chart

 

21

2.2

 

TEHIP Program Budget

 

28

2.3

 

Organization of the TEHIP Databases

 

29

3.1

 

Executive Branch Departments and Agencies Involved in Environmental Health Issues

 

57

5.1

 

National Network of Libraries of Medicine

 

93

6.1

 

Primary Access Points to the TEHIP Databases

 

104

7.1

 

NLM Advisory Committees

 

122

B.1

 

Toxicology and Environmental Health Information Resources Most Often Consulted

 

147

B.2

 

Primary Factors Limiting Use of the NLM Toxicology and Environmental Health Databases

 

147

Boxes

2.1

 

Locator Field in the ChemID Database

 

36

2.2

 

Major Categories of HSDB Data

 

37

2.3

 

Excerpt from the TRIFACTS Record on Toluene

 

45

2.4

 

DIRLINE Record for the Association of Occupational and Environmental Clinics

 

46

4.1

 

Examples of the Applicability of the TEHIP Databases for the Work of Health Professionals

 

78

5.1

 

Previous IOM Recommendations on the Training of Health Professionals in Occupational and Environmental Health

 

90

5.2

 

Howard University

 

95

6.1

 

Methods of Searching the TEHIP Databases

 

102

6.2

 

TOXNET Selection Menu

 

106

Suggested Citation:"Front Matter." Institute of Medicine. 1997. Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine. Washington, DC: The National Academies Press. doi: 10.17226/5496.
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6.3

 

Sample Search on HSDB

 

109

6.4

 

Initial TRI Menu

 

110

6.5

 

Experimental World Wide Web Search Interface: Criteria for Narrowing the Search Strategy

 

111

Suggested Citation:"Front Matter." Institute of Medicine. 1997. Toxicology and Environmental Health Information Resources: The Role of the National Library of Medicine. Washington, DC: The National Academies Press. doi: 10.17226/5496.
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The environment is increasingly recognized as having a powerful effect on human and ecological health, as well as on specific types of human morbidity, mortality, and disability. While the public relies heavily on federal and state regulatory agencies for protection from exposures to hazardous substances, it often looks to health professionals for information about routes of exposure and the nature and extent of associated adverse health consequences. However, most health professionals acquire only a minimal knowledge of toxicology during their education and training.

In 1967 the National Library of Medicine (NLM) created an information resource, known today as the Toxicology and Environmental Health Information Program (TEHIP). In 1995 the NLM asked the Institute of Medicine to examine the accessiblity and utility of the TEHIP databases for the work of health professionals.

This resulting volume contains chapters on TEHIP and other toxicology and environmental health databases, on understanding the toxicology and environmental health information needs of health professionals, on increasing awareness of information resources through training and outreach, on accessing and navigating the TEHIP databases, and on program issues and future directions.

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