Senate Hearing Focuses on Reid/ Clinton Health Tracking Legislation

http://reid.senate.gov/record2.cfm?id=181692

OCC-ENV-MED-L occ-env-med-l@mc.duke.edu
Wednesday, March 6, 2002

Washington, D.C. - Continuing his work to help Fallon families find
answers to the childhood leukemia cancer cluster, Senator Harry Reid
today spoke on the need to identify and track chronic illnesses and
their environmental factors. Reid testified at a Senate health
committee hearing exploring the links between the environment and
human health.

"I am here today to bring the personal experience of the small Fallon
community in Nevada to you as you consider the important issue of
tracking and responding to chronic disease," Reid testified. "We don't
know what caused this leukemia outbreak, and we don't have a tracking
system to tell us how many other Fallons there are out there yet to be
identified."

Last April, Senator Reid was joined by Senator Hillary Clinton at a
field hearing in Fallon to look at possible causes and solutions to
the childhood leukemia outbreak in the community. That hearing and the
on-going response to the Fallon cancer outbreak have provided a
roadmap for what the senators will seek to establish on the national
level. Senator Reid recently secured a $17.5 million down payment to
develop pilot programs in states as a first step in the development of
a nationwide health tracking network. Reid and Clinton will introduce
their national health tracking legislation in the coming weeks. The
bill would provide for a nationwide network to track both chronic
diseases and environmental exposures so that correlations between
disease and environmental factors may be identified, tracked and
monitored. The legislation would also establish a public health rapid
response system to respond to higher than normal incidents of chronic
diseases.

"In the case of Fallon, the Centers for Disease Control has done a
good job responding and helping us investigate possible causes and
connections. But this is the first cancer cluster investigation they
have conducted since the 1980s," Reid added. "If we had a nationwide
tracking system and a federal response team, we could focus the
resources of the CDC and other federal agencies. We could, perhaps,
find some answers and help other communities avoid the anguish that
has befallen Fallon."

The hearing looked at the overall need for improved surveillance data
on health outcomes and relevant environmental factors needed to either
document or rule out possible links between environmental risk factors
and chronic disease. Reid and Clinton will use information from
today's hearing as the final step before introducing their bill.


STATEMENT OF SENATOR HARRY REID Committee on Health, Education Labor,
and Pensions Subcommittee on Public Health Hearing on Health Tracking:
Improving the Surveillance and Response to Chronic Disease and Links
to Environmental Exposures March 6, 2002

- I thank the Subcommittee for the opportunity to testify here today.

- I am here to bring the experience the small community of Fallon,
Nevada to you as you consider the important issue of tracking and
responding to chronic disease.

- That is the most important reason for me to be here today.

- Fallon is a small rural community outside of Reno. In the short span
of just a few years, 15 children in that community of about 8,000 have
been inflicted with leukemia.

- Since I was joined in Fallon by my colleague from New York, Senator
Clinton, at the first hearing on this issue nearly a year ago, two
children have passed away.

- We don't know what caused their leukemia. We don't know whether
there was an environmental cause.

- We don't have a tracking system to tell us how many other Fallons
there are out there yet to be identified.

- We don't have a system that allows us correlate possible connections
between a chronic disease like leukemia and pollution.

- And, we don't have a federal rapid response team to help communities
like Fallon when it becomes apparent that they have been hit with a
cancer cluster or other chronic disease outbreak.

- In the case of Fallon, the Centers for Disease Control has done a
good job helping us investigate possible causes and connections. So
too has the Agency for Toxic Substances Control and Disease Registry.

- They have done fine work in Fallon.

- But this is the first cancer cluster investigation CDC has conducted
since the 1980s.

- If we had a nationwide tracking system and a federal response team,
we could focus the resources of the CDC and other federal agencies.

- We could - perhaps - find some answers.

- More important, we could help other communities avoid the anguish
that has befallen Fallon's families.

- These are the reasons why my colleague Senator Clinton and myself
believe our bill to bring a new national commitment to understanding
the role the environment plays in chronic diseases is so important.

- It is why we have worked so hard on our bill to help communities
track chronic diseases like childhood leukemia, to help them correlate
disease with pollution, and to help them respond when a tragedy like a
cancer cluster hits.

- We hope to introduce that bill within the next week so that the
nation can benefit from our experience in Fallon, Nevada, Long Island,
New York and the other communities around the nation.

- That bill will help states establish networks to monitor, track and
correlate chronic diseases like cancer with environmental pollution.

- States will get grants to do this work. The federal government will
help them with technical advice and will establish minimum standards
for what information they should collect.

- The bill then requires the federal government to synthesize that
information into a nationwide network.

- What's the benefit of that network to a community like Fallon?

- If it existed today, investigators from the CDC would be able to
identify other places in the nation with higher than normal incidences
of childhood leukemia.

- CDC would be able to look to see whether those other communities
shared a similar environmental problem in common.

- This would let CDC focus in on possible causes. It could help answer
some questions about cancer and other chronic diseases. It could help
us find the underlying cause.

- Since I began my service in the Senate, I've worked on the issue of
how environmental pollution can affect health.

- For example, we don't know if the environment plays a role in the
development of breast cancer, and if it does, we don't know how
significant that role is.

- Senator Chafee and I have sponsored legislation, the Breast Cancer
and Environmental Research Act, that would give scientists the tools
they need to pursue a better understanding of potential links between
breast cancer and the environment.

- In addition, several years ago, I served as the Chairman of what was
then known as the Subcommittee on Toxic Substances and the
Environment. It was a subcommittee of the Environment Committee on
which I still serve.

- In that Subcommittee, we worked on a number of bills and held
hearings on the possible connections between exposure to chemicals
like pesticides and chronic disease.

- We tried for years to make improvements in the environmental
legislation that regulates the use of chemicals in the environment.
The industry fought us in that effort at the time.

- They told us that we couldn't show them any connection between
chemical exposures and chronic diseases.

- My view at the time was that it was their burden to show us that
there was no connection.

- That debate ended in a stalemate.

- I think they recognize today that an effort to track and monitor
chronic disease and environmental pollution is something we need to
do.

- We need to answer the questions about whether there are indeed
connections so that - if there are - we can deal with them.

- It is an idea - for all the Fallons out there - whose time has come.


March 21, 2002

http://clinton.senate.gov/~clinton/news/2002/03/2002321D32.html

Senators Clinton and Reid Introduce Bill to Establish a Nationwide
Health Tracking Network

Health Track Legislation Would Help To Identify Connections Between
Disease and Environment, Develop a Rapid Response Capability To Public
Health Threats

Washington, DC -Senators Hillary Rodham Clinton (NY) and Harry Reid
(NV), the Assistant Senate Majority Leader, today introduced the
Nationwide Health Tracking Act of 2002. The legislation is the product
of months of work and several Congressional hearings held by Senators
Reid and Clinton in Washington, D.C., as well as in two communities
suffering from a concentrated and unexplained outbreak of chronic
disease. These two field hearings, held in Fallon, NV and Long Island,
NY, looked for possible environmental links to cancer in the
communities and resulted in a firm recommendation for establishing a
nationwide tracking network for chronic diseases.

Representatives Pelosi, King, and Slaughter, who joined Senators Reid
and Clinton at the press conference, announced their introduction of
companion legislation in the House. The Trust for America's Health,
March of Dimes, American Lung Association, Children's Environmental
Health Network, U.S. Public Interest Research Group, and Natural
Resources Defense Council and other groups also attended.

"There is a saying, what you don't know can't hurt you - but when it
comes to chronic disease, what we don't know can hurt us. The bill we
are introducing today will help get to the bottom of the mystery
behind high rates of chronic disease that afflict communities like
Fallon, Nevada and Long Island, NY. And once we are able to track
these diseases, and detect links to environmental or other causes, we
will be able to attack the problem and ultimately prevent public
health problems before they occur," said Senator Clinton. "We must act
now because as Senator Reid and I learned from our field hearings in
Fallon and on Long Island, when it comes to the hidden health hazards
in our environment, ignorance is anything but bliss."

"Almost one year ago, Senator Clinton and I traveled to the small
community of Fallon, Nevada to investigate why, against all odds, 15
children out of a community of a few thousand had been afflicted with
leukemia," said Senator Reid. "What we found was a mystery that first
emerged when parents found themselves in hospital waiting rooms with
other parents whose children had developed the same deadly form of
cancer. We now know that what started out as a horrible coincidence
has become a nightmare, taking the lives of two of Nevada's children,
and mystifying the doctors and environmentalists who search for a
cause and cure. Today Senator Clinton and I unveil a bill designed to
track the outbreak of disease, locate potential environmental causes
of this cancer cluster and get us working on a cure. This bill will
begin the important work of keeping tragedy from further visiting
communities all across America, communities like Fallon, NV."

The National Health Tracking Act of 2002 will:

Establish a Nationwide Health Tracking Network to connect state
systems tracking chronic diseases, environmental exposures, and other
risk factors so that causes of priority chronic diseases can be
identified, addressed, and ultimately prevented in the future, and so
that public health officials, the research community, and the public
have the information they need to fight back against chronic disease.

Provide States with Environmental Health Tracking Network Grants so
that States can develop the infrastructure they need to participate in
the Nationwide Network, including the appointment of State
Environmental Health Investigators.

Create a National Environmental Health Rapid Response Service to
develop and implement strategies with State and local governments for
coordinated rapid responses to public health and environmental health
concerns.

Require a National Environmental Health Report that will provide the
public with the annual findings of the Nationwide Health Tracking
Network, helping to educate and arm them with valuable information in
the fight against chronic disease.

Expand Our Environmental Health Infrastructure through the
establishment and operation of at least five regional biomonitoring
labs, five Environmental Health Centers of Excellence, and the John H.
Chafee Environmental Health Scholarship Program.

Our current public health surveillance systems were developed when the
major threats to health were infectious agents. Currently, 50
infectious diseases are tracked on a national basis, but now chronic
diseases, such as cancer and cardiovascular disease are the nation's
number one killers, and there is some evidence that rates of some
chronic diseases and conditions are rising. Survey data from the CDC
suggests that endocrine and metabolic disorders (such as diabetes) and
neurological conditions (including migraines and multiple sclerosis)
have risen roughly 20 percent between 1986 and 1995. Asthma is on the
rise, and some have cited an increase in autoimmune diseases, and
learning disabilities. Yet our systems for tracking chronic disease
are woefully underdeveloped.

Last April, Senator Clinton joined Senator Reid (NV) at a field
hearing in Fallon, Nevada to investigate childhood leukemia cases in
the area of Fallon. In June, Senator Clinton, along with Senators Reid
(NV) and Chafee (RI), hosted a field hearing at Long Island's Adelphi
University to discuss possible environmental links to chronic
diseases, including breast cancer.

Earlier this month, Senator Clinton chaired a hearing in the Senate
Commmittee on Health, Education, Labor, and Pensions on the link
between the environment and public health, including the need for
legislation to create a health tracking system. At the hearing, a
researcher from the New York University School of Medicine discussed a
new study that demonstrates a link between the environment and public
health, showing that exposure to air pollution in an urban area can
increase risk of lung cancer and heart disease as much as living with
smoker.

In a speech at the National Press Club Luncheon on July 19, 2001,
Senator Clinton talked about the importance of creating a national
tracking system for chronic diseases.

--
Gary N. Greenberg, MD MPH    Sysop / Moderator Occ-Env-Med-L MailList
gary.greenberg@duke.edu     Duke Occupat, Environ, Int & Fam Medicine
OEM-L Maillist Website:                      http://occhealthnews.net

Committee on Health, Education, Labor, and Pensions Subcommittee on
Public Health Hearing on Health Tracking:

Improving Surveillance of Chronic Conditions and Potential Links to
Environmental Exposures


March 6, 2002



Witnesses

Panel 1

Dr. Kenneth Olden Director National Institute of Environmental Health
Sciences

GENE-ENVIRONMENT INTERACTION . . . THE CENTERPIECE FOR DISEASE
PREVENTION

Dr. Richard Jackson Director National Center on Environmental Health
Centers for Disease Control and Prevention

CDC Efforts to Develop and Implement an Environmental Health Tracking
System

Dr. Henry Falk Assistant Administrator Agency for Toxic Substances and
Disease Registry

ATSDR's Role in Environmental Health Tracking

Panel 2

Dr. John Harris Director California Birth Defects Monitoring System
March of Dimes


Dr. F. E. Thompson, Jr., M.D., M.P.H. State Health Officer Mississippi
State Department of Health Association of State and Territorial Health
Officials

HEALTH TRACKING: IMPROVING SURVEILLANCE OF CHRONIC CONDITIONS AND
POTENTIAL LINKS TO ENVIRONMENTAL EXPOSURES

Dr. George Thurston New York University School of Medicine Nelson
Institute of Environmental Medicine

THE USE OF THE NATIONWIDE REGISTRIES TO ASSESS ENVIRONMENTAL HEALTH
EFFECTS

Dr. Thomas Burke The John Hopkins University School of Hygiene and
Public Health

Dr. Shelley Hearne Executive Director Trust for America's Health


Last Updated: 03/12/02


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