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Active surveillance
With active surveillance the agency collecting data regularly contacts people, such as health care providers, to get information about health conditions. Active surveillance is expensive to conduct, but it provides the most accurate and complete information.
Age-adjusted rate (direct adjustment)
A measure of the frequency of an event per population unit that has been statistically adjusted to minimize the effect of different age distributions in different populations. People of different ages are more or less susceptible to certain illnesses, and more or less likely to engage in behaviors that might protect their health or put it at risk. Age-adjusted rates show if there are differences among groups independent of the age distributions within the groups. They also show differences in a group over time independent of the changing age structure of the group.
Age-specific rate
A rate in which the number of events and population at risk are restricted to an age group (e.g., the birth rate for women age 15 to 19; death rate for people age 45 to 64).
Aggregate level data
Information about characteristics of a group rather than characteristics of specific individuals in that group.
AQI
Air Quality Index. The Environmental Protection Agency (EPA) created the AQI to report daily air quality, focusing on health effects that may result from a few hours or days of breathing unhealthy air. The AQI is calculated for four major air pollutants that are regulated by the Clean Air Act: ground-level ozone, particle pollution, carbon monoxide, and sulfur dioxide.
Aquifer
A natural underground layer, often of sand or gravel, that contains water.
Arsenic
A metallic element that occurs naturally in rocks and soil.
Asthma
A chronic disease that causes the airways of the lungs to become swollen, tighten and fill with fluid. Asthma can be controlled by taking medicine and avoiding allergens and irritants that can cause an asthma attack.
Bacterial vaginosis
A condition in women where the normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of certain bacteria.
Birth Cohort
A group of people born during a specific period of time, such as a particular year.
Birth defects
Major birth defects are conditions that are present at birth, cause structural changes in one or more parts of the body and have a serious, adverse effect on health, development, or functional ability.
BRFSS
Behavioral Risk Factor Surveillance System. BRFSS is a system of telephone surveys sponsored by CDC to monitor lifestyles and behaviors related to leading causes of illness, injury and death. In Colorado over 1,000 adult residents complete the survey each month. Questions about environmental health were added to the Colorado BRFSS in 2009 and may be included in future surveys.
Capillary test
A capillary blood test is when the blood to be tested is collected by pricking a finger or a baby’s heel, then collecting blood from the puncture site into a tube. Capillary blood sampling is useful when small amounts of blood are needed or when blood is very difficult to obtain, such as from infants.
Carbon monoxide
A colorless, odorless poisonous gas that is produced by incomplete burning of various fuels. Breathing in high levels of carbon monoxide can lead to severe illness or death.
Carcinogen
Any substance that can cause cancer.
Cardiovascular
Relating to the heart and blood vessels.
CDC
Centers for Disease Control and Prevention. Federal public health agency, one of the major components of the Department of Health and Human Services. For more information visit the CDC web site.
CDPHE
Colorado Department of Public Health and Environment. For more information visit the CDPHE web site.
Central Nervous System
The main organs of the nervous system, including the brain and the spinal cord.
Cerebral palsy
A group of disorders that affect a person’s ability to move and maintain balance and posture.
COEPHT
Colorado Environmental Public Health Tracking Program. A Colorado Department of Health and Environment program, funded by CDC, which brings together Colorado health and environmental data on a searchable, Web-based surveillance system. COEPHT also contributes data to CDC’s National Environmental Public Health Tracking Program so we can further our understanding of how health and environment are connected at a national level.
Community water system (CWS)
A water system that supplies drinking water to 25 people or more year-round in their residences.
Concentration
The relative amount of a substance present in another substance.
Confidence interval
A confidence interval is a range of values for a variable of interest (such as a rate) calculated so that this range has a specified probability of including the true value of the variable. For example, a 95% confidence interval for an average is the range of values that would contain the true average 95% of the time. A calculated statistic may differ from the true value due to sampling error. The confidence limit gives a better understanding of how accurate the calculated statistic might be. Narrow confidence intervals for rates indicate with greater certainty that the calculated rate is a reliable approximation of the true rate, while wide confidence intervals signal greater variability and less certainty that the calculated rate is a good estimation of the true rate. If the confidence intervals for two calculated statistics overlap, then those two statistics are not considered to be statistically different.
Confidence limit
The upper or lower end of a confidence interval. These limits are established based on statistical tests. They establish a range of values likely to contain the true value for the parameter being estimated. A very wide interval indicates more uncertainty and may mean that more data should be collected before drawing any firm conclusions about the outcome.
Confirmed elevated blood lead test
An elevated blood lead test is considered confirmed if there is either one elevated venous test or two elevated capillary tests which are done less than 12 weeks apart.
Denominator
The lower portion of a fraction used to calculate a rate or ratio. In calculating rates, such as prevalence and incidence, the denominator is the number of people in a specified population. Everyone in the denominator must be eligible to be counted in the numerator. The denominator is often called the "population at risk."
Diethylstilbestrol (DES)
The earliest synthetic (man-made) form of a hormone in the estrogen classa drug. It once was prescribed during pregnancy to prevent miscarriages or premature deliveries.
Dioxin
The generic name for a group of chemicals including both polychlorinated dibenzodioxins and polychlorinated dibenzofurans. Dioxin in very small amounts is found almost everywhere in the environment. It is made and released into the environment mostly from burning fuels, wood and waste. Other common sources are wastes from factories making chlorinated phenols, and the chlorine bleaching process used at pulp and paper mills. Dioxin does not easily break down and tends to stick tightly to soils and sediment where it can stay for a long time. Health effects from environmental exposure to dioxin are not well understood.
Disinfection byproducts (DBPs)
A family of chemicals that form when disinfectants, such as chlorine used in water treatment, react with bromide and/or naturally occurring organic matter in the water, for example, decomposing plant material.
Endocrine disruptors
Chemicals that interfere with endocrine (or hormone system) in animals, including humans. These disruptions can cause cancerous tumors, birth defects, and other developmental disorders.
Endometriosis
An often painful disorder in which tissue that normally lines the inside of the uterus — the endometrium — grows outside the uterus.
Environmental Hazard
Substance or situation in the environment that could adversely affect human health. People can be exposed to physical, chemical, or biological toxins from various environmental sources including air, water, soil, and food.
Environmental Public Health Tracking
The ongoing, systematic collection, integration, analysis, interpretation, and dissemination of data from environmental hazard monitoring, and from human exposure and health effects surveillance.
EPA
Environmental Protection Agency. Federal agency with a mission to safeguard the environment and protect human health. For more information visit the EPA web site
EPHT
Environmental Public Health Tracking
Estrogen
A female steroid hormone that is produced by the ovaries and, in lesser amounts, by the adrenal cortex, placenta, and male testes. Estrogen helps control and guide sexual development, including the physical changes associated with puberty. It also influences the course of ovulation in the monthly menstrual cycle, lactation after pregnancy, aspects of mood, and the aging process.
Exposure
Contact with a substance by swallowing it, breathing it in, or having it touch the skin or eyes. Exposure may be short-term (acute), of intermediate duration, or long-term (chronic).
Fertility
The ability to conceive a child.
Fetal alcohol spectrum disorder (FASD)
A group of conditions that can occur in a person whose mother drank alcohol during pregnancy. These effects can include physical problems and problems with behavior and learning. Often, a person with an FASD has a mix of these problems.
Fetal death
Death prior to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of pregnancy. Fetal death is also commonly referred to as miscarriage and spontaneous abortion.
Fetal growth restriction
Refers to a fetus that has failed to achieve its genetically determined growth potential and affects up to 5–10% of pregnancies.
Fetus
An unborn human baby more than eight weeks after conception
Folic acid
Folic acid is a B vitamin. Folic acid is very important because it can help prevent some major birth defects of the baby's brain and spine (anencephaly and spina bifida).
Gestation
The period of development between conception and birth
Ground water
Water that is pumped and treated from an aquifer.
Haloacetic acids (HAA5)
The sum of the concentrations of five regulated haloacetic acids (monochloro-, dichloro-, trichloro-, monobromo-, dibromo-) that form as disinfection byproducts when drinking water is treated with chlorine and chloramine.
Health Effect (Health Outcome)
Changes in health, such as disease or disability.
Health Indicator
A measure that reflects (indicates) the health status of people in a defined population. For example, rates of disease, disability and death are health indicators.
Health Outcome
See “Health effect”
Herbicide
Chemicals used to control undesirable weeds and plants in agricultural, residential, and water environments. A type of pesticide.
Hospitalizations
When an individual is admitted to the hospital for at least one night. The Environmental Public Health Tracking program classifies hospitalizations geographically by the county where the patient lives, not by county where the patient was hospitalized.
Hypertension
High blood pressure. Blood pressure is a measurement of the force against the walls of your arteries as your heart pumps blood through your body.
Incidence
The number of new cases or events of a specific illness in a defined population during a specific time period among those at risk of becoming a case in the same area and time period. Provides a measure of the impact of illness relative to the size of the population. Calculated by dividing incidence in the specified period by the population in which cases occurred. It is often expressed as per 100,000 population.
Indicator
For environmental public health tracking, an indicator is one or more data category, measure or population characteristic that is assessed to provide information about a population’s health status, environment, or other factors with the goal of allowing us to monitor trends, compare situations, and better understand the link between environment and health. Indicators may be direct or indirect measures (e.g. levels of a pollutant in the environment as a measure of possible exposure) that describe health or a factor associated with health (i.e., environmental hazard, age) in a specified population.
Infant death
Death of an infant in the first year of life.
Infant mortality rate
The number of deaths of infants, one year of age or younger, per 1,000 live births.
Infant mortality
Death of an infant in the first year of life.
Infertility
A condition occurring when a couple cannot get pregnant after one year of trying.
Intellectual disabilities
Conditions that begin before the age of 18 and can be caused by injury, disease or other problems in the brain. These disabilities can affect a person's ability to speak, learn, and live independently.
Intervention Level
The level at which action is suggested to protect public health. For example, the current Centers for Disease Control and Prevention (CDC) intervention level for blood lead is 10 micrograms per deciliter (10µg/dL). Specific case management steps, such as education about exposure prevention, nutritional guidance, medical testing or treatment may be recommended. The recommended intervention depends on the level of lead found.
Ionizing radiation
Any one of several types of particles and rays given off by radioactive material, high-voltage equipment, nuclear reactions, and stars. The types that are normally important to your health are alpha particles, beta particles, x rays, and gamma rays.

Lead poisoning
Lead poisoning is defined as the current CDC intervention level of 10 micrograms of lead per deciliter of blood or more (≥10 µg/dL).
Low birth weight
A baby is considered to be of low birth weight when its weight is less than 5.5 lbs, or 2500 grams, at birth. For Tracking, low birth weight is measured among singleton births only.
Maximum contaminant level (MCL)
The highest level of a contaminant that the U.S Environmental Protection Agency (EPA) allows in drinking water. This is a legally enforceable standard.
Mean value
The mean value is also called the arithmetic mean or the average. It is calculated by adding up all the individual values in a group or list, then dividing that total by the number of values in the group.
Menstruation
The periodic blood that flows as a discharge from the uterus. Also called menorrhea, the time during which menstruation occurs is referred to as menses. The menses occurs at approximately 4 week intervals to compose the menstrual cycle.
Metadata
Data about data. COEPHT provides metadata - including data collection methods, source of data, level of geographic detail, and other information - for all data on the COEPHT web portal.
MI
Myocardial infarction, also called a heart attack or an acute myocardial infarction (AMI). When part of the heart muscle gets damaged or dies because it isn’t getting enough blood, usually because of a blocked artery in the heart.
Miscarriage
See fetal death.
Mortality
Death
NAAQS
National Ambient Air Quality Standards. Standards established by EPA that apply to outdoor air throughout the United States.
National Environmental Public Health Tracking Network
A web-based, secure network of standardized electronic health and environmental data collected from state grantees, and built and maintained by CDC with the goal of providing information to improve the health of communities.
NCDMs
Nationally Consistent Data and Measures. Using these consistent forms of measurement and data reporting make it possible to compare data collected from different states.
Neonatal
The time period between birth and the first four weeks of life.
Neurodevelopment
Neurodevelopment refers to the growth and development of the nervous system as well as the sensory and perceptual abilities of the child. Neurodevelopmental effects may include decreases in brain weight, brain cell number, exploratory behavior and movement.
Newborn jaundice
Newborn jaundice is when a baby has high levels of bilirubin in the blood. Bilirubin is a yellow substance that the body creates when it replaces old red blood cells.
Nitrate
A naturally occurring chemical compound made of nitrogen and oxygen (NO3).
Number children confirmed elevated blood lead (lead cohort)
This is the number of children born in this cohort year who had a confirmed elevated blood lead test before their third birthday. An elevated blood lead test is considered confirmed if there is either one elevated venous test or two elevated capillary tests which are done less than 12 weeks apart.
Number children confirmed elevated blood lead
This is the number of children in the selected age group who had a confirmed elevated blood lead test during the selected year. An elevated blood lead test is considered confirmed if there is either one elevated venous test or two elevated capillary tests which are done less than 12 weeks apart.
Number children tested (lead cohort)
This is the number of children who were born in the selected cohort year (e.g. 2007) who were tested for lead before their third birthday.
Number children tested
This is the number of children in the selected age group in the selected year who were tested for lead during that same year.
Number children unconfirmed elevated blood lead (lead cohort)
This is the number of children born in this cohort year who had a confirmed elevated blood lead test before their third birthday. An elevated blood lead test is considered unconfirmed if there is one elevated capillary test with no additional elevated test within a 12 week period.
Number of children born (lead cohort)
This is the number of children born in the birth year for this particular cohort. For example, the 2007 birth cohort is all children born in 2007.
Number of drinking water systems
The number of drinking water systems with contaminant levels in this concentration range.
Numerator
The upper portion of a fraction used to calculate a rate or ratio. In calculating rates, such as prevalence and incidence, the numerator is the number of events in a specified population
Ovulation
The release of the ripe egg (ovum) from the ovary. The egg is released when the cavity surrounding it (the follicle) breaks open in response to a hormonal signal. Ovulation occurs around 14 or 15 days from the first day of the woman's last menstrual cycle. When ovulation occurs, the ovum moves into the Fallopian tube and becomes available for fertilization.
Ozone
A highly reactive gas compound made up of three oxygen atoms (O3). Ground-level ozone is an air pollutant, a major component of smog and hazardous to human health. High in the atmosphere ozone plays a beneficial role, protecting the Earth’s surface from harmful UV radiation.
Particulate Matter
Particles of dust, dirt, smoke, soot, or liquid droplets suspended in the air that can contain a variety of chemical components.
Passive surveillance with follow-up
This is when an agency collects data using passive surveillance, but follows up on what is reported with methods used in active surveillance such as reviewing medical records, confirming reported data, or conducting active surveillance for a select group.
Passive surveillance
With passive surveillance the agency collecting data receives reports submitted from hospitals, clinics, public health units, or other sources. This is a relatively inexpensive way to monitor community health or environmental issues, particularly over a large area, but it depends on many different people submitting data and the timeliness and quality of the data can vary depending on the reporting source.
Pelvic inflammatory disease
PID occurs when certain bacteria, such as chlamydia or gonorrhea, move upward from a woman's vagina or cervix (opening to the uterus) into her reproductive organs.
Percentage children confirmed elevated blood lead (lead cohort)
This is the percent of children born in this cohort year who had a confirmed elevated blood lead test before their third birthday. An elevated blood lead test is considered confirmed if there is either one elevated venous test or two elevated capillary tests which are done less than 12 weeks apart
Percentage children confirmed elevated blood lead
This is the percent of children in the selected age group who had a confirmed elevated blood lead test during the selected year. An elevated blood lead test is considered confirmed if there is either one elevated venous test or two elevated capillary tests which are done less than 12 weeks apart.
Percentage children tested (lead cohort)
This is the percent of children who were born in the selected cohort year (e.g. 2007) who were tested for lead before their third birthday.
Percentage children tested
This is the percent of children in the selected age group in the selected year that was tested for lead during that same year.
Percentage of children below poverty
This is an estimate of the percentage of children age 5 years and younger that was living below the federal poverty level in the selected year. Poverty data provides an approximation of the percentage of children in this population that should be targeted for blood lead testing based on Colorado recommendations. While it is not known if those who were tested come from this target group, this allows for comparison between the percentage tested and the estimated size of the target group.
Percentage of drinking water systems
The percent of drinking water systems with contaminant levels in this concentration range.
Percentage of population served
The percent of people who get their water from a public water system and are served by water systems with contaminant levels in this concentration range.
Perinatal death
A fetal death of 28 weeks gestation or more and an infant death in the first 6 days of life.
Person-days
A measure of the impact of an event that takes into account how many people are affected. For example, if air quality at a certain place is hazardous for 1 day and only 1 person is at that place that is 1 person-day of hazardous air quality. But if air quality at a certain place is hazardous for 1 day but 500 people are at that place that is 500 person-days of hazardous air quality.
Pesticides
The term pesticide applies to insecticides, herbicides, fungicides, disinfectants and various other substances used to control pests. Pesticides play an important role in food supply protection and disease control, but they can also be harmful to human health.
Phthalates
A group of aromatic chemicals containing a phenyl ring with two attached and extended acetate groups. They are typically colorless liquids used to make plastics more flexible and resilient, and are often referred to as plasticizers. Because they are not a part of the chain of chemicals (polymers) that makes up plastics, they can be released fairly easily from these products. These plastics are found in products such as toothbrushes, automobile parts, tools, toys, and food packaging. Some are also used in cosmetics, insecticides, and aspirin.
Pica
A craving to eat nonfood items, such as dirt, paint chips, and clay. Some children and pregnant women exhibit pica-related behavior.
PM2.5
measure of particles in the atmosphere with a diameter of equal to or less than 2.5 micrometers
Polychlorinated biphenyls (PCBs)
Mixture of individual chemicals which are no longer produced in the United States, but are still found in the environment. Health effects that have been associated with exposure to PCBs include acne-like skin conditions in adults and neurobehavioral and immunological changes in children. PCBs are known to cause cancer in animals.
Polycyclic aromatic hydrocarbons (PAHs)
A group of over 100 different chemicals that are formed during the incomplete burning of coal, oil and gas, garbage, or other organic substances like tobacco or charbroiled meat.
Population served
The estimated number of people served by water systems with contaminant levels in this concentration range. These numbers are provided by each water system as an estimate of the number of people they serve. These population number may not represent the entire population of the county since some people may get their water from a source other than a public water system, such as a private well.
Population
This is the number of children in the selected age group in the selected year.
Preconception health care
Preconception health care is the medical care a woman or man receives from the doctor or other health professionals that focuses on the parts of health that have been shown to increase the chance of having a healthy baby.
Prematurity
See preterm birth.
Prenatal care
Prenatal care is medical care you get when pregnant. Prenatal care can be given by health providers like an obstetrician, a family practice doctor, a certified nurse-midwife, a family nurse practitioner or a women’s health nurse practitioner.
Prenatal
Prenatal refers to the period during which a woman is pregnant or the period before birth.
Preterm birth
Preterm birth is the birth of an infant at least three weeks before the due date (less than 37 weeks gestation). For Tracking, preterm births are measured among singleton births only.
Prevalence
The number of people living with a disease or condition in a defined population on a specified date, divided by that population. It is often expressed per 100,000 population. Prevalence is affected by the incidence and the duration of the condition being measured.
Public water system (PWS)
A water system which supplies drinking water to at least 25 people for at least 60 days each year
Radionuclides
Any natural or man-made element that emits radiation and that may cause health problems, including cancer and birth defects, after many years of exposure. People may be exposed to radionuclides through drinking water and air.
Radon
A colorless, odorless, radioactive gas that forms naturally in soil. Radon is produced when uranium in the soil breaks down.
Rate
A measure of the frequency of an event per population unit. The use of rates, rather than raw numbers, is important for comparison among populations, since the number of events depends, in part, on the size of the population.
Risk factor
Something that increases the likelihood that a person will have an illness or injury. Risk factors can be environmental exposure, genetic predispositions, or behaviors that put the person at increased risk of illness or injury.
Screening rate
A measure of how many people are screened for a particular condition per population unit. For example, the number of low-income children under the age of six who were tested for elevated blood lead levels out of all the low-income children under the age of six.
Secondhand smoke
Secondhand smoke is a mixture of gases and fine particles that has been exhaled or breathed out by the person or people smoking.
Sex ratio
For Tracking this is the ratio of males to females at birth among term single births.
Socioeconomic status (SES)
A description of a person's societal status using factors or measurements such as income levels, relationship to the national poverty line, educational achievement, neighborhood of residence, or home ownership.
Solvents
A liquid capable of dissolving or dispersing another substance (for example, acetone or mineral spirits).
Spontaneous abortion
See fetal death.
Statistical difference
When quantitative differences between populations are labeled as statistically different it means the differences are considered highly likely to be real and are not due to random error. When the confidence intervals around two values do not overlap the values are considered to be statistically different.
Stillbirth
The birth of a fetus that died before or during delivery.
Sudden Infant Death Syndrome (SIDS)
Sudden Infant Death Syndrome (SIDS) is defined as the sudden death of an infant less than 1 year of age that cannot be explained after a thorough investigation is conducted, including a complete autopsy, examination of the death scene, and review of the clinical history.
Surface water
Water that is pumped and treated from sources open to the atmosphere, such as rivers, lakes, and reservoirs.
Surveillance
The ongoing and systematic collection, analysis, and interpretation of data about a health condition or an environmental condition.
Targeted testing
Targeted testing is when only those at higher risk are targeted for testing. For example, targeted testing for childhood lead poisoning might recommend screening all low-income children before they reach six years of age.
Testosterone
Testosterone is a steriod hormone (androgen) and the principal male sex hormone. It is produced by the testicles and is responsible for the proper development of male sexual characteristics. Testosterone is also important for maintaining muscle bulk, adequate levels of red blood cells, bone density, sense of well-being, and sexual and reproductive function.
Total trihalomethanes (TTHM)
The sum of the concentrations of the following disinfection byproducts: chloroform, bromoform, bromodichloromethane, and dibromochloromethane.
Tracking
See “Environmental Public Health Tracking”
Trichomoniasis
A very common sexually transmitted disease (STD) that is caused by infection with a protozoan parasite called Trichomonas vaginalis. Although symptoms of the disease vary, most women and men who have the parasite cannot tell they are infected.
Unconfirmed elevated blood lead test
An elevated blood lead test is considered unconfirmed if there is one elevated capillary test with no additional elevated test within a 12 week period.
Unintended pregnancies
Pregnancies occurring sooner than desired or occurring when no pregnancy is desired
Universal testing
Universal testing (also called universal screening) is when everyone is targeted for testing, including people at higher risk and those at lower risk. For example, universal testing for childhood lead poisoning might recommend screening all children before they reach six years of age.
Vaccinations
Injection of a killed or weakened infectious organism in order to prevent the disease.
Vaginitis
Any infection or inflammation of the vagina.
Venous test
A venous blood test is when the blood to be tested is drawn directly from a vein.
Vital statistics
Data derived from certificates and reports of birth, death, fetal death, induced termination of pregnancy, marriage, and related reports.

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