Disaster Preparedness: Participation of Public Health Departments in Epidemiologic Data Collection Los Angeles County Department of Public Health Bureau of Toxicology and Environmental Assessment Toxics Epidemiology Program

Background Evaluation of subjects, gathering samples, and recording of data is a serial process Any step can be rate-limiting Public health agencies must maximize efficiency of data collection during disasters Little evidence comparing efficiency and utility of data collection tools in a disaster

Incident: Marble Challenge Improvised nuclear device in Indianapolis, IN Expectation of fear and panic among the public Projection of people fleeing the area, without notice

Background

Incident: Marble Challenge People may flee to multiple locations Some fleers may be more determined than others – Look for immediate means of transportation – Get as far away from incident as possible

Incident: Marble Challenge “Load up the truck and move to…”

Incident: Marble Challenge Barstow

Incident: Marble Challenge

Radiation portal monitors used for passive screening of cars entering California at Barstow Public Health screening of occupants of “hot” cars

Incident: Marble Challenge LA County DPH assisted CDC in processing victims CDC sent spiked urine samples and devised an array of victims’ symptoms 3 survey tools were designed, to collect health information and to prioritize

Incident: Marble Challenge

Paper/handwritten format Handheld/PDA Laptop Each victim was evaluated through all 3 health screens and asked to note preferred format Data collectors rotated, using all 3 health screens, and asked to note preferred format

Incident: Marble Challenge Completion of epidemiologic screening Urine sample prioritizations with data transfers to laboratories Sr-90 and uranium spiked urine samples sent to LA County DPH, CA DPH, and CDC labs

Incident: Marble Challenge All 3 methods were equally accurate (>90% for each format) and able to identify high priority samples Collector preferences: – 57% laptop, 43% handheld, 0% paper Victim preferences: – 21% laptop, 29% handheld, 21% paper

Incident: Marble Challenge

Conclusion: Data Collection All methods were effective Electronic methods were preferred overall for the collection of epidemiologic and laboratory sampling data

Questions Raised How do we optimize local IDs/other logistics? How do we format data for transfer to other agencies? How can we best coordinate victim tracking, for medical management, sampling, and other triage issues?

Potential Benefits of Electronic Data Collection Immediate compilation of results Potential to ask more questions in less time Elimination of data re-entry Rapid transmission of results Rapid statistical analysis Linkage of data sets, GIS mapping “Red-flag” detection