sponse teams have a critical need for access to exposure and background data. This was reinforced during the tragic events of September 11, 2001, and the anthrax outbreak in 2001. The challenge is that the information is needed quickly and in a usable format in order to develop appropriate interventions and to inform the public.

Environmental health professionals have called for further research into complex environmental exposures. According to many workshop participants, we know very little about the role of the environment in many disease incidences. This is a growing concern because, in the United States alone, chronic disease contributes to more than half of all deaths and illnesses at an annual cost of $325 billion. The role of the environment in disease is further questioned because of increases in the number of reported clusters for cancer, Parkinson’s disease, multiple sclerosis, and Alzheimer’s disease.

Environmental health monitoring provides an important linkage between exposure to environmental toxicants and health outcomes. Its purpose, according to Richard J.Jackson, Centers for Disease Control and Prevention, is to find emerging threats over time, to put control tools in place, to evaluate whether they work, and to adjust them as needed. Environmental health monitoring is the use of epidemiological, toxicological, and other knowledge in an action-oriented way to accomplish the following:

  • Monitor a move toward sustainable development

  • Monitor trends in the state of the environment

  • Monitor trends in the health effects of hazards

  • Investigate links between the environment and health

  • Monitor effects of policies and preventive actions

  • Compare trends across geographic areas

The concept of environmental health monitoring in the United States dates back to the 1970s, when the Council on Environmental Quality (CEQ) and Project Upgrade in the Carter administration used mapping to link health and the environment and to provide a “national report card” as a basis for moving forward. Environmental health monitoring was advanced further by the Institute of Medicine’s report The Future of Public Health (1988) and the Pew Environmental Health Commission Report America’s Environmental Health Gap: Why the Country Needs a National Health Tracking Network (2000b). This work provided the momentum at the national level for current legislative efforts to establish



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