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MILL CREEK ROAD AREA <br />COMMUNITY HEALTH ASSESSMENT PLAN <br />August 8, 2005 <br />Sequence of Actions with Associated Timelines <br />I. Convene OCHD Epi Team and selected NCDHHS personnel August 8~~'). <br />The OCHD Epi Team consists of staff from multiple divisions with relevant expertise in <br />disease surveillance and investigation. We intend to augment the team for this situation by <br />including members of the Region Four Public Health Surveillance Team (PHRST4). The Epi <br />Team will have the following charges for this investigation. <br />• Review situation and establish Incident Command System (ICS) structure for response. <br />Rosie Summers will be the incident commander for this investigation and response. <br />• Discuss and develop study framework and establish parameters for personal questionnaire <br />including possible exposures routes, health history and time in community, <br />• Develop a sampling plan for all environmental testing regimes, including water and air <br />(radon).. <br />• Consider additional state and federal resource agencies to be contacted. <br />II. Defiue Area of Study <br />The exact area to be studied will be determined by staff based on the geographic distribution <br />of residents reported to be affected in the community. Staff will log all the households into <br />the GIS system in order to define the area.. <br />III. Questionnaires (by end of August) <br />The initial questionnaire allows for gathering of preliminary data used in the epidemiological <br />evaluation. It will contain general information such as name, address, age and contact <br />information and will also ask for other information to determine current and past chronic <br />diseases and specific cancer types in the community.. Once this initial data is gathered, staff <br />will review it in consultation with state cancer experts and epidemiologists. If the initial <br />findings indicate rates higher than would be expected, staff will seek assistance from experts <br />in the cancer field to develop a more intensive questionnaire covering possible environmental <br />exposures including water supplies, work history, length of time at their current residence, age <br />of residence, and possibly travel history. If a follow-up questionnaire is warranted, it will <br />contain a section for medical history including known malignancies, medical providers and <br />current disease status. Participating residents will be asked for a medical release for review of <br />medical records if a diagnosis of cancer is listed. For deceased residents from the area, we will <br />attempt to piece the information together through relatives and medical providers or from the <br />NC Cancer Registry. Participation by community members will be on a voluntary basis with <br />strict control of privacy of all data related to individuals in the study. <br />IV. Environmental sampling plan (samples collected by end of September and results back <br />to OCHD by end of October) <br />OCHD staff will secure vohmtary permission to sample wells at the residences in the def ned <br />geographical area for a variety of contaminants. The routine tests are for pathogenic bacteria <br />presence and inorganic chemicals, which includes arsenic, lead and other toxic constituents. <br />We will expand the tests for this area to also include pesticides, semi-volatile and volatile <br />organic chemicals and radon (both from water and air). The well video camera will be used to <br />