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Virtual CDC Field Experience, April 7 2021, Part 1

May 6, 2021, 12:56 PM by Jessica Bloomer
Part 1: ERC faculty and students met with CDC representatives for a virtual field experience on April 7, 2021

This blog post was compiled by the interdisciplinary field trip lead, Cynthia Betcher, as well as the UC ERC students who attended the virtual experience. 
Dr. Betcher welcoming attendees to the CDC meeting
Dr. Betcher welcomes CDC hosts and ERC faculty and students to the CDC virtual field experience

On April 7th, 2021, the University of Cincinnati ERC hosted a virtual field experience featuring four representatives of the Centers for Disease Control and Prevention (CDC). In attendance were about 40 ERC students and faculty representing:

  • University of Kentucky
  • University of Illinois at Chicago
  • University of Michigan
  • University of Cincinnati

The CDC representatives, who shared about the CDC, their individual career paths, and what they do in their current positions included:

  • Christopher Reh, Associate Director, Agency for Toxic Substances and Disease Registry
  • Yulia Carroll, Associate Director for Science, Division for Environmental Health Science and Practice, CDC
  • Daniel Mandel, Associate Director for Policy, Division of Laboratory Sciences, CDC
  • Elizabeth Maples, Senior Scientific Program Official, NIOSH

A student debrief session with UC Faculty followed in a separate virtual session.

Blog Entry by Jennifer Naylor and Denise Daniel:
During our CDC virtual meeting, we were educated by multiple people who graduated from one of the Education and Research Centers (ERCs). Two of those people presenting were Yulia Carroll, M.D. PhD. and Elizabeth Maples, PhD.

Dr. Yulia Carroll graduated from University of Cincinnati ERC and joined the Epidemic Intelligence Service at the CDC/NIOSH after graduation. She loves studying respiratory diseases and worked at the National Institute for Occupational Safety and Health (NIOSH) for 2 years. She worked as an epidemic intelligence service officer doing field investigations on outbreak surveillance and response. Some of the investigations included new chemicals being introduced, investigations related to allergies to food chemicals, restaurant workers and respiratory diseases. She is currently the Associate Director for Science in the Division of Environmental Health Science & Practice at the CDC. Before serving in the Division for Environmental Health Practice, she provided leadership in various roles at the Office of Science at the National Center for Environmental Health at the Agency of Toxic Substances and Disease Registry (CDC/ATSDR). Part of her job overseas involves scientific quality in environmental health but is more focused on setting priorities for the highest quality research protocols. She feels you need to choose the best study design and time to complete the research due to the availability of resources and funding and then pick where it will have the most impact. In addition, she discussed the organizational chart of the CDC and the CDC’s vision. 
Dr. Carroll presents on her experience at NIOSH
Dr. Carroll presenting on the Epidemic Intelligence Service at CDC/NIOSH

Elizabeth Maples, PhD is a Scientific Program Official at the CDC/ National Institute for Occupational Safety and Health (NIOSH). Dr. Maples has worked for the CDC since 2015. Her work with NIOSH focuses on the disbursement of funding to trainees in occupation safety and health (OSH) related programs. She was excited to discuss the “birthdate” of NIOSH being April 25, 1971 and the impact that NIOSH has had from the beginning to now. NIOSH has 18 ERCs, and Training Project Grants (TPGs) for OSH training and research. When they started 50 years ago, they had an annual budget of $17.6m, and now they have $29m annually for ERCs alone.

Blog Entry by Ruth Norrell and Judy Jobe:
Dr. Elizabeth Maples quizzed us on CDC trivia. She spoke to the changes and improvements in the ERC. This is the 50 year anniversary for the CDC. 50 years ago, roughly 45 people died per day from work-related exposures or accidents. Today, we are down to approximately 15 people per day. This decrease can almost certainly be attributed to the vital work of the CDC. The number of ERCs has increased from the original 9 to 18! This is so important in that these are the pools of diverse health and safety professionals that shape and guide our future workplace safety. 

One final take-away from Dr. Maple’s presentation is to recognize the importance of eliciting and listening to the perspectives from other disciplines. This interdisciplinary communication between fields helps broaden understanding and sparks ideas. 

Thank you, Dr. Maples!

Blog Entry by Elizabeth Keller & Sherry Steele-Cooper:
This experience highlighted how the CDC provides surveillance and outbreak response, while collecting information about different diseases, risk factors, and symptoms for each state. Various programs are implemented to support community health and reduce the risk of disease and transmission through health promotion and communicating best practices in educational interventions. Translation of information is vital in ensuring the community knows what risks are present and how to mitigate those. 

While the list of departments and divisions within the CDC is extensive, The Division of Environmental Health Science and Practice (DEHSP) is one of those divisions with responsibilities essential to all areas of public health and safety.  The DEHSP currently encompasses an impressive volume of priority topics of public health concern. Though the DEHSP has stretched resources due to the pandemic, the priority public health topics of asthma, lead, well water contamination, the impact of a weather-related disaster on public health, and environmental public health preparedness are the leading public health concerns. Though these priority topics are significant in scope to public health outcomes, the pandemic has required a concentrated public health effort into COVID-19 surveillance, outbreak response, and prevention. Some other focus areas for the DEHSP are electronic medical records and artificial intelligence (AI) utilization for public health hazard surveillance and prevention.

Overall take away points from the experience included the need for collaborative efforts on projects and interdisciplinary team members to deliver information to the masses. Toxicologists, industrial hygienists, physicians, nurses, health educators and health communication specialists are important members of the team that each contribute their unique skills to problem solving and innovation.
 
Outside a CDC building in Atlanta, GA

Outside a CDC building in Atlanta, GA

Blog Entry by Meghan Weller:
During the virtual tour of the CDC with representatives from the Atlanta office, Dr. Elizabeth Maples, Senior Scientific Program Official for NIOSH, took some time to speak with the regional ERC students regarding the growth of the ERC programs nationwide. ERC programs are credited with drastically improving workplace safety and health standards nationwide.

The Occupational Safety and Health Act allowed OSHA and NIOSH to begin operations on April 25, 1971. Since then, NIOSH has spent the last fifty years developing safety professionals and improving workplace safety practices. Before NIOSH implementation, approximately forty-five daily fatalities stemmed from workplace injuries, illnesses, or exposures. In the fifty years that NIOSH has been in existence, that number has dropped to about fifteen people per day. With the growth of NIOSH over the years, the number of ERC programs has increased as well. Initially, there was a total of nine ERC programs (University of Cincinnati ERC was one of them), and today there are a total of eighteen ERC programs across the country. The most recent ERC program to be established was at the University of Kentucky. The Occupational Health Nursing program in this ERC has been responsible for vaccinating over 5,000 individuals daily which is an amazing success story for the city of Lexington, Kentucky. 

NIOSH has also grown over the years. In 1971, NIOSH had a little over 500 employees and a budget of 17.6 million dollars. In 2021, the ERC budget alone is 29 million dollars which allows occupational safety and health students to develop real-world experience through training, research, and travel. Dr. Maples described her role with NIOSH as being responsible for distributing funding to ERC programs across the country. Dr. Maples spoke highly of her time spent working with ERC programs because of the satisfaction of student involvement and development. She accredits this to the different perspectives coming from students with a variety of backgrounds. With the continued growth of ERC programs, there will be further improvements in workplace safety and health. 

Blog Entry by Xinyi Niu, Runcheng Fang, & Jaijain Ding:
The CDC is an agency of the U.S. Department of Health and Human Services that provides reliable information for the protection of public health and safety. Through strong partnerships with national health departments and other organizations, the CDC emphasizes the improvement of health decision-making, environmental sanitation, and health education, to promote the health of people. CDC focuses on the development and application of disease prevention and control, environmental sanitation, occupational health, health promotion, prevention, and educational activities. 

Dr. Christopher M. Reh, who was appointed as the Associate Director for the Agency for Toxic Substances and Disease Registry (ATSDR) in the CDC’s National Center for Environmental Health, told us his career development in the field of public health. The mission of the CDC is "To promote health and quality of life by preventing and controlling disease, injury, and disability". To accomplish this mission, the primary responsibilities of the CDC are to monitor health; detect and investigate health problems; research to enhance prevention; develop and advocate sound public health policies; implement prevention strategies; promote healthy behaviors; foster safe and healthful environments; and provide leadership and training.

Following the completion of his MS in industrial hygiene at UC-ERC, Dr. Christopher Reh received his PhD in Environmental Sanitation Engineering from the Bloomberg School of Public Health at Johns Hopkins University in 1998. Since then, he began his CDC/NIOSH career as an industrial hygienist. He has also served as the Chairperson of the State of Massachusetts and a member of the Health Committee, working to improve the public health of the community. His research mainly focuses on chemical exposure, including exposure to isocyanates, mercury, halogenated solvents, magnetic fields, and forest fire extinguishing processes. In addition, there are more than ten publications on chemical exposure assessment and health hazard assessment. Dr. Reh also has 17 years of private sector experience, having served as Chief Medical Officer of 3M and Head of Environmental Health, Workplace Safety and Sustainability for companies such as LifePoint Health.

Blog Entry by Yao Addor:
ERC students and faculty participated in an interdisciplinary virtual experience to learn about the CDC. Opportunities were offered to explore the various agency’s programs in protecting public health.

One aspect of interest was the presentation of Dr. Reh, Associate Director of the ATSDR which is a “sister” federal public health agency of the CDC. ATDSR aims to protect communities from harmful hazardous substances. Some areas of actions of the ATSDR include:

  • Community risk assessment and community outreach
  • Environmental justice
  • Human health effects of contaminants (mostly carcinogens)
  • Children’s health and asthma
  • Safe drinking water
  • Determination of minimum exposure levels standards focused on the more vulnerable people such as developing fetuses, children, elderly, etc.
  • Mental health due to hazardous contaminants
  • National disaster and environmental health emergency response for which ATSDR is a lead within the CDC framework.
Takeaways:

It was exciting to learn about the ATSDR and the scope of work they are doing for public health. It also was good to know that there are job opportunities in the agency for people like Industrial Hygienists.

Blog Entry by Vianessa Ng and Victoria Stotzer:
The four Midwest ERCs had the honor and privilege to safely and virtually meet with various health and safety experts from the CDC based in Atlanta, Georgia. Those experts included Dr. Daniel Mandel, Associate Director for Policy, Division of Laboratory Sciences, CDC. 

Unlike other experts, Dr. Mandel, has a basic science background in genetics and biochemistry and joined the CDC as an ORISE (Oak Ridge Institute for Science and Education) fellow. He graduated from the University of Georgia with a BS double major in Genetics and Biochemistry & Molecular Biology. Afterward, Dr. Mandel pursued a PhD in Biomedical Sciences studying under a neuroscientist in a physiology laboratory. His dissertation focused on single neuron recordings in rats to study how the respiratory and cardiovascular system interacted with the brain stem. Currently, he is pursuing a Doctor of Law degree at Georgia State University College of Law. 

As an ORISE fellow, Dr. Daniel learned to program epidemiology surveillance data on birth defects, such as muscular dystrophy and fragile X syndrome, using small angle X ray scattering (SAXS)*. He quickly learned he did not enjoy this work. Fortunately, at CDC, he was able to transition to a different department and role within the company for 7 years, where he utilized the epidemiology skills he learned during his fellowship and was able to contribute to the new program in various roles. During this time, he was initially a writer to discuss newborn screening. His work led him to a management role as the Branch Operations & Support specialist to manage the budget and liaise with congressional officials. He was later promoted to an administrative role as a deputy chief manager overseeing 25 different laboratories. By using and learning new skill sets for over 7 years and following his passion, he was promoted to an Associate Director for Policy in Feb 2020.  

Takeaway:
Ultimately, discover what your passions are and find what is lacking in the area of interest. You will be able to follow your dreams!

*According to the University of South Carolina Department of Chemistry and Biochemistry (2018), SAXS is “a powerful method to gather quantitative nanoscale information from a diverse range of samples from liquids to pastes, powders, and films”.

The 7 branches of the division of lab sciences that Dr. Mandel oversees include emergency response, organic compounds, tobacco, newborn, clinical chemistry, and nutritional biomarkers. These resources can be used by various agencies and groups throughout the United States to monitor and evaluate different chemicals. This includes quality assurance checks sent to laboratories throughout the United States. This is one way that the CDC makes sure that commercial and public laboratories have the supplies and expertise they require. In addition, it is a way that the CDC provides identification and planning for chemical/radiological threat agents and toxins. These may cover a wide array of topics, including looking at the toxins in an algal bloom to the opioid and marijuana response within a community. The Division of Laboratory Sciences has over 100 million dollars in funding, more than 300 mass spectrometers, and more than 400 masters and doctoral staff

References
University of South Carolina Department of Chemistry and Biochemistry. (2018). Small-Angle X-Ray Scattering (SAXS): Fundamental Principles. 
https://sc.edu/study/colleges_schools/chemistry_and_biochemistry/research/core_facilites/sc_saxs/saxs/

End of part 1 - click here to read part 2

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