1. Demonstration of MD Environmental Public Health Tracking (EPHT) Public Portal: The Maryland Tracking Network (MTN) John T. Braggio, PhD, MPH, Environmental Health Bureau, Maryland Department of Health and Mental Hygiene

2. Prevention and Health Promotion Administration [September 11, 2013] 2 o Environmental Public Health Tracking (EPHT) data accessible from the Maryland Tracking Network (MTN) public and secure portals o Public portal includes county aggregated health data for o Asthma o Acute Myocardial Infarction (heart attacks) o Birth defects o Low birth weight o All-cause mortality o Other measures o Secure portal includes zip code aggregated asthma and acute MI o No restriction on air (fine PM and ozone) and water data displays o Exposure as children’s blood lead test results Understanding EH Profile, Where We Live:

3. Prevention and Health Promotion Administration [September 11, 2013] 3 o Data analysis tools and metadata permit the discovery of space-time patterns in EPHT data o Answer the user’s questions o Generate ecological hypotheses o Results can be used to o Inform communities o Basis for interventions o Communicate with policy makers o MTN data analysis tools o Queries utility (with results in tables and graphs) o GIS utility (three data layers displayed on same computer map) o Download data to user’s computer Maryland Tracking Network Data Utilities

4. MTN Home Page and Queries Utility http://phpa.dhmh.maryland.gov/OEHFP/EH/tracking/SitePages/Home.aspx http://phpa.dhmh.maryland.gov/OEHFP/EH/tracking/SitePages/Home.aspx MTN Home PageAsthma Data Query Prevention and Health Promotion Administration [September 11, 2013] 4

5. Asthma Query Results Results in Table and GraphRisk Communication Message Asthma is a chronic disease of the lungs in which the airways get narrow and fill with secretions, causing difficulty breathing. People with asthma have shortness of breath, chest tightness, wheezing, and cough, which can be serious or even fatal if not treated. Asthma attacks can be treated effectively and asthma attacks can be prevented by a combination of medication and avoidance of triggers. These triggers include allergens from animals and pests, fine particles (PM2.5), ozone, tobacco smoke, exercise, and stress. Pay attention to the daily Air Quality Index and follow the advice to limit physical activity outdoors on yellow, orange, and red days. For more information, see the MTN Topics Pages on asthmaAir Quality IndexMTN Topics Pages on asthma Bottom of Form Prevention and Health Promotion Administration [September 11, 2013] 5

6. Prevention and Health Promotion Administration [September 11, 2013] 6 Asthma and Ozone in 2009 (Asthma Legend)

7. Prevention and Health Promotion Administration [September 11, 2013] 7 Asthma and Ozone in 2009 (Ozone Legend)

8. Prevention and Health Promotion Administration [September 11, 2013] 8 Asthma and PM 2.5 in 2009 (PM 2.5 Legend) Asthma and PM 2.5 in 2009 (PM 2.5 Legend)

9. Prevention and Health Promotion Administration [September 11, 2013] 9 Asthma and PM 2.5 in 2009 with Poverty in 2008

10. Prevention and Health Promotion Administration [September 11, 2013] 10 Myocardial Infarction and PM 2.5 in 2009 with Poverty in 2008

11. Prevention and Health Promotion Administration [September 11, 2013] 11 Birth Defects and PM 2.5 with Poverty in 2006 Birth Defects and PM 2.5 with Poverty in 2006

12. Prevention and Health Promotion Administration [September 11, 2013] 12 All Types of Cancer in 2006-2009 and PM 2.5 in 2009 with Poverty in 2008 All Types of Cancer in 2006-2009 and PM 2.5 in 2009 with Poverty in 2008

13. Prevention and Health Promotion Administration [September 11, 2013] 13 Low Birth Weight and PM 2.5 with Poverty in 2008

14. Prevention and Health Promotion Administration [September 11, 2013] 14 Air Indicators for Ozone and PM 2.5

15. Prevention and Health Promotion Administration [September 11, 2013] 15 Ozone Days Above EPA Standard Ozone Days Above EPA Standard

16. Prevention and Health Promotion Administration [September 11, 2013] 16 Baltimore City Ozone-Days Above EPA Standard

17. Prevention and Health Promotion Administration [September 11, 2013] 17 PM 2.5 Person-Days Above EPA Standard

18. Prevention and Health Promotion Administration [September 11, 2013] 18 MTN Secure Portal

19. Prevention and Health Promotion Administration [September 11, 2013] 19 o MTN resources permit the discovery of space-time attributes of EPHT data, including criteria air pollutants o Low-level, long-term exposure can influence the onset of various chronic diseases such as asthma, acute myocardial infarction, and low birth weight o One environmental hazard (ozone or fine PM) can affect different multiple chronic diseases or health outcomes o Multi-year data permit the evaluation of changes over time (years) o Limitations of EPHT data are that they are ecological and descriptive, and cannot be used to confirm causal effects Summary

20. Prevention and Health Promotion Administration [September 11, 2013] 20 Questions?

21. Prevention and Health Promotion Administration [September 11, 2013] 21 John T. Braggio, PhD, MPH EPHT Coordinator & Chief, Environmental & Occupational Epidemiology, Environmental Health Bureau, Prevention and Health Promotion Administration Maryland Department of Health and Mental Hygiene 201 West Preston Street, 3 rd Floor Baltimore, Maryland 21201-2301 E-mail: john.braggio@maryland.govjohn.braggio@maryland.gov Phone: 410-767-6661 Web Site: http://phpa.dhmh.maryland.govhttp://phpa.dhmh.maryland.gov Presentation made at the Air Quality & Community Health Workshop, Polish Home Hall in Curtis Bay/Brooklyn (4416 Fairhaven Avenue, Baltimore, Maryland). Workshop sponsored by the Maryland Environmental Health Network and hosted by the Curtis Bay Brooklyn Association. Contact Information for Presenter: