1. Healthy People 2010 Focus Area 8: Environmental Health Progress Review February 2, 2007

2. Key Components of Environmental Health Source: Department of Health and Human Services. Healthy People 2010. 2 nd edition. With understanding and improving health and objectives for improving health. Vol. 1. Washington: U.S. Government Printing Office. November 2000. Water Quality Toxics and Waste Outdoor Air Quality Healthy Homes and Healthy Communities Global Environmental Health Infrastructure and Surveillance Health of Individuals & Communities n=13 n=40 n=10 n=8 n=9

3. Environmental Health Criteria † pollutant-related illness alone costs about $250 billion annually. Excess deaths related to air pollution estimated at 50,000 – 100,000 per year Excess lifetime cancer risk related to air pollution is estimated at 1,400 per million persons Poor indoor air quality costs tens of billions of dollars per year due to –lost productivity –direct medical costs, –and damage to equipment and materials. † Criteria pollutants include: ozone, particulate matter, carbon monoxide, nitrogen dioxide, and sulfur dioxide.

4. Highlighted Objectives Improving (n=17) 8-1a,b Ozone, particulate matter 8-9 Beaches open and safe for swimming 8-11 Elevated blood-lead levels in children 8-13 Pesticide exposures causing visits to health care facility 8-25 b,c,e Exposure to cadmium, lead, mercury in children 1- 5 years 8-25q Mercury in females 18-49 years 8-25pLindane Target met or exceeded (n=14) Getting worse (n=8) 8-10a,b Fish consumption advisories

5. Source: Aeromatic Information Retrieval System (AIRS), Environmental Protection Agency. Persons Living in Areas that do not Meet EPA Standards for Ozone Percent of population 2010 Target = 0% 1997 Total American IndianWhiteBlackHispanicAsian Native Hawaiian Obj. 8-1a Decrease desired

6. Source: Aeromatic Information Retrieval System (AIRS), Environmental Protection Agency. Persons Living in Areas that do not Meet EPA Standards for Ozone Percent of population 2010 Target = 0% 19972004 Total American IndianWhiteBlackHispanicAsian Native Hawaiian Obj. 8-1a Decrease desired

7. Persons Living in Areas that do not Meet EPA Standards for Particulate Matter Percent of population 2010 Target = 0% 1997 Total American IndianWhiteBlackHispanicAsian Native Hawaiian Decrease desired Source: Aeromatic Information Retrieval System (AIRS), Environmental Protection Agency. Obj. 8-1b

8. Persons Living in Areas that do not Meet EPA Standards for Particulate Matter Percent of population 2010 Target = 0% 19972004 Total American IndianWhiteBlackHispanicAsian Native Hawaiian Decrease desired Source: Aeromatic Information Retrieval System (AIRS), Environmental Protection Agency. Obj. 8-1b

9. Particulate matter Monitor Locations Note: Locations illustrate general distribution of monitors, monitor locations are not georeferenced Source: Monitor Data Queries, Office of Air and Radiation, Environmental Protection Agency.

10. Ozone Particulate matter Monitor Locations Note: Locations illustrate general distribution of monitors, monitor locations are not georeferenced Source: Monitor Data Queries, Office of Air and Radiation, Environmental Protection Agency.

11. 1997 Ozone Non-attainment Counties (1-Hr standard) Source: Green Book, Office of Air and Radiation, Environmental Protection Agency. Obj. 8-1a 2010 Target = 0% Decrease desired

12. 2004 Ozone Non-attainment Counties (1-Hr standard) Source: Green Book, Office of Air and Radiation, Environmental Protection Agency. Obj. 8-1a 2010 Target = 0% Decrease desired

13. 1997 Particulate Matter Non-attainment Counties (10 micron standard) Source: Green Book, Office of Air and Radiation, Environmental Protection Agency. Obj. 8-1b 2010 Target = 0% Decrease desired

14. 2004 Particulate Matter Non-attainment Counties (10 micron standard) Source: Green Book, Office of Air and Radiation, Environmental Protection Agency. Obj. 8-1b 2010 Target = 0% Decrease desired

15. Beaches Open and Safe for Swimming Percent of beach days Source: BEACH Program, U.S. Environmental Protection Agency. Obj. 8-9 2010 Target: 98 Increase desired 100 95 90 85 80 0 20022005

16. Source: National Listing of Fish Advisories, Office of Water, U.S. Environmental Protection Agency. Fish Consumption Advisories Obj. 8-10a-b Decrease desired 2010 Targets River and Stream Miles Lake and Reservoir Acreage Percent of assessed waters under advisories 20022004

17. Children ages 1-5 years with Elevated Blood-lead Levels *Data are statistically unreliable and are suppressed. Source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS. Percent Black LowTotalWhite Decrease desired 2010 Target: 0 % Obj. 8-11 FemaleMale 1991-1994 Med. High ** Race/ethnicity GenderFamily Income

18. Children ages 1-5 years with Elevated Blood-lead Levels *Data are statistically unreliable and are suppressed. Source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS. Percent Black LowTotalWhite Decrease desired 2010 Target: 0 % Obj. 8-11 FemaleMale 1991-1994 1999-2004 Med. High ** Race/ethnicity GenderFamily Income

19. Pesticide Exposures Source: Toxic Exposure Surveillance System (TESS), American Association of Poison Control Centers Obj. 8-13 Pesticide Exposures (Resulting in Visits to Health Care Facilities) 2010 Target: 11.398 Visits (in thousands) Decrease desired 24 22 20 18 16 0 14 12 10 19971998199920002001200220032004

20. Heavy Metals in the Blood (Highest concentration for 95% of the population) Cadmium Lead Blood concentration (ug/L ) Females & Males 1-5 years Females 16-49 years ………. Mercury 1999-2000 2001-2002 Decrease desired 2010 Targets Source: National Report on Human Exposure to Environmental Chemicals, CDC, NCHS Obj. 8-25b,c,e,q

21. Source: National Report on Human Exposure to Environmental Chemicals, NCEH, CDC. Lindane (beta-HCH) in the Blood (Highest concentration for 95% of the population) Obj. 8-25p 2010 Target: 48.2 Decrease desired Serum concentration (ng/g lipid) 90 80 70 60 50 0 40 1999-2000 2001-2002

22. Status of Environmental Health Objectives Target met or exceeded Improving Little or no change Getting worse No tracking data Dropped at midcourse Retained as developmental 14 17 6 8 30 6 12

23. Challenges –Environmental measurements are only proxies for human exposure, which through mobility varies from day to day, and place to place. Barriers –Lack of systematic data collection Strategies New or enhanced data systems –National Biomonitoring Program –National Environmental Public Health Tracking Program New tools for assessment of exposure and health –Genes and Environment Initiative / Exposure Biology Program –National Children’s Study Data Challenges, Barriers, and Strategies

24. Progress Review data and slides can be accessed on the web at: http://www.cdc.gov/nchs/hphome.htm