SURVEILLANCE IN ENVIRONMENTAL PUBLIC-HEALTH - ISSUES, SYSTEMS, AND SOURCES

This article describes environmental public health surveillance and pr oposes a framework to enhance its practice in the United States. Speci al issues for surveillance in environmental public health are examined , and examples of existing systems useful for environmental public hea lth practice are provided. Current and projected surveillance needs, a s well as potential sources of data, are examined. The proposed framew ork for conducting environmental public health surveillance involves d ata from three points in the process by which an agent in the environm ent produces an adverse outcome in a host: hazards, exposures, and out comes. Environmental health practitioners should build on efforts in o ther fields (e.g., infectious diseases and occupational health) to est ablish priorities in the surveillance of health conditions associated with exposure to environmental toxicants. For specific surveillance pr ograms, existing data systems, as well as data gaps, should be identif ied. Coordinated surveillance systems can facilitate public health eff orts to prevent and control disease, injury, and disability related to the interaction between people and their environment.