| Using the Behavioral Risk Factor Surveillance System (BRFSS) for Exposure Tracking: Experiences from Washington State Denise M. Laflamme and James A. VanDerslice Office of Environmental Health Assessments, Washington State Department of Health, Olympia, Washington, USA Abstract
One of the goals of the National Environmental Public Health Tracking Network is to link environmental data with chronic disease data as a means of improving our understanding of the environmental determinants of disease. Such efforts will rely on the ongoing collection of population exposure information, and there are few systems in place to track population exposures. In many cases, exposures can be estimated by combining environmental contaminant data with data about human behaviors. The Behavioral Risk Factor Surveillance System (BRFSS) provides a good opportunity to implement tracking of exposure-related behaviors. Washington State has used the BRFSS to collection information on environmentally related knowledge, attitudes, and behaviors. In this article we present case studies of modules covering drinking water, perceptions of environmental risk, and radon awareness and testing. Data on exposure-related behaviors have been useful for population exposure assessments and program evaluation. Questions about knowledge and attitudes and perceptions of environmental issues were not as useful because they lacked sufficient detail from which to modify existing education efforts. In some cases these data had not been used at all, indicating that the need for the data had not been well established. National development efforts should focus on compiling existing questions and developing questions on topics that are a priority at the state and national levels to be included as core questions and optional modules in future BRFSS surveys. Key words: BRFSS, environmental health, environmental public health tracking, exposure assessment. Environ Health Perspect 112: 1428-1433 (2004) . doi:10.1289/ehp.7148 available via http://dx.doi.org/ [Online 3 August 2004]
This article is part of the mini-monograph "National Environmental Public Health Tracking," which is sponsored by the U.S. Centers for Disease Control and Prevention (CDC) . Address correspondence to D. Laflamme, Office of Environmental Health Assessments, Washington State Department of Health, 7171 Cleanwater Lane, Building 2, P.O. Box 47846, Olympia, WA 98504-7846 USA. Telephone: (360) 236-3174. Fax: (360) 236-2251. E-mail: denise.laflamme@doh.wa.gov We thank H. Ammann, Washington State Department of Ecology, and K. Wynkoop Simmons, Washington State Department of Health, for their comments. This work is funded in part by CDC Environmental Public Health Tracking cooperative agreement U50/CCU022H38-01. BRFSS is supported in part by cooperative agreements U58/CCU002118-1 through -17 and U58/CCU022819-01-01. This article was supported by an environmental public health tracking cooperative agreement from CDC. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC. The authors declare they have no competing financial interests. Received 1 April 2004 ; accepted 3 August 2004.
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