September 1, 1998 - Boston, MA
"GIS APPLICATIONS IN EPIDEMIOLOGY"The following sections provide brief summaries, in outline form, of the main points presented by the listed speakers at the September 1, 1998 meeting of the Massachusetts Geographic Information Council (MGIC).
Moderator - Joan Gardner, President of Applied Geographics, Inc. (AGI)
Overview of the topic by Joan Gardner, President of Applied Geographics
The Past...
Today . . .
- Evolution of GIS in Epidemiology
- London 1884
- 500 cholera deaths in 10 days in a neighborhood
- John Snow observed the connection between 2 water companies drawing from the Thames River and their service areas and the London neighborhood
- Evolution of GIS
- Snow mapped the source of drinking water for each home and the cases of cholera
- He demonstrated the association between the illness and the water supply
- He found the key for prevention
- Site Selection
- Market Analysis
- Descriptive Epidemiology
- Demographic Analysis
- Outbreak Investigation
- Patient Origin Analysis
- Static Map Publishing
- Retrospective Data
- Epidemiology/GIS/Internet
- Search in anticipation of this talk
- Following slides a brief glimpse of what’s out there
- Flu in France, Winter of 1996-1997
- General Healthcare Organizations
- World Health Organisation (WHO)
- Centers for Disease Control and Prevention (CDC)
- Morbidity Mortality Weekly Report (MMWR)
- Communicable Diseases Surveillance Centre (CDSC) of the Public Health Laboratory Service for England and Wales
- Department of Epidemiology and Biostatistics of UCSF
- Kibic at the Karolinska Institute
- National Institutes of Health (NIH)
The Future. . .
WORLD HEALTH ORGANIZATION PUBLICATION
The final chapter focuses on geographical information systems (GIS) and explains how these research methods, developed by computer scientists, have revolutionized opportunities for the capture, manipulation, graphic presentation, and interpretation of georeferenced data. Noting that many questions facing the environmental epidemiologist are inherently geographical in nature, the chapter describes the specific uses of GIS as powerful research tools for the collection and integration of spatial data and equally powerful policy tools for directing attention to areas and problems of greatest need. A discussion of the expanding application of GIS is balanced by an alert to their particular analytical dangers and advice on ways to avoid errors and inconsistencies
- 21st Century Health Sciences Issues
- Spatial Epidemology
- Bio-terrorism
- Emerging Infections
- Cost and Value of Virtual Health Records
- Automated Health Monitoring
- The Value of GIS in Health ?
- Better Questions
- Greater Anticipation
- Clearer Vision
- Health “Industry” Challenges
- Improving customer service and accountability
- Increasing organizational productivity and efficiency
- Leveraging technology within limited budgets
- Increasing public knowledge about health issues
- Improving Outcomes (Clinical and Social)
- Integrating geo-referenced health related data
- Lower or eliminate costs
- Everybody, Everywhere GIS
- Cyber Self Diagnosis & Referral
- Automated In-home Service Routing
- Real-time Patient Referral Tracking
- Clinical Intervention Monitoring
- Medical Resources Intervention Alerts
- Virtual Medical Assets Management
- Global Medical Response
- Computerized biohazard “swat teaming”
- Geographically Targeted Health Interventions
Contact Information:
Phone: (617)292-7125
E-mail: jng@appgeo.com
Web Site: http://www.appgeo.com
Presentation by Bob Knorr, Deputy Director for Epidemiology, Bureau of Environmental Health Assessment, Department of Public Health
"Using GIS in Epidemiology and Environmental Toxicology Studies"The DPH Bureau of Environmental Health Assessment uses GIS in a variety of ways to analyze the relationship between health and the environment as well as to illustrate health risks to the public. This presentation described some of the health risk assessment projects conducted by the Bureau, including a project that used GIS to investigate possible correlation between reproductive outcome and the location of industrial sites in the City of Woburn.
Detailed speaker notes unavailable.
Contact Information:
Robert Knorr
Deputy Director for Epidemiology
Bureau of Environmental Health Assessment
Department of Public Health
250 Washington Street, 7th Floor
Boston, MA 02108Phone: (617) 624-6000
Fax: (617) 624-5777
E-Mail: rknorr@state.ma.us
Presentation by Richard Sutton, Senior GIS Analyst/Project Manager at Applied Geographics, Inc.
"Cape Cod Breast Cancer and Environment Study"The Massachusetts Cancer Registry data for 1982-1992 indicated that Cape Cod was an area with an elevated breast cancer incidence. With funding from the Massachusetts Department of Public Health, the Silent Spring Institue assembled a multidisciplinary team that included AGI, who developed the GIS as a tool for the epidemiological analysis. This presentation focused on the issues involved with gathering data from various sources and times in order to map the location of the individual breast cancer diagnoses with variables hypothesized to relate to health risk.
Mass DPH Cancer Registry Identifies Problem:Silent Spring Institute Multi Disciplinary Team
- Elevated cancer incidence in Cape Cod: Since 1982 60% of towns have breast cancer rates higher than statewide average
Funding
- BU, Schools of Public Health & Medicine
- Tufts University School of Medicine
- Menzi-Cura & Associates
- Applied Geographics, Inc.
Proposed Study
- State Legislature
- MA Dept. Public Health
- Three year, $3.6 Million
Environmental criteria that set the Cape apart from the rest of the state:Estrogen Connection
- Soil and Water
- Cape geology consists of sandy, porous glacial deposits.
- Percolation rate is very fast (1’/day)
- Low fraction of organic carbon “filters”
- > 90% of Cape residents dispose of domestic sewage in cesspools and private septic systems.
- Agricultural / Pest Control
- History of Cranberry Cultivation
- Decades of Pesticide Application, Large scale pest control, golf course management
- DDT used extensively for gypsy moths, brown tail moths, mosquito, cranberry pest control
Endocrine Disrupters
- Estrogens are hormones that stimulate cell growth / reproductive maturity in the female body
- Most factors that increase a woman’s risk of breast cancer appear to be related to estrogen exposure
- Endocrine Disrupters: Industrial chemicals that upset bodily estrogen (mimic, antagonize, or suppress it)
Other Culprits
- SSI field sampling program shows that endocrine disrupters are present in Cape wastewater and groundwater
- Concentrations of these substances span six orders of magnitude among the different locations and dates of sampling
- Dieldrin, endosulfan, toxaphene, PCBs, DDT
GIS (AGI) Role: Identify Patterns; find and predict hot spots
- Electromagnetic fields
- Radon
- Fish/Shellfish consumption patterns
- Point sources
System Architecture
- System Design/Architecture
- Data Acquisition
- Data Integration
- Data Development/Enhancement
- End user Query Flexibility
- Analysis
- System Support
- Training
Data Acquisition
- Sun Microsystems SPARC20
- ArcInfo and ArcView
- HP plotter,color printer
- Networked to Staff Macs
Data Integration
- MassGIS
- Cape Cod Commission Parcels
- MacConnell Land Use 1951-1990
Queries
- Four decades of landuse
- Census data from 1980 and 1990
- Multiple pesticide spray areas
- Geocoded cancer incidence points
Sample Analysis: Pesticide Spray Impact
- Developed parcel query tools for public meetings.
- Developed interface for display and query by non-GIS fluent SSI staff
System Support
- Pesticides and landuse
- Distance from residence to sprayed area
- Influence of forested buffers
Training
- AGI continues to provide system support
- Software updates and patches
- Expanded capacity of system
- Data layer updates and enhancements - geocoding, overlay analysis
Current Data Status
- ArcView
- Silent Spring Staff
Next Steps
- Hundreds of coverages, dozens of layers integrated
- geocoded breast cancer cases (approx 2200)
- groundwater contours/census tracts
- golf course distance to residential parcels
- Four decades of pesticides coverages
New Funding
- Tracking the movement of compounds that may be related to breast cancer (endocrine disrupters) through the environment
- Collecting and linking information about individual women to the environmental data in the GIS
- Lateral studies: other parts of the country where drinking water is drawn from shallow, permeable aquifers impacted by high density local land use including on site sewage disposal.
Peer Review Committee
- State Legislature has appropriated Second Phase funding
- Second Phase began March 1998
- $1.1M July 1, 1998-June 30, 1999
- “Perhaps the most valuable accomplishment thus far is the development of the GIS database.”
- This recorded archive of drinking water quality, contaminant plumes, and sources of various other potential environmental impact factors will be a most valuable resource for a variety of investigations for years to come
Contact Information:
Richard Sutton
Applied Geographics
Phone: (617) 574-7334
E-mail: rs@appgeo.com
Presentation by Christian Jacqz, Manager, MassGIS
Overview of State GIS Legislation
GIS legislation - FY99 budgetGIS legislation - mission
- What happened to the GIS legislation?
- Section 63 of the budget amends Chap.21A (enabling legislation for Executive Office of Environmental Affairs) to establish an office of geographic and environmental information and define its mission
- The EOEA line item “earmarks” $500k in EOEA operating budget for the office of geographic and environmental information
- So what is the mission of the office?
GIS legislation - FY99 budget
Collect, consolidate store and provide geographic and environmental information in order to improve stewardship of natural resources and the environment, promote economic development and guide land-use planning, risk assessment, emergency response and pollution control
What will EOEA do with the money?Duties - “subject to appropriation”
- Most of new operating money will fund “conversion” of 03 contractors at MassGIS
- Some new money will support a part of the mission for the geographic and environmental information center as described in section (l) "coordinating the development and dissemination of scientific and technical expertise to support an inter-agency, cross-disciplinary approach to natural resource management."
Doing a lot with a little
- Foster cooperative data development and data sharing
- Expand library of GIS information, linked to other “environmental” information and provide access
- Set standards “for the acquisition and management of geographical and environmental data by any agency, authority or other political subdivision of the Commonwealth”
- Provide technical support to towns and regional agencies
- Establish regional service centers
- Establish statewide advisory board
- Coordinate “scientific and technical expertise”
Regional Service Centers
- Provide incentives for data sharing
- useful data (larger scale)
- cooperative funding arrangements
- grants or reimbursement
- technical support e.g. conversion services, software tools
- distribution services
- Setting standards for data portability
- “open” exchange formats that work
- documentation and tools
- Technology
- internet access
- relational database storage for GIS data
Statewide Advisory Board
- coordinate participatory process to set regional GIS priorities
- collect, compile, standardize, automate, document and distribute data from local governments, NGOs and private sector - “repository” function
- provide technical support to regional users
- collect and make available technical information
- specifications and sample contracts
- vendor lists and project histories
- exemplary needs assessments
We’re in this together
- Provide input from the broadest possible representation of GIS and environmental information users:
- state agencies
- regional and local entities
- academic institutions
- non-profit organizations
- private sector
- Help set priorities for the acquisition and management of new information
- Help define the mission and future direction of the office
Can we develop the vision of a shared, statewide information resource of GIS and other data?
- a library of information that will serve a variety of needs
- current, large-scale, accurate data
- GIS technology that is scaleable and affordable
- public access to government information
Contact Information:
Christian Jacqz
MassGIS
Phone: (617) 727-5227 x322
E-mail: christian.jacqz@atate.ma.us
Last Updated 4/19/2000
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