Disease surveillance has a century-long tradition in public health, and environmental data have been collected at a national level by the U.S. Environmental Protection Agency for several decades. Recently, the CDC announced an initiative to develop a environmental public health tracking (EPHT) network with "linkage" of existing environmental and chronic disease data. On the basis of experience with established disease surveillance systems, we suggest how a system capable of linking routinely collected disease and exposure data should be developed. The primary operational goal of EPHT has to be the "treatment" of the environment to prevent and/or reduce exposures and minimize population risk for developing chronic diseases. Thus, EPHT should be synonymous with a dynamic process requiring regular system updates to a) incorporate new technologies to improve population-level exposure and disease assessment, b) allow public dissemination of new data that become available, c) allow the policy community to address new and emerging exposures and disease "threads," and d) evaluate the effectiveness of EPHT over some time interval. It will be necessary to weigh the benefits of surveillance against its costs, but the major challenge will be to maintain support for this important new system.
Environmental health; Evaluation; Intervention; Registries; Surveillance
