HomeMy WebLinkAboutMINUTES - 06271989 - IO.4 I.O. 4
TO: Board of Supervisors
FROM: INTERNAL OPERATIONS COMMITTEE
DATE: June 19, 1989
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4 COUt�
SUBJECT: STATUS REPORT ON THE PROSPECTIVE STUDY OF THE
INCIDENCE OF CANCER IN CONTRA COSTA COUNTY
Specific Request(s) or Recommendations(s) & Background & Justification
RECOMMENDATIONS:
1. Direct the Public Health Director to present our Committee on December 11, 1989 with an outline
on how a prospective study of the incidence of cancer in Contra Costa County should be
conducted.
2. Direct the Public Health Director to ask the Bay Area Cancer Coalition to make a report on the
concept of a prospective study of the incidence of cancer in Contra Costa County to the San
Francisco Bay Area Air Quality Management District's Advisory Committee and thereafter to
the Air Quality Management District's Board of Directors, requesting their respective
endorsements for the need for such a prospective study of the incidence of cancer in Contra Costa
County.
3. Direct the Public Health Director to write to each county and city in the geographical area served
by the San Francisco Bay Area Air Quality Management District, explaining the concept of a
prospective study of the incidence of cancer in Contra Costa County and requesting their
endorsement of such a study, with any and all such endorsements to be forwarded to the San
Francisco Bay Area Air Quality Management District's Board of Directors.
Continued on attachment: YES Signature:
Recom nenda ' on ty Administrator _� Recommendation of Board Committee
Appr Ot
Signature(s): 6M POW(Oi� SUNNE WRIGHT MC PEA
Action of Board on: June 27, 1989 Approved as Recommended x Other
Vote of Supervisors I HEREBY CERTIFY THAT THIS IS A TRUE
AND CORRECT COPY OF AN ACTION TAKEN
x Unanimous (Absent iii ) AND ENTERED ON THE MINUTES OF THE
Ayes: Noes: BOARD OF SUPERVISORS ON DATE SHOWN..
Absent: Abstain:
Attested a7 /989
cc: County Administrator Phil Bat elor, Clerk of the Board
Health Services Director of Supervisors and County Administrator
Public Health Director -
By � ,Deputy Clerk
CLVM:eh(io-4bo)
BACKGROUND:
On December 6, 1988 the Board of Supervisors referred to our Committee oversight of the outline
of a prospective study of the incidence of cancer in Contra Costa County. The Health Services
Director and Public Health Director were asked to identify the individuals who were most likely to
be influential in funding such a study.
On June 19, 1989 our Committee received and reviewed the attached report which outlines possible
funding sources which are being pursued by the Health Services Department. While we appreciate
these possibilities,we are concerned that we have not yet seen the actual outline of how such a study
would be conducted. This information is essential in order to actively seek funding for such a study
and we have been asking for this information for some time. We are, therefore, specifically
requesting that this information be provided to us in six months and that endorsements for such a
study be sought from jurisdictions in the Bay Area and the BAAQMD's Advisory Committee and
Board of Directors in order to move the possible funding of such a study ahead as quickly as possible.
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S� L Health Services Department
Public Health Division
'i OFFICE OF THE DIRECTOR
- Administrative Offices
O' .')Illl�lla -� •,� 20 Allen Street
Martinez,California 94553
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(415)646-4416
COUK'
June 14, 1989
To: Supervisor Sunne McPeak
Supervisor Tom Powers
Internal Operations Comm
From: Wendel Brunner, M.D.
Director of Public Health
Re: Potential Funding Sources For Prospective Cancer
Study and Cancer Prevention Interventions
We were asked to report to the I.O. Committee on potential funding
sources for a prospective cancer study. We have identified a
number of such sources, and have begun to discuss the kinds of
prospective cancer proposals that might be funded in Contra Costa
County with potential funding contacts . At the same time we have
been looking for funding sources for cancer prevention
interventions, including occupational and environmentally induced
cancers as well as life style cancer causes, which could be
implemented through the auspices of Bay Area Cancer Coalition.
In addition to the National Cancer Institute, we have identified
several other significant sources of potential funding. Those
include the Centers for Disease Control Chronic Disease
Surveillance Section, the National Institute for Occupational
Safety and Health (NIOSH) , the Agency for Toxics Substances and
Disease Registries, the National Institute for Occupational Safety
and Health, and private industry.
The CDC Chronic Disease Surveillance Section is interested in
developing cancer and other chronic disease surveillance mechanisms
and may be interested in following cancer rates prospectively in
various parts of the Bay Area. That section has an existing
cooperative agreement with the State Department of Health Services
(DOHS) which is administered by Dr. George Kaplan of DOHS, who is
a member of our Public and Environmental Health Advisory Board.
We are working with Dr. Kaplan as he prepares for a renewal of his
cooperative agreement to see if the CDC would be interested in some
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aspects of the prospective cancer study in Contra Costa County.
We are also proposing Bay Area wide cancer surveillance activities
which the Bay Area Cancer Coalition could use to analyze cancer
trends on a regional basis. The Chronic Surveillance Branch at CDC
is interested in developing specific surveillance with worker
groups or industrial cohorts, which would be particularly
applicable to the prospective cancer study.
The National Cancer Institute put out two small RFP's earlier this
year for cancer identification and interventions in the industrial
work force. Those programs would consider both occupational
cancers and life style induced cancers . We have reason to believe
that the NCI will come out with further, more extensive, RFP's
along those same lines . We have been working with Dr. Don Austin
of the DOHS Cancer Epidemiology program and Dr. Anna Osario of the
DOHS Occupational Health program to outline joint Contra Costa
County-State DOHS responses to these anticipated RFP's . In
addition, Dr. Osario is investigating NIOSH, which has been
promoting small business initiatives around work place carcinogens.
NIOSH has recently suffered about 40% reductions in funding,
however, so the prospects from that source are unclear.
An intriguing funding source, particularly for Contra Costa County,
is the Agency for Toxics Substances and Disease Registries, which
is maintained in conjunction with the federal Superfund hazardous
waste site program. That agency is interested in funding
intervention programs targeted to industry and communities which
use coalitions involving voluntary health agencies, industry, local
health departments, and community groups . Such an approach is
particularly suited to the methods of the Contra Costa County
Health Services Department and the Bay Area Cancer Coalition.
Working with private industry to further the implementation of a
prospective cancer study has also proceeded. Don Austin, before
he left the Tumor Registry, developed a collaborative program with
Dow Chemical to link their employee cohort with the Tumor Registry
to study the cancer rates among their employees . Dr. Eva Glazer,
currently working with the Tumor Registry, has continued that
approach, and has been meeting with representatives of Shell,
Unocal, and Chevron to see if a similar program could be
implemented 'in those sites in Contra Costa County. Our Health
Services Department has been supportive of those efforts.
Identification of federal funds. for our local public health
projects generally depends on a close collaborative relationship
between the local and state health services departments. That
collaboration with our county and other counties in the Bay Area
and the State DOHS has been facilitated by the location of key
State DOHS programs here in the Bay Area. Those programs include
the Tumor Registry which has been of such assistance both to our
Health Services Department and to the Bay Area Cancer Coalition,
Epidemiological Studies and Assessment, Toxic Hazard Evaluation,
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Occupational Health, Air Pollution, Human Population Laboratory,
and Birth Defects Registries . The location of those programs in
the Bay Area has facilitated also the collaboration with the Bay
Area academic institutions, including the University of California
at Berkeley School of Public Health, the University of California
School of Medicine at San Francisco, and Stanford University
Medical School and Health Promotion Research Center. This
collaboration between the Bay Area local health departments, the
State Department of Health Services programs, and the academic
institutions provides the opportunity to create and implement some
of the most innovative and advanced public health programs in the
country. It is that collaboration which makes possible activities
such as the Bay Area Cancer Coalition, and it makes conceivable
projects like the prospective cancer study.
The State Health Services Department is planning, apparently for
administrative reasons, to consolidate these programs in
Sacramento. As a first step, they have announced their intention
to move the Tumor Registry and staff out of the Bay Area. Such a
move will be extremely disruptive to both the Bay Area Cancer
Coalition and to our efforts to implement 'a prospective cancer
study. Not only will the convenient access be eliminated,
including the participation of key State DOHS personnel on our
advisory boards, but the move will entail a major turnover in
staffing, as Bay Area professionals working for DOHS seek other
employment. I am concerned about the impact of these moves on the
quality of public health activities in the Bay Area region.
WB:rm
cc: Mark Finucane,
Health Services Director
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