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Environmental Health Information Processing System - Executive summary
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ENVIRONMENTAL HEALTH INFORMATION PROCESSING SYSTEM (EHIPS)

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THIS DOCUMENT
    This document is an overview of EHIPS as it is now (mid-1998) and as it is expected to extend in several years. The black color refers to the present status, teal color to expected extensions.
    The target audience of the document is an official in municipal environmental or health service, whose task it is to decide whether the service can or should deploy EHIPS. The document intends to give information necessary for such a decision. Technical problems are outside its scope.
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WHAT IS EHIPS
    In a narrow sense, EHIPS is the software that processes data and model calculations related to the chemical pollution of environment and population health status.     In perspective, EHIPS will also     If understood in a wider sense, EHIPS is not just the software core, but also the experts that direct data processing, the service personnel, the network of connections to data sources and information users, the peer data analysis centers. It also includes an organizational structure which supports all that. Presently, the primary organizational ground for EHIPS deployment is the municipal centers of sanitary and epidemiological supervision ('SanEpid') and the municipal committees on environment ('Ecological committees').
    The primary users of EHIPS are the official organizations entitled to control of environmental status and related health effects: SanEpid, Ecological committee and municipal administration. The primary uses of EHIPS for them are:     Additionally, EHIPS can execute orders from other users:     EHIPS is a good basis for education and hands-on experience in environmental health domain. Official EHIPS centers can provide educational services as a by-product, or EHIPS workplaces can be shipped directly to universities. EHIPS-based educational courses can be spinned off the regular EHIPS training courses (see below).
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WHAT PROBLEMS ADDRESSES EHIPS?
    There exists a lot of software for environmental problem analysis: pollutant dispersion modeling, health risk calculation, environmental epidemiological studies etc. However, each software addresses just a specific aspect of data processing. In contrast, EHIPS was designed to connect these multiple aspects and to make one way of data analysis build on another. This drive toward universality can help in the following problems.
    Usually, the software made for regulatory purposes (e.g., compliance check) uses some fixed algorithm to calculate concentrations and risks, fill data gaps and so on. However, environmental issues are scientifically intricate and usually need much experimenting and data fitting to obtain a defensible result. Such scientific analysis is supported by completely different software, if at all. EHIPS synthesizes regulatory calculation thread and scientific analysis thread. The latter sets parameters for the former and, in its turn, checks the results and, if necessary, adapts parameters. By default, the scientific analysis is done by the expert staff of EHIPS (possibly, through remote access). Regulatory calculations can be done by any trained EHIPS user.
    EHIPS does not call for creation of special monitoring systems. It is oriented towards standard databases that exist in Russia on pollutant emissions, measured concentrations, morbidity, mortality etc. Such data mostly lie dead or are used very superficially because before they can be effectively used, they need a lot of preparatory checking, linking to other data, fitting into a specific problem framework. EHIPS brings data deposits back to life by providing a flexible interface (checked on several dozen types of Russian databases) through which data are imported into the universal processing engine and thus are made active.
    All types of data mentioned above have a common set of basic operations:     Universal statistical analysis packages support such operations for any type of data, but they contain no specific environmental 'machinery'. In contrast, environmentally oriented packages are normally confined to specific types of data, so that, e.g., mapping operations are not readily extensible from concentration contours to morbidity statistics. EHIPS standardizes handling of diverse data types by embedding each in a 'dataspace' with the following 'axes' :     Each axis is hierarchically organized. All charting, mapping, statistics etc. Is independent on dataspace choice. Thus, EHIPS is potentially a standardization tool for environmental analyses. Also, it can readily translate between national and international standards. Data quality analysis, which will be included in EHIPS, will combine uncertainties that come from different data types into output information.
    Normally, environment-oriented software uses either results of direct measurements or results of computer simulation, but not both. However, none of the two is beyond doubt, and it is advisable to use them concomitantly, for mutual check and adjustment. By supporting this regime, EHIPS provides for verifiability of results.
    Finally, due to the synthetic nature of EHIPS, it was possible to design it as an evolving and adaptive system. It should adapt to changes in monitoring data nomenclature and types (and initiate such changes); in methodology of health risk assessment, in requirements to output information and, last but not least, in hardware and software on which it is built. EHIPS, as a data processing tool, continues into this domain the open-interface ideology of programming tools it was built with.
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FUNCTIONS
    The main functions of EHIPS are as follows.     In contrast to the functions above, the model construction and model parameter setting belongs to the research thread of EHIPS. It includes empirical models, like regression, physically based models, e.g. pollution dispersion, and models that embody the expert judgment, e.g. risk formation and risk expression in morbidity. All these types are treated in a unified manner: model predictions are compared to actual data and the model parameters are obtained from the best fit. This can be done automatically or by experts. The models are used to generate 'simulated' data which are then processed into hotspots, priorities etc. Some results of model fit (e.g., pairs of tightly correlated environmental and health indicators) are a direct output for decision-makers, since it helps to identify hazards.
    Uncertainty estimation is an ancillary function which accompanies all stages of data processing. It combines all sources of uncertainty: statistical variation, model inaccuracy, data errors etc. It finally produces the quality index for EHIPS output information.
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EHIPS STRUCTURE
    EHIPS consists of sequentially linked modules, one for each data type. Presently, there are 5 modules for emissions, concentrations, risks, morbidity and mortality. Extended EHIPS structure will include also modules for integral indices of health loss, related economic loss, cost/benefit criteria, choice of control measures, control implementation plan, and technological processes that lead to pollutant emission.
    The background data processing consists in exchange of information between modules. Normally the data is passed along the module sequence, transition between modules being performed by models (e.g., from emissions to concentrations by the pollutant dispersion model; from concentrations to risk by the exposure model etc.). In a module, the model calculations are harmonized with the measurements taken from databases linked to the module, and then passed on. In extended EHIPS, this process includes the choice of emission control measures, after which the calculation starts with new emissions. Thus, the cycle is closed and runs in circle until a steady state is reached so that a plan of control and respective evolution of hazard are obtained.
EHIPS minimal configuration: data flow (1114 * 743 = 63K)     On this background, EHIPS builds up its functions described above. They are performed by the functional blocks that work with all data modules on equal footing. There is the data overview block that performs tabulating, charting, mapping; the statistical block that performs correlation, regression, cluster and pattern analyses and so on.
    Finally, EHIPS includes the service modules that perform links to databases, form the output document, support the network data exchange etc.
The backbone structure of EHIPS in minimal configuration is shown in Figure.
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EHIPS DEVELOPMENT STATUS
    EHIPS was initiated in 1995 by the environmental modeling group in the Space Research Institute, Russian Acad. Sci., Moscow. In 1996 - 1997 the work was continued by the same group and some additional staff in the framework of RF Environmental Management Project (EMP), and in 1997 - 1998 again by the Space Research Institute.
    Three configurations of EHIPS have emerged.     The first configuration is basically ready for installation, the third one exists only in a design document made for EMP, and for the second one, some work has been done and some not. Presently (mid-1998), begins the distribution of the minimal configuration to several regions of Russia. In one of them (the city of Cherepovets), the prototype of EHIPS was already tested in 1997 by the local EMP group.
    Presently, the federal SanEpid officials consider EHIPS as an option for a standard nation-wide tool for environmental health data analysis within local SanEpid services. Before that, EHIPS yet has to pass the necessary testing and certification stages.
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INSTALLATION REQUIREMENTS
    In all configurations, the core software of EHIPS runs on a single Pentium-II with 32MB RAM or more (downsizable to '486 at a sacrifice of speed only). The minimal configuration needs 200MB of disk space (wothout databases), and the intermediate one, 500 MB. As the user can save the processed datasets for further use, the storage requirements for them are the user's responsibility, not an element of system specifications.
The core software is made almost entirely in Borland Delphi and runs under Windows 95. All configurations need also MS Word 6.0 or higher because the output documentation is generated in rich text format. The maximal configuration needs also the Delphi installed at least as a command line compiler, since EHIPS evolution implies recompiling parts of the software by the staff of the local center. If additional statistical analysis is desirable, the user can install Statistica for Windows to which EHIPS has an interface.
    The following databases should exist for the territory of interest and for at least 1 year. (The format is almost arbitrary.)     In the minimal configuration of EHIPS, some of these databases may lack and be substituted by model calculations.
   In the maximal configuration, the following additional databases should be present:     The users of EHIPS should be trained before and after installation. The basic training will include two one-week workshops in Moscow: one before installation and one after. The additional training will include the yearly upgrading courses and on-the-spot 'master classes' of data processing offered by EHIPS team specialists. EHIPS team will also distribute the recommended reading in Russian and in English, on paper and in electronic form.
    As a separate part of training, the local experts that will run EHIPS installation and the local end-users (mainly, decision-makers) will be brought together in several sessions to ensure that the output information is understandable and usable by the end-users.
    In the maximal configuration, installation will include ensuring the network connection to the center in Moscow with at least 1Kbyte/sec average download speed.
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SUPPORT, MAINTENANCE, AND EXTENSION
    The core EHIPS team in Moscow includes the specialist in computer modeling, toxicology, environmental epidemiology, demography etc. It implements the user support mainly through Internet from EHIPS team site at Space Research Institute or from the Moscow EHIPS center site, when the latter is created. It will provide for general access the help updates, question-and-answer documents, examples of dataset processing. For registered customers, support will include answers to questions in real time, with 1-hour or 24-hour delay and processing of 'difficult' data at a separate cost. In addition, EHIPS team will provide on-the-spot personal consultations.
    Maintenance includes     Adaptation and extension of EHIPS includes     EHIPS can be relatively easy extended/adapted to diverse types of source data and requirements to output information existing in different countries. In each such case, a short preliminary pilot project should be run in order to elucidate requirements, design and perform necessary adaptations.
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CONTACTS
    For additional information and documentation please contact EHIPS team through:
Balter Boris Mikhailovich: Balter@iki.rssi.ru (095)333-4467
Egorov Victor Valentinovich: Egorov@iki.rssi.ru (095)333-3589
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