ally, baseline data already exists for a number of measures relevant to a surveillance system.

  • Unanswered Questions. Identifying knowledge gaps and pertinent questions can be equally as informative to developing a framework for surveillance systems as what is already known. Based on discussions over the course of the workshop, Adler stated that many questions still remain, such as which outcomes to monitor, which covariants to measure and control for, whether to use passive or active data collection, and who should be responsible for different areas within a surveillance system.

As briefly noted in Chapter 2, Maureen Lichtveld also proposed six components of a multi-pronged action plan (see Box 7-1) to assess exposures, identify the risk of these exposures, and communicate the results and findings to affected populations throughout the Gulf Region.

BOX 7-1

Components of a Multi-Pronged Action Plan

  • Characterize the contaminants of concern in all environmental media over time by conducting toxicity assays and seafood toxicity monitoring.

  • Fingerprint exposures by developing novel biomarkers of exposure, gathering real-time exposure monitoring data, or geospatial modeling.

  • Protect vulnerable populations through psychosocial interventions and through long-term monitoring and biospecimen banking (even if it is not yet clear what answers the biospecimen banking will provide) and perhaps by looking for susceptibility biomarkers.

  • Communicate about the risks clearly, early, and in a way that accounts for varying levels of health literacy.

  • Educate health providers so that they can provide answers to the community.

  • Disseminate information “just in time” and “just in case” so that communities have it at their fingertips.

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