International Paper Tire Burn
- Medical Surveillance Plan

Vermont Early Aberration Reporting System

The Vermont Department of Health routinely uses CDC’s Early Aberration Reporting System (EARS) to conduct syndromic surveillance at six Vermont hospitals, including Fletcher Allen Health Care and Rutland Regional Medical Center.

Through Vermont’s EARS program (VT EARS), the Health Department receives daily transmissions of data, without personal identifiers, representing all unplanned inpatient admissions and emergency department visits in the preceding four days. The data include limited patient demographics, chief complaint, available diagnosis fields and a unique identifier, which allows hospital follow-up if an unusual pattern of illness is identified. The hospital data are automatically scanned by the Health Department to classify admissions into “syndromes” (combinations of signs, symptoms, and diagnoses) that may indicate a public health threat.

One of the syndromes currently tracked daily in VT EARS is a general respiratory category, consisting of patients with respiratory complaints such as cough, sore throat, and shortness of breath. The respiratory category typically includes both patients with chronic ailments (e.g. asthma, emphysema) and patients with acute infectious conditions (e.g. influenza, pneumonia, pharyngitis).

Fletcher Allen Health Care & Rutland Regional Center

During the period immediately before, during, and after International Paper’s test burn of tire-derived fuel, the Health Department will temporarily use VT EARS data from Fletcher Allen Health Care and Rutland Regional Medical Center to also track a subset of chronic respiratory conditions known to be exacerbated by airborne pollutants; additional search terms (e.g. wheezing) would be added to better reflect the chronic respiratory symptoms in this group. In addition, the new syndrome definition would be applied to retrospective VT EARS data to allow seasonal comparisons to previous years’ counts.

Porter Medical Center, Rainbow and Middlebury Pediatrics

The CDC Early Aberration Reporting System does not yet include Porter Medical Center in Addison County. However, Porter Medical Center has agreed to provide emergency room visit data that relate to exacerbation of asthma and Chronic Obstructive Pulmonary Disease. This information will be provided for a limited time only – during the two weeks prior to, two weeks during, and two weeks after the International Paper tire burn.

Porter Medical Center has also agreed to provide town information about cases and a historic seasonal comparison from the previous years. Town information will not include street address or zip code but does provide a geographic location, which we will later be able to correlate with air pollution sample information

Additional data sources for medical surveillance are Rainbow Pediatric Clinic in Middlebury and several other clinics via Porter Practice Management in Middlebury. These sources will provide limited outpatient health data for both adults and children who live in Addison county. Data will be collected for six weeks and will only include town of residence, age, and specific billing diagnoses code.

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