Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page R1
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
OCR for page R2
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 Additional copies of this report are available for sale from the National Academy Press, Box 285, 2101 Constitution Avenue, Washington, DC 20055. Call (800) 624-6242 or (202) 334-3313 in the Washington metropolitan area, or visit the NAP’s on-line bookstore at http://www.nap.edu. Copyright 1997 by the National Academy of Sciences. All rights reserved. Printed in the United States of America.
OCR for page R3
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)
OCR for page R4
This page is blank in original.
OCR for page R5
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
OCR for page R6
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
OCR for page R7
Contents EXECUTIVE SUMMARY 1 1 INTRODUCTION 11 Health Professionals and Other User Communities 13 Public Health Impacts of Hazardous Substances 14 Changing Trends in Health Practice 15 Organization of the Report 16 2 THE NATIONAL LIBRARY OF MEDICINE'S TOXICOLOGY AND ENVIRONMENTAL HEALTH INFORMATION PROGRAM 19 National Library of Medicine 20 Division of Specialized Information Services 25 Toxicology and Environmental Health Information Program 26 TEHIP Databases 29 TEHIP Factual Databases 30 TEHIP Bibliographic Databases 47 Conclusions 52 3 OTHER TOXICOLOGY AND ENVIRONMENTAL HEALTH INFORMATION RESOURCES 55 Conclusion and Recommendation 58
OCR for page R8
4 UNDERSTANDING THE INFORMATION NEEDS OF HEALTH PROFESSIONALS 69 Information Needs 69 Factors Affecting Information Seeking 71 Current and Potential Users of the TEHIP Databases 75 Conclusion and Recommendation 82 5 INCREASING AWARENESS: TRAINING AND OUTREACH 87 Training 88 Outreach 91 Future Directions and Recommendation 96 6 ACCESSING AND NAVIGATING THE TEHIP DATABASES 101 Access: Getting Connected to the Databases 101 Navigating the TEHIP Databases 105 Future Directions 114 Conclusions and Recommendations 116 7 PROGRAM ISSUES AND FUTURE DIRECTIONS 119 Program Issues 120 Future Directions 126 GLOSSARY AND ACRONYMS 131 APPENDIXES A Acknowledgments 143 B Questionnaire 145 C Workshop on Toxicology and Environmental Health Information Resources: Agenda, Participants, and Summary of Focus Group Discussions 153
OCR for page R9
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
OCR for page R10
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
OCR for page R11
This page is blank in original.
OCR for page R12
This page is blank in original.