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ANNUAL REPORT of the BOARD of HEALTH --2001
In the
summer of 2001, Thomas L. Treadwell was re-appointed to a three-year term on
the Board of Health. The Board members
are pleased that Dr. Treadwell agreed to seek re-appointment. The Board of Health reorganized--electing
James A Gordon as chairman and Nelson Goldin as the board secretary. As chairman, Mr. Gordon submits timely
articles on current public health issues to the newspaper in order to further
our goal of a healthier Framingham.
The post September 11th
anthrax bio-terrorism events provided a tragic background to the Board of
Health’s efforts to become knowledgeable and plan for these types of events
should they occur in Framingham.
Framingham should be very proud of the Town’s establishment of a
certified Emergency Operations Center that could be used to address terrorism
events as well as natural disasters that may occur. The EOC can bring tremendous resources and
expertise together to address these types of events should they happen in
Framingham. The Board of Health has
provided the community with literature, seminars and other educational tools so
that the citizens of Framingham can be knowledgeable and vigilant in their
daily lives.
A major task of the
Board of Health is the surveillance of communicable diseases within the
community. The public health nursing
staff follows and tracks all diseases deemed dangerous to the public health by
the Mass. Dept. of Public Health. This
activity allows us to see and evaluate trends in disease within the community
with the goal of preventing its spread from the source of infection. This activity is especially important in this
new age of bio-terrorism. The Public
Health Nurses continue to offer immunizations to children and adults during nurse
office hours. Immunization clinics for
high-risk groups are conducted throughout the year to provide services for
residents in need. The new Varicella (chicken pox) vaccine has dramatically
reduced morbidity among children in the community—reducing reported cases of
chicken pox from 625 in 1987 to only 4 in 2000.
This is a great accomplishment for our immunization program--a success
that could not have been reached without the assistance of the school nurses
and area physicians. Tuberculosis surveillance and prevention remain a high
priority at the Board of Health as well as our cardiovascular clinic and our
educational activities. The flu vaccine
was late again this year. Even with the
late start the Board of Health conducted six clinics and was able to immunize
almost 2200 Framingham residents. In
addition, we offered adult immunization for tetanus and pneumonia at these
clinics. Flu shots will be offered into
early 2002.
In 2001, the Board of
Health received a level-funded grant of $98,398 to continue with its Tobacco
Control Program. Staff members
aggressively educate retail merchants as to their role in preventing access to
tobacco products by minors. This is
accomplished by using compliance visits and compliance checks. On the Average, 94% of Framingham’s tobacco
retailers did not sell cigarettes to minors during these checks. The Board of Health commends these
retailers. This year the Tobacco Program
was able to employ an agent to check establishments for compliance on nights
and weekends. The Board continues to be
a strong advocate for smoke-free workplaces and smoke-free dining. In December,
the Board of Health conducted a public hearing to take testimony on a proposal
to make all workplaces within the Town smoke free. A list of Framingham’s smoke-free restaurants
is available in the Board of Health office.
The Environmental Health
Section has seen a high workload over the past year from food establishments
changing owners rather than totally new establishments. In addition, the Mass. Dept. of Public Health
has adopted the Federal Food Code. This
new set of regulations governing the food service industry required extensive
training for our sanitarians. The new
training was time-consuming and has also created a new workload on our
sanitarians by requiring our department to impart this new system to the
operators of Framingham’s food service establishments. This is requiring our sanitarians to spend
almost twice the time in each establishment.
The new Food Code emphasizes safe food handling, storage and preparation
as well as employee health and hygiene.
Again this year, the staff has overseen septic system installations and
repairs in areas of the Town with no public sewers and well installations in
areas with no Town water. The Board of
Health investigated 277 housing complaints in 2001. Recreational camps, public beaches, swimming
pools, tanning and body piercing establishments are also routinely inspected by
Board of Health sanitarians.
The
Board of Health would like to express its appreciation to the staff, the
medical community, and all the other Town departments for their assistance and
cooperation in the past year.
Respectfully submitted,
James A. Gordon, Chairman
Thomas L. Treadwell, MD, Secretary
Nelson Goldin
ENVIRONMENTAL HEALTH--2001
The
mission of the environmental health division of the Board of Health remains the
same. The staff works to protect the
community from any chemical, physical or biological agent that could adversely
affect the health of the citizens of Framingham.
The
major sub-divisions of this section include inspection of food establishments,
bathing areas (Public beaches, semi-public swimming pools, and whirlpools), and
inspection of residential housing units within the Town. The main focus of the food related
inspections is the prevention of food-borne and water-borne diseases. These diseases are easily and commonly
acquired through the introduction of contamination into food and water. Inspection and education of food service and
bathing area personnel are the main tools used in this prevention
activity. Inspections related to the
food and water sanitation account for approximately 60% of the man-hours
available in this division.
Under
Chapter II of the State Sanitary Code, environmental health staff must
investigate all housing complaints received by the Board of Health. These complaints must be closely followed
until compliance is attained. In 2001,
the Board received 277 complaints, which required approximately 4 inspections per
complaint to gain compliance with the code. Lead paint determinations are also
required in units where children under six reside. Trash improperly put out for collection,
especially the large items and restricted items, have created many complaints
to the Board of Health. A trash
education program targeted at problem areas has shown great success.
The
Title V regulations governing subsurface sewage disposal have resulted in more
inspections and longer, more detailed reviews of septic system installations
and repairs. The Board of Health has
five Licensed Soil Evaluators on staff for this work. As the more rural areas of Town are developed
the Board of Health will see more septic work as well as the installation of
private water supplies.
Miscellaneous
actions, primarily garbage and rubbish complaints, coupled with air and water
pollution, noise and odor complaints also add to the total number of
inspections accomplished by the division.
In late 2000, the Board of Health purchased noise-metering equipment to
better address and quantify noise pollution. These inspections are made to gain
compliance with any applicable health or safety codes and thus ensure a more
healthful living environment.
EAST MIDDLESEX MOSQUITO CONTROL PROJECT -- 2001
The
East Middlesex Mosquito Control Project conducts a program in Framingham
consisting of mosquito and wetland surveillance, larval and adult mosquito
control, ditch maintenance and public education.
For the second year, the risk
of mosquito borne disease continued to be a concern. Over the past year in eastern Massachusetts
there were 3 human cases of West Nile Virus (WNV) including 1 fatality and 1
human case of Eastern Equine Encephalitis.
There were also 37 horses that became sick or died from WNV and large
numbers of crows and other birds that were killed by WNV. Project personnel participated in the
development and implementation of the State’s Surveillance and Response Plan To Reduce the Risk of West Nile Virus
Transmission and Human Encephalitis.
The adult mosquito surveillance program has been expanded to include the
use of traps designed to collect WNV vector species. These trap collections are tested for WNV by
the Mass. Dept. of Public Health. The
larval surveillance program has been expanded to monitor mosquitoes associated
with WNV in both catchbasins and wetlands.
In addition the Project is participating in research efforts to evaluate
control methods against WNV vector species
In 2001
after two years of below average populations, the spring floodwater mosquito
populations returned to normal levels.
Following June rains, most neighborhoods experienced above average pest
populations of mosquitoes through mid summer.
During the summer and early fall mosquito populations were monitored at
5 sites for a total of 38 survey trap collections.
The larval mosquito control
program relies on the biological larvicide, Bti (Bacillus thuringiensis var. israelensis). An April 2001 helicopter application of Bti
controlled mosquito larvae at 45 wetland acres.
Field crews using a truck mounted hydraulic sprayer and portable
sprayers applied Bti in the spring and the summer to 14.3 wetland acres when
high densities of mosquito larvae were found breeding in stagnant water. The Project supplied 1000 Altosid Briquets
to the Framingham DPW for use in controlling mosquito larvae that breed in the
stagnant water of roadside catchbasins.
The adult mosquito control
program used truck mounted aerosol sprayers at night to treat 4,500 acres when
survey traps indicated high populations of mosquitoes. The Project uses a formulation of resmethrin
to control adult mosquitoes. Advance
notification of the spray program is done through newspaper notices in the
MetroWest Daily News and notices on the Project’s web site.
The Project maintains waterways
as a preventative mosquito control service that seeks to manage wetlands by
preventing the buildup of standing water caused by obstructions such as sand,
sediment and debris. An excavator was
used to maintain 397 feet of a channel adjacent to Grove St. near Shady
Lane. The excavator maintained 389 feet
of a channel that drained into the Beaver Dam Brook adjacent to Beaver St. The Project also removed a buildup of sand
obstructing the Eames Brook by Mt. Wayte Ave.
The Project’s public education program is designed to
develop awareness within the public and the private sectors as to their roles
in mosquito control. The Project serves
as a resource to residents, schools, municipal officials and the local media on
controlling mosquitoes, breeding sites and mosquito borne diseases. A web page
was developed to provide residents with information on mosquitoes, Project
control programs and related topics. The
website address is www.town.sudbury.ma.us/services/health/emmcp
PUBLIC HEALTH NURSING REPORT--2001
Reflecting
on past health promotion programs that the nursing department has offered to
help guide Framingham residents to healthier lifestyles, we note objectives
that have been achieved. We continue to evaluate the programs that have been
presented as we look to the future for specific concerns that still need
addressing.
The public health nurses are
concerned for the health and safety of all residents and will continue to
educate the public about general health issues and offer specifics during
critical health alerts. We will be on the frontline of defense in the event of
any significant health threat or bio-terrorist attack.
Since the nursing department of the Framingham Board of Health is a major provider of immunizations to school age children in town, one of our goals this year was to assure that children were not only receiving the vaccinations they needed to enter school, but were being offered connection to health care providers for continuity of care. Our concern is that Framingham children have access to needed health services such as physical exams, sick visits and the remainder of immunization series. We have compiled a list of regional providers to give to our children and their families. Our numbers of immunizations given during our nurses’ clinics increase in critical months of August, September and October and are somewhat reduced the rest of the year.
A goal
for any health department is to increase public awareness of preventable
disease and work for its elimination. Public health officials, health
professionals and parents are gratified by the reduction in cases of chicken
pox due to the mandated use of Varivax vaccine for entry into day care and
school. In Framingham, we have gone from a high of 625 cases in 1987 to 4 cases
in 2001.
Our numbers for tuberculosis skin testing have been reduced due to state mandated targeted testing of high risk populations only. Even with this reduction in testing, more patients are being referred to our regional chest clinic. People are referred to the chest clinic for evaluation and may receive preventative treatment/discharge, or they may be sick with active tuberculosis and need full treatment and follow-up.
One concern we have had is the response to chest clinic appointments, reflected in our no show rate. Our goal has been to increase the compliance rate of 52%. Our overall rate for this year has improved slightly. However, by working in collaboration with different departments within the Metro-West Medical Center, streamlining clinic procedure and improving follow-up procedures, we have seen an increase to 70% in our compliance rate toward the end of this year. We are so pleased with this response to our efforts and expect this increase in patient participation will continue.
The
nursing department is responsible for monitoring and investigating communicable
illness. By collaborating with other Boards of Health, local physicians,
schools, hospitals and the state Department of Public Health, we try to keep
fully informed so we may better understand the origin and etiology of disease
and work to prevent illness.
One of
our goals this year was to make our services more accessible to the public.
Immunization clinics have been held at Nevin’s Hall and in community settings.
In recognition of Skin Cancer Prevention Month, a Skin Cancer Screening was
organized at the BOH, utilizing the voluntary skills of a local
dermatologist. The monthly
Cardiovascular Clinic continues at the Callahan Senior Center, where more than
250 patients have been seen. Many seniors took advantage of the doctor present
(provided by MWMC) and received additional guidance.
We
also offered six flu clinics this year, providing vaccination to nearly 2200
adult residents. We continue to
participate in the Medicare B program and aggressively seek reimbursement from
the Medicare program and participating HMO’s. This year, with town budgets
stretched to meet increased demands on town services, we note that the monies
the BOH is reimbursed go directly to the town and help pay for extra security
concerns.
We continue to offer our support to other departments and health agencies. This year, we again offered our program, Tuberculosis Review, to assist local health professionals to stay current regarding this world health concern. We continue our longstanding partnership with the Metro-West Medical Center by augmenting the staff in the outpatient pediatric clinic and doing outreach for the clinic when possible. Through our chest clinic, which is held in the clinic area twice a month, we work closely with other hospital departments as well.
The public health nurses would like to thank all who have
helped this department to meet its goals this past year. We look forward to
continuing our close association with many of the local health agencies in town
to better serve Framingham residents. By
forming partnerships, the health community works together to identify and meet
the needs of the distinct populations in the town of Framingham, who may have
cultural differences but live together in one community.
SAVE THE DATE REMINDER! Day of
Health and Beauty-April 6, 2002 Nevin’s
Hall, Memorial Building
A program for women over 50… to celebrate health and wellness.
(Sponsored by ACS, MWMC, The Framingham BOH)
TOBACCO CONTROL PROGRAM – 2001
The Framingham Board of
Health’s Tobacco Control Program (the “Program”) is funded by the Massachusetts
Department of Public Health (MDPH) through the Health Protection Fund. The Health Protection Fund was established
upon passage of voter referendum Question 1 in November 1992. The Master Settlement Agreement, an agreement
between the Attorneys General of most states and the tobacco industry, also
provides partial funding. The Program
enforces the Framingham Board of Health’s “Rules and Regulations Relative to
the Sale, Vending and Distribution and Use of Tobacco within the Town of
Framingham,” and the Town of Framingham Bylaw, Article V, Section 5 “Clean
Indoor Air”. The Program outreaches and
educates the Framingham Community on tobacco issues and policies.
The bylaw went into effect on
January 2, 2000. Under the bylaw
establishments without a liquor license or those with a liquor license but
without a separate bar area must be 100% Smoke-free. Establishments with a liquor license may
allow smoking in a separately enclosed bar area, provided that minors are not
allowed in the area, that food is only incidental to the alcoholic beverages
served in the bar area and that access to common areas (e.g. bathrooms) is not
through the bar area. Establishments
holding Club Alcohol licenses and bars, as defined in the Bylaw, may have
smoking provided that certain conditions are met. An enforcement agent inspects establishments
at night and on weekends to make sure that the bylaw is being followed at all
times.
The Board of Health has enacted
comprehensive regulations that protect the public from secondhand smoke and
also control minors’ access to tobacco products. The “Youth Access” provisions of the
regulations included licensing of all tobacco merchants, fining and possibly
suspending the license of merchants who sell tobacco to minors, requiring that
merchants train employees about laws concerning the sale of tobacco products,
ensuring that all tobacco products are kept off of the counters and thus making
it more difficult for minors to steal tobacco, and removing vending machines
from all establishments into which minors can enter. The regulation also requires that each
merchant post signage reminding clerks and minors about the illegality of
selling tobacco to minors
In furtherance of ensuring that
minors cannot purchase tobacco products in Framingham, the Program carried
numerous compliance checks during 2001.
The minors used were 16 and 17 year olds who looked their age and were
dressed age appropriately. During those
compliance checks minors entered all tobacco merchants at least once. The Framingham tobacco merchants had a
compliance rate of 94% in 2001. The
compliance rate for Framingham merchants has shown a steady increase since the
FBOH-TCP began doing the checks. During
the early stages of the Program, in August 1994, the compliance rate was 43%
and in 1996 the compliance rate was 79%.
The compliance rate was 90% in 1997, 91% in 1998, 93% in 1999 and 94% in
2000.
The second part of the Board of
Health Regulations sections prohibits smoking in most public places and
workplaces. Restaurants, bars and
schools were specifically exempted from the regulations because the restaurants
and bars are covered by the bylaw and schools are governed by Massachusetts
law.
The Program publishes a
quarterly newsletter in which is sent to all tobacco merchants. The newsletter explains all tobacco laws,
offers ways for merchants to be in compliance, gives information on tobacco
related issues and keeps the merchants up-to-date on other relevant
matters. Newsletter articles are
translated into Portuguese to help Brazilian merchants easily understand the
important issues. All merchants are also
offered training programs to educate their employees on the proper way to
conduct tobacco sales. Merchant education
programs are tailored to the needs of the individual merchants are usually
conducted in the stores at times that are convenient for the employees.
The Program refers people who
want to quit smoking to the Wayside Quit Smoking Program. This ensures that all residents and employees
have access to affordable cessation programs in both English and Portuguese. The Wayside Quit Smoking Program, which is
also funded through the MDPH, has group and individual counseling available to
its clients. Referrals are also made to
the Massachusetts Smoker’s Quitline that conducts telephone counseling and has
a web site available for people who prefer that method of receiving information
on quitting.
The MDPH sponsors numerous
trainings and seminars for the Program staff.
These trainings and seminars ensure that the staff is knowledgeable on
all tobacco related issues. This is
critical because tobacco issues are being discussed nationally and the Program
staff regularly called upon to communicate this information locally. The Program staff continues working on
statewide projects that will benefit the residents of Framingham. The FBOH-TCP director is a member of both the
MetroWest Region’s steering committee and the Statewide Coordinating Committee.
PUBLIC HEALTH NURSE ACTIVITY REPORT
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FRAMINGHAM BOARD OF HEALTH |
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IMMUNIZATIONS-OFFICE |
Jan |
Feb |
Mar |
Apr |
May |
Jun |
July |
Aug |
Sept |
Oct |
Nov |
Dec |
TOTAL |
|
Hepatitis B |
56 |
35 |
33 |
12 |
37 |
14 |
15 |
95 |
100 |
61 |
14 |
22 |
494 |
|
DTaP |
3 |
3 |
2 |
1 |
1 |
2 |
1 |
15 |
12 |
10 |
1 |
1 |
52 |
|
Td |
44 |
23 |
37 |
18 |
18 |
11 |
11 |
76 |
71 |
27 |
12 |
13 |
361 |
|
IPV |
25 |
11 |
11 |
9 |
13 |
9 |
2 |
21 |
25 |
17 |
3 |
4 |
150 |
|
Hib |
0 |
0 |
2 |
0 |
0 |
0 |
0 |
1 |
2 |