1. Land of Fun and Sun…. and Water Karen Hamilton PhD, RN Alice Godfrey MPH, RN, BC This project is supported by funds from the Division of Nursing (DN), Bureau of Health Professions (BHPr), Health Resources and Service Administration (HRSA), Department of Health and Human Services (DHHS) under (D09HP05319,Health Resources and Service Administration $ 286,092.00). The information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any official endorsement be inferred by, the DN, BHPr,HRSA,or the US Government.

2. Mobile Bay Area HOST: 581,775 pop. Environment Industrial growth Deforestation Hurricanes Agent: Water Borne Illnesses

3. Jubilee! Fish on Shore- Not in the Ocean! A Jubilee is a “phenomenon" bringing blue crabs, shrimp, and fish swimming from the depths of Mobile bay into the shallow waters of the Eastern shoreline. The phenomenon occurs in the summertime when decompensation occurs and oxygen is rapidly depleted from the salt water at the bottom of Mobile Bay. Source: daphneal.com/jubilee.asp

4. Communities along the Gulf Coast are experiencing rapid growth. This growth has resulted in increased in populations in urban and rural areas and a concern for the environmental impact on the many canals, rivers and waterways in the area. Population Growth Mobile Bay Area 1990476,9232000540,250*2008581,775**2013607,696 Sources: 1. 1980, 1990, 2000: Bureau of the Census 2. Decision Data Resources2008 (*estimated - **projected ) cited by Mobile Area Chamber of Commerce.

5. Water Facts Water Facts At least one-sixth of the surface area of Alabama is comprised of lakes, ponds, wetlands, estuaries, and flowing rivers and streams. At least one-sixth of the surface area of Alabama is comprised of lakes, ponds, wetlands, estuaries, and flowing rivers and streams. Alabama has 50 miles of Gulf Coast shoreline and beaches Alabama has 50 miles of Gulf Coast shoreline and beaches and approximately 65 to 70 miles of bay beaches that are classified for swimming. Approximately 10% of freshwater resources in the entire continental United States originate or flow through Alabama. Additionally, 20% of Alabama’s population depends on private water supplies, such as wells, for drinking water. Approximately 10% of freshwater resources in the entire continental United States originate or flow through Alabama. Additionally, 20% of Alabama’s population depends on private water supplies, such as wells, for drinking water. The use of groundwater for human use and recent severe droughts has led to drops in ground water levels. Groundwater recharge zones or aquifers are reservoirs for the run-off of water from developed areas of buildings and streets. If the land contains pollutants and other contaminates then the groundwater is contaminated. The use of groundwater for human use and recent severe droughts has led to drops in ground water levels. Groundwater recharge zones or aquifers are reservoirs for the run-off of water from developed areas of buildings and streets. If the land contains pollutants and other contaminates then the groundwater is contaminated. Source: U. S. Geological Survey, 2009; AL Dept. Public Health, 2009; Encyclopediaofalabama.org, 2009 Encyclopediaofalabama.org, 2009

6. Surveillance Activities Alabama Coastal Beach Monitoring Program Alabama Coastal Beach Monitoring Program In June 1999, the Alabama Department of Environmental Management (ADEM), in cooperation with the Alabama Department of Public Health, initiated a program to monitor selected swimming beaches on the Gulf of Mexico for the presence of fecal coliform and Enterococcus bacteria. The effort began with five (5) stations located along the Alabama Gulf coast and in August 2000, was expanded to include six (6) additional stations located in and around Mobile Bay. Currently, routine collection of water samples from 25 high use and/or potentially high risk public recreational sites are conducted. Alabama Coastal Beach Monitoring Program for 24 beaches – Gulf Shores, Orange Beach, Fairhope Park, Dog River, Dauphin Island, Fort Morgan, Fowl River, etc. Mobile County Board of Health reportable cases of waterborne diseases Mobile County Board of Health reportable cases of waterborne diseases e coli & shigellosis (bacteria), giardiasis & cryptosporidiosis (parasites), and vibriosis e coliO157:H7 & shigellosis (bacteria), giardiasis & cryptosporidiosis (parasites), and vibriosis Sources: Alabama Department Environmental Management, 2009; Mobile County Helth Department, 2009

7. Interagency Collaboration Alabama Department of Public Health (ADPH) Alabama Department of Public Health (ADPH) Alabama Department of Environmental Management (ADEM) Alabama Department of Environmental Management (ADEM) Alabama Coastal Beach Monitoring Program Alabama Coastal Beach Monitoring Program Mobile Watershed- Mobile Bay Watershed covers 2/3rds of the state of Alabama. There are over 200 rivers, bays, bayous, creeks, inlets and sloughs associated with the fourth largest drainage basin in North America. Mobile Watershed- Mobile Bay Watershed covers 2/3rds of the state of Alabama. There are over 200 rivers, bays, bayous, creeks, inlets and sloughs associated with the fourth largest drainage basin in North America. Mobile Baykeepers - Non-profit organization who’s mission is to provide citizens a means to protect the beauty, health and heritage of the Mobile Bay watershed. Mobile Baykeepers - Non-profit organization who’s mission is to provide citizens a means to protect the beauty, health and heritage of the Mobile Bay watershed. County Extension Service – education and information on seafood preparation County Extension Service – education and information on seafood preparation University Researchers at USA and the Dauphin Island Sea Lab University Researchers at USA and the Dauphin Island Sea Lab National Oceanic and Atmospheric Administration National Oceanic and Atmospheric Administration Alabama Department of Public Health Reportable diseases Alabama Department of Public Health Reportable diseases Source: ADPH, 2009; ADEM, 2009 Source: ADPH, 2009; ADEM, 2009

8. Future Activities Graduate students in the Master of Science Degree in Nursing program will monitor the impact of demographic and environmental changes in their communities. Data from surveillance activities and case finding in clinics and other community centered activities will contribute to the community assessment process. Graduate students in the Master of Science Degree in Nursing program will monitor the impact of demographic and environmental changes in their communities. Data from surveillance activities and case finding in clinics and other community centered activities will contribute to the community assessment process.