Applied epidemiology in tasmania

Abstract

I completed my placement as a Masters of Philosophy in Applied Epidemiology scholar at the Department of Health and Human Services in Tasmania. I was attached to the Communicable Diseases Prevention Unit which sits in the Population and Environmental Health Services Branch. Tasmania is a small jurisdiction, both in size and population. This allowed my involvement in projects both in communicable diseases and environmental health. I describe the placement, my participation in the day to day activities of the Unit, my applied epidemiology projects to demonstrate a range of applied epidemiological skills. I evaluated the Tasmanian hepatitis C virus (HCV) surveillance system. This system has been operational since 1995 without review or development of objectives. This evaluation was focused on the usefulness of the system and its ability to achieve objectives proposed by an internal working group. The system was found to be stable, flexible and useful. The major recommendation to increase the usefulness of the system is to improve reporting of data to stakeholders for use in program development, evaluation and advocacy. In my epidemiological project I completed a data linkage study of rates of hospital admission and death in a cohort of Tasmanians with HCV. HCV notifications from the Tasmanian Notifiable Diseases Database were linked with statewide hospital admissions and death data. This project was the first time data linkage had been used on Tasmanian notification data and an objective of the study was to determine if this methodology was suitable. It was found to be useful with potential uses to explore co-infections among Tasmanians. I found the most common causes of admissions in this cohort were mental and behavioral conditions and injuries and poisoning. In completing my data analysis, I participated in an investigation into water tanks in Tasmania that had high water lead concentrations. We found the manufacturer had been using non-compliant construction materials. I coordinated the follow up of children with elevated blood lead concentrations. Water lead concentrations found in the water tanks were extremely high compared with findings from other Australian studies. A moderate association was found between water lead and blood lead concentrations. All children re-tested after they stopped drinking the contaminated water had a reduction in blood lead concentrations. I presented the preliminary findings from this investigation to the 2013 Annual OzFoodNet Meeting and final analysis to the 2014 National Environmental Health Association Conference. I participated in the investigation of a norovirus outbreak in Tasmania that was associated with locally grown oysters. Precautionary action was taken early in the investigation but the outbreak progressed rapidly and resulted in significant morbidity. I presented the investigative methods and findings from this outbreak to the 2014 Tasmanian Environmental Health Association Annual Conference. To fulfill the requirements of the program I prepared two teaching sessions. The "lessons from the field" case study was an introduction to data linkage for other MAE scholars in my cohort. I also prepared and taught a session on risk assessment in the context of outbreak investigation to the 2014 MAE scholars. Show more