Maine Center for Disease Control & Prevention An Office of the Maine Department of Health and Human Services

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Glossary

A .B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z

A

Adverse Birth Outcomes - The result of harmful environmental exposures to the mother and father, prior to and during the pregnancy, adverse birth outcomes place the child at risk for long term negative health effects. Examples of adverse birth outcomes are pre-term births, low birth weight, congenital abnormalities, pregnancy loss (miscarriage), or neurodevelopmental defects.

Age-adjusted Rate - A rate that has been statistically modified to eliminate the effect of varying age distributions in different populations. Age adjustment is a statistical method that is used to allow health measures (like rates of disease, death, or injuries) to be compared between communities with different age structures. The age distribution of a population may change over time and differ from place to place. Because some health conditions or diseases are more common in certain age groups of people, it can be misleading to compare rates or prevalence estimates of populations if the age distribution of the populations compared are different. A rate is age-adjusted by applying age-specific rates in the population of interest to the U.S. standard population (e.g., 2000 Census). Age-adjusted rates are relative and should not be considered exact rates that necessarily represent the true underlying burden of disease in the population.

Air Quality - Good air quality is important for humans to live everyday. Air pollution in the form of ozone and particulate matter has been linked to health problems like asthma, heart disease, and breathing problems. Ground level ozone (not the ozone layer in the atmosphere) is a gas that you cannot see or smell, and can be formed when exhausts from cars and power plants react with the heat of the day and sunlight to make smog. Particulate matter comes from motor vehicles, factories, and construction sites, which float in the air in the form of dust, dirt, soot, and smoke. Another particulate, pollen, comes from various plants and trees. Small diameter particles can be inhaled deeply into the lung airways, causing irritation and potentially serious health outcomes.

AnalyteA substance measured in the laboratory. A chemical for which a sample (such as water, air, or blood) is tested in a laboratory. For example, if the analyte is arsenic, the laboratory test will determine the amount of arsenic in the sample.

ArsenicA silver-gray or white metallic element of the periodic table of elements. It is a naturally occurring metal that is found in the Earth's crust.

Asthma - A respiratory disease that affects the airways that carry oxygen in and out of the lungs. These airways are sensitive, and if they react with an irritant, they become swollen and inflamed. Some people are more prone to having asthma, and it often starts in childhood and is more common in children than adults.

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B

Behavioral Risk Factor Surveillance System (BRFSS) - Established in 1984 by the Centers for Disease Control and Prevention (CDC), the Behavioral Risk Factor Surveillance System (BRFSS) is a state-based system of health surveys that collects information on health risk behaviors, preventive health practices, and health care access primarily related to chronic disease and injury. For many states, the BRFSS is the only available source of timely, accurate data on health-related behaviors. States use BRFSS data to identify emerging health problems, establish and track health objectives, and develop and evaluate public health policies and programs. Many states also use BRFSS data to support health-related legislative efforts.

Benchmark - An objective that is measurable and identifies a step you hope to achieve as you move towards your ultimate goal. A standard by which something can be measured, compared, or judged.

Biological Monitoring or Biomonitoring - A means to monitor a specific chemical or group of chemicals in an environment. For example, to understand how a chemical is affecting a water body like a stream, a sampling of living organisms—plants, insects, fish—would be done and then analyzed for that specific chemical. In humans, blood, hair, and urine are analyzed to determine the quantity of a chemical in the body. A good example of this would be measuring the amount of lead in blood. Although sampling of the chemical in the air may give its concentration that is present, biomonitoring provides an understanding of how the chemical is being absorbed and used in the living body, leading to potential negative health effects.

Birth Defect - A birth defect is defined as an abnormal condition that occurs before or at the time of birth. Birth defects include a wide range of abnormalities with varying levels of impact. Examples of birth defects include spina bifida, cleft palate, upper and lower limb deformities, and anencephaly.

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C

Cancer - Cancer is not just one disease, but rather a group of diseases, which involves a process of abnormal and uncontrolled cell growth. Cancers are caused by internal (genetic and hormonal) as well as external (viral, social, environmental) factors.

Carbon Monoxide - Carbon Monoxide (CO) is a toxic gas that you cannot smell or see. CO is given off whenever fuel or other materials are burned. Breathing high levels of CO can cause severe illness or death in a matter of minutes.

Carbon Monoxide Poisoning - Carbon Monoxide (CO) poisoning is a disease that affects the amount of oxygen getting to the brain and vital organs. As CO gas is inhaled, it readily displaces oxygen in the blood. CO poisoning causes headache, dizziness and nausea, but as CO gas concentrations increase, people can become unconscious or die.

Cardiac - Relating to the heart. In regards to Lyme Disease, one of the later symptoms can be heart block.

Cardiovascular Disease - Cardiovascular disease refers to a group of diseases and conditions affecting the heart and blood vessels, with heart attack and stroke having the highest number. Congestive heart failure, hypertension (also known as high blood pressure), and disease of the arteries, veins, and circulatory system are the other diseases and conditions included in the term cardiovascular disease. Cardiovascular disease is the leading killer of adults in Maine.

Centers for Disease Control and Prevention (CDC) - The U.S. Centers for Disease Control and Prevention is an agency within the U.S. Department of Health and Human Services, and is the national agency responsible for protecting and promoting human health in America. The Maine Center for Disease Control and Prevention is the public health agency within the Maine Department of Health and Human Services.

Chronic Disease - Chronic disease is the general category for diseases that involve a long course or time in their development or in having symptoms. Some diseases, like asthma and diabetes, are chronic because a person has symptoms over a long time, as much as a lifetime. Other diseases, like arthritis, heart disease, and cancer, are chronic because they develop over many years and symptoms occur later in one’s life. Mental health diseases, like dementia, depression and Alzheimer’s, are also considered chronic. For many chronic diseases, there are no cures to the disease, but medicines are available to moderate the symptoms.

Chronic Obstructive Pulmonary Disease (COPD) - Chronic Obstructive Pulmonary Disease (COPD) refers to a group of diseases that cause airflow blockage and breathing-related problems. It includes emphysema, chronic bronchitis, and in some cases asthma. Smoking is the leading cause of COPD, but other risk factors or exposures that make COPD worse include air pollution and workplace lung irritants.

Community Water SupplyA public water system that serves year-round residents of a community, subdivision, or mobile home park that has at least 15 service connections or an average of at least 25 residents.

Concentration - The amount of a substance present in a certain amount of soil, water, air, food, blood, hair, urine, breath, or any other media.

Confidence Interval - A range around a measurement conveying the amount of precision. In general, the wider the range, the less precise the number.

ContaminantA substance that is either present in an environment where it does not belong or present at levels that might cause harmful health effects.

Count - The number of individuals who meet a definition.

County - There are sixteen county units in Maine: Aroostook, Androscoggin, Cumberland, Franklin, Hancock, Kennebec, Knox, Lincoln, Oxford, Penobscot, Piscataquis, Sagadahoc, Somerset, Waldo, Washington, and York.

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D

Department of Health and Human Services (DHHS) - The department within the State of Maine government responsible for programs and services that supports the health and well being of Maine citizens.

Dermatologic - Relating to the skin. For example, a dermatologic manifestation may be a rash on the skin.

Disinfection Byproduct A compound formed by the reaction of a disinfenctant such as chlorine with organic material in the water supply; a chemical byproduct of the disinfection process.

Drinking Water Quality - Clean drinking water is important for humans to live everyday. In less developed countries, water borne diseases like cholera cause epidemics of sickness and death. Drinking water can be contaminated by natural sources, like bedrock, or from man-made sources, like disinfection chemicals, agricultural run-off, or plumbing fixtures. Arsenic is naturally found in drinking water supplied by bedrock wells in Maine. Nitrates originate from fertilizers and manures and dissolve readily in water sources.

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E

E-codes - When a person enters a hospital, the cause for their visit is coded.  E-codes or "external cause of injury" codes are diagnostic categories, based on the 9th revision of the International Classification of Diseases (ICD-9). E-codes differ from nature of injury codes (N-codes) in providing data on the cause, rather than type, of injury.

Environmental Data - Wide category of data types that are used to measure an environmental factor. For instance, air pollutants like ozone and particulate matter can be measured as a concentration per volume of air. For lead exposure, one factor that is a known hazard is older housing is lead paint and so knowing the amount of houses built before 1950 when lead paint was used can be determined. For Carbon Monoxide exposures, there is a different type of measure that can be used: having a carbon monoxide detector in the home measures the behavior of the home owner to prevent a potential carbon monoxide exposure.

Environmental Health - How the environment affects human health. Understanding how our interactions with our surroundings—air, water, chemicals, soil—can change the quality of our health.

Environmental Justice - The fair treatment and meaningful involvement of all people regardless of race, national origin, color or income when developing, implementing and enforcing environmental laws, regulations and policies. Fair treatment means that no group of people, including a racial, ethnic, or socioeconomic group, should bear more than its share of negative environmental impacts.

Environmental Public Health Tracking - Environmental public health tracking is the ongoing collection, integration, analysis, and interpretation of data about the following factors: environmental hazards, exposure to environmental hazards, and health effects potentially related to exposure to environmental hazards.

Environmental Public Health Tracking Network - One objective of Environmental Public Health Tracking is to make environmental and health data available electronically to data partners and the public. To do this, EPHT will have a network of states and the federal governments provide data at one site, or portal, where partners and the public can query the data, or get report displays of these data, along with content information and links to related resources.

Epidemiology - The study of the distribution and determinants of disease frequency in people. That is, epidemiology is concerned with the frequency and types of illnesses in groups of people and with the factors that influence the distribution of these diseases. Where physicians and nurses analyze the symptoms and fix the illness, epidemiologists study the illness from a population level to better understand why the illness occurred and what factors may have contributed to the illness.

Erythema Migrans (EM) - Skin rash often seen in the early stage of Lyme disease.  This rash tends to expand and look like a bullseye.  The rash, when present, normally appears in the first 30 days after being bitten by an infected tick.

Ethnicity - Ethnicity is often used synonymously with ancestry and includes concepts of culture, language, and national origin. Ethnic groups are often multiracial.

Exposure - Contact to an activity or substance. Exposure can be measured as the dose, or amount of the substance that enters or contacts the person. There are three means for entrance or routes for an exposure to enter the body: inhalation, direct contact, and digestion. The route of exposure can tell you if the toxic substance has an effect. Touching solid lead typically does not enter the body; breathing in or eating lead dust can cause negative health effects. Besides the dose, the amount of time of the exposure is important. A short time frame (seconds to hours) is known as an acute exposure; a longer extended time frame (months to years) is known as a chronic exposure. Additionally, how sensitive the person is to the toxic substance is important. Sensitivity is a factor of age, diet, alcohol use, if you have allergies, if you are pregnant, if you take medications, and genetic differences.

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F

Five-year Trailing Average - In some instances, five years of data are combined and the average across the five years presented. This is done to improve the stability of the estimates, which would otherwise fluctuate due to small numbers of occurrences. For example, the five-year trailing average for 2004 is calculated using data from the years 2000-2004.

FluorideA naturally occurring mineral that is found in many types of rocks, as well as in most water sources. It helps prevent tooth decay, but can be harmful at high levels.

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G

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H

Hazard - Biological, chemical or physical substance or activity that may cause an unacceptable health risk.

Health and Environmental Testing LaboratoryMaine’s public health laboratory, charged with isolating, identifying, analyzing, and monitoring any biological, chemical, or radiological hazards which are capable of causing harm.

Health Data - More specific category of data types typically focused on disease, injury or illness. For lead poisoning, a screening test measures the concentration of lead in the blood, and lead poisoning can be defined as having an elevated blood lead level (for children, the level is 10 ug/dL or greater). For carbon monoxide poisoning, a blood test measuring the amount of carbon monoxide that binds to the blood (carboxyhemoglobin) can be defined as having an elevated blood carboxyhemoglobin level. For the effects of air pollution, a known proxy is the amount of hospital visits for those with significant asthma events (attacks).

Health Disparities (Health Inequities) - Poor health status in the United States is often associated with being a member of a population group whose definition has little to do with health per se. For instance, it is well documented that people who are a member of a racial minority or who earn low wages suffer poorer health status, even through skin color and low wages do not themselves biologically or directly cause poor health. These inequalities in health status are also known as health disparities. Health disparities can also mean those populations at risk for experiencing barriers to accessing health care and prevention. Environmental health disparities or inequities can occur if a waste dump or a known polluting industry is located near neighborhoods of lower economic conditions. Thus those living in the neighborhood that cannot move due to economic reasons are now forced to live near hazards, with the higher potential for negative health effects due to these exposures and through no fault of their own.

Health Effects - Also known as health outcomes: it is the disease itself, such as asthma, cancer, etc., or the condition, such as lead poisoning, that occurs after the exposure.

Healthy Days - There is a set of questions related to the health-related quality of life entitled "Healthy Days" in the BRFSS survey. These questions ask how individuals have reported feeling in terms of their physical and mental health over the last 30 days. This line of questions provides an over-time measure of perception of well-being. Evidence suggests this can be used not only as a measure of individual health but as a proxy for measuring community level health.

Healthy Maine PartnershipOne of 27 local organizations in Maine dedicated to promoting and improving health, both at the local level and statewide.

Heart Attack (Myocardial Infarction) - Heart Attack (also known as Myocardial Infarction or MI)  is a condition that is caused by the lack of adequate blood supply to the heart muscle, causing damage or death to that section of the heart muscle. Some people are more susceptible to heart attack, due to their family history or their lifestyle. Environmental factors like poor air quality can lead to a greater increase in having a heart attack.

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I

Incidence - The number of new cases arising in a given period of time in a specified group of people (population).

Incidence Rate - The number of new cases of a disease occurring in a period of time divided by the size of the population at risk of becoming a case during that period of time. The result is often multiplied by a base number, such as 1,000 or 100,000, so that the resulting rate is the number of new cases of that disease per 100,000 people, which can then be compared.

Incidence Rate, Age-adjusted - The number of new cases diagnosed per 100,000 people, over a given time period for a specific age group. (standardized by population for each age group). See Age-Adjusted Rate for more explanation.

Infant Mortality, Neonatal - Neonatal mortality is defined as death in the first 28 days of life. The leading causes of neonatal deaths are birth defects, disorders due to prematurity and low birth weight, and pregnancy complications.

Infant Mortality, Post-neonatal - Post-neonatal mortality is defined as death from one month of age until the first birthday. The leading causes of post neonatal morality include sudden infant death syndrome (SIDS), birth defects, and injuries.

Infant Mortality Rate - The number of children in a population who die before their first birthday divided by the number of live births in that population during the same time period.

International Classification of Diseases, 9th Revision (ICD-9) - The Ninth Revision of the International Classification of Disease. The ICD-9 is published by the World Health Organization. Hospitals use this classification to code a patient who enters the hospital system, either at the Emergency Department, as an Out-patient or as an In-patient.

Ixodes Scapularis - A species of tick, also known as the deer tick, or the blacklegged tick. This tick is known to carry diseases including Lyme disease, Anaplasmosis, and Babesiosis.

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K

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L

Lead - Lead is a heavy metal that exerts toxic effects on brain cells, causing learning disabilities and behavior disorders in children as well as nerve damage in adults.

Lead Poisoning - Lead poisoning occurs when a child ingests or breathes in lead dust. Once lead enters the body, it can act like calcium and is readily absorbed into the blood, bones, and organs. Lead like mercury, is a neurotoxin, and has the potential to cause damage to the brain and nervous system. Lead poisoning can cause learning disabilities, behavioral problems, and at very high levels, seizures, coma and even death. At lower levels, the effects of lead poisoning frequently go unrecognized.

Limit of DetectionThe minimum concentration of an analyte that can be identified, measured, and reported with 99% confidence that the analyte concentration is greater than zero.

Lyme Disease - A bacterial infection spread through the bite of an infected deer tick.

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M

Maine Center for Disease Control and Prevention (Maine CDC) - The State of Maine's public health agency--an agency within the State of Maine's Department of Health and Human Services. Maine CDC's mission is to preserve, protect, and promote the health of all Maine people.

Maine Health Data Organization (MHDO) - Independent executive agency charged with collecting clinical and financial health care information and to exercise responsible stewardship in making this information accessible to the public. MHDO collects data from all thirty-eight hospitals in Maine.

ManganeseA naturally occurring metal that is found in many types of rocks, as well as in most water sources.

Margin of Error - The margin of error is a measure of the degree of uncertainty in an estimate, such as prevalence or rate, often due to the estimate stemming from a sampled portion of the population. Consider this, a survey finds that 25 percent of adults in Maine have high blood pressure and the survey's margin of sampling error is plus or minus 1.6 percentage points. The estimate, 25 percent, is considered the most likely value, but we consider a range of plausible values between 23.4 and 26.6 percent (25 - 1.6 and 25 + 1.6). This range is sometimes referred to as the 95 percent confidence interval. In 95 out of 100 samples, we expect the 95 percent confidence interval to reflect (sic) the true value. If the range of estimates based on the margin of error between the state and the district overlap, then it is unlikely that there is a statistically significant difference between the district and the state on that indicator.

MaximumThe highest data value recorded during the period of record.

Maximum Contaminant Level (MCL)The highest level of a contaminant that the U.S. Environmental Protection Agency (EPA) allows in drinking water. MCLs ensure that drinking water does not pose either a short-term or long-term health risk. EPA sets MCLs at levels that are economically and technologically feasible.

Maximum Exposure Guideline (MEG)The Maine CDC develops maximum exposure guidelines  to assist risk managers, homeowners, and others in making decisions about whether or not water with certain levels of contaminants is safe to drink.  MEGs are not meant as legally enforceable drinking water “standards,” but instead represent the State’s most recent recommendations for the levels of contaminants in drinking water below which there is minimal risk of a harmful health effect resulting from long-term ingestion of 2 liters per day of contaminated water.

MeasureOn the Maine Tracking Network, a measure is a summary characteristic or statistic, such as a sum, percentage, or rate. 

Median The middle value in a set of statistical values that are arranged in ascending or descending order.

Microgram per LiterA unit of concentration used to measure the mass of a contaminant measured in micrograms (one millionth of a gram) found in one liter of water.

Milligram per Liter A unit of concentration used to measure the mass of a contaminant, in milligrams (one thousandth of a gram), found in one liter of water.

Mortality - A fatal outcome; death.

Mortality Rate - The number of deaths attributed to a disease during a specific period of time, divided by the size of the population during that period of time. The result is often multiplied by a base number, such as 1,000 or 100,000.

Myocardial Infarction - Myocardial infarction (MI) or heart attack is a condition that is caused by the lack of adequate blood supply to the heart muscle, causing damage or death to that section of the heart muscle. Some people are more susceptible to heart attack, due to their family history or their lifestyle. Environmental factors like poor air quality can lead to a greater increase in having a heart attack.

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N

Nervous System - The part of the body that coordinates the actions and transmits signals.  The brain, spinal cord, and nerves are all part of the nervous system.

Neural Tube Defects - Neural tube defects, including spina bifida, occur when the fetal neural tube fails to close fully, interrupting development of the central nervous system. About half of all neural tube defects can be prevented when women take adequate folic acid from one month before conception through the first three months of pregnancy.

Neurologic - Relating to the nervous system. For example, a neurologic manifestation of a disease might be meningitis or encephalitis.

Nitrates and NitritesNitrogen-oxygen chemical units that combine with various organic and inorganic compounds. Once taken into the body, nitrates are converted into nitrites. The greatest use of nitrates is as a fertilizer. Other sources include animal manure and human sewage.

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O

Ozone - Ozone is an odorless, colorless gas composed of three atoms of oxygen. Occurring naturally in the upper atmosphere, it forms a protective layer that shields us from the sun's ultraviolet rays. It also occurs near ground level when pollutants from cars, power plants, and refineries react chemically in sunlight, forming ozone. Ground-level ozone is found in Maine primarily during hot summer days and causes irritation to people's respiratory systems, especially to children and people with chronic lung disease such as asthma.

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P

Percentage - A ratio where the value for the numerator is included in the total denominator. Prevalence is a percentage. The prevalence of diabetes is the number of people with diabetes divided by the entire population, with and without diabetes.

Percentile - A percentile is a measure used in statistics indicating the value below which a given percentage of observations in a group of observations fall. For example, the 95th percentile is the value below which 95 percent of observations may be found.

Percent of Wells above Guideline - The percent of tested wells in a given area that exceed Maine’s Maximum Exposure Guideline (MEG) for a given analyte.

Prevalence Rate - The percent of the population with a particular condition or characteristic. It is calculated as the number of people in a population who have a health condition divided by the total number of people in the population. Or, the proportion of a defined population affected by a disease at a specified point in time. The numerator of the proportion comprises all those who have the disease at that instant, regardless of whether it was diagnosed recently or long ago. Diseases with a long duration tend to have a higher prevalence than short-term illnesses.

Prevention - Any activity which reduces the burden of mortality or morbidity from disease.

Public Health - The study and practice of managing threats to the health of a community. Using the social context of disease and health, public health agencies focus on improving health through society-wide measures.

Public Health Districts - In 2007, Maine created eight Public Health Districts as a means of providing more efficient public health services at the local level. These Districts generally fall along County lines and are the base units for Public Health planning. The eight PHD (counties that are in the districts) are: Aroostook (Aroostook), Central Maine (Somerset & Kennebec), Cumberland (Cumberland), Downeast (Hancock & Washington), Mid-Coast (Knox, Lincoln, Sagadahoc, & Waldo), Penquis (Penobscot & Piscataquis), Western Maine (Androscoggin, Franklin & Oxford), and York (York).

Public Water SupplyA public water system that serves year-round residents of a community, subdivision, or mobile home park that has at least 15 service connections or an average of at least 25 residents.

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R

Race - Race is a sociological characteristic, generally thought of as a characteristic by which one is identified by others. Often these characteristics are related to skin color and / or facial features. Genetic studies have thoroughly discredited the concept of race as a biological characteristic.

Radon - Radon is an odorless and colorless gas and exists in varying concentrations in geographic areas in Maine. Radon is the leading cause of lung cancer among nonsmokers.

Rate - A measure of new events or occurrences in a population. The crude rate is calculated as the number of events per time period divided by the total number of people in the population in the same time period. The crude rate represents the actual burden of disease in the population.

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S

Skeletal System - The framework of the body, consisting of bones and other connective tissues, which protects and supports the body tissues and internal organs.

Statistically Significant - The difference between two rates is considered statistically significant if the difference would have occurred by chance less than five times out of 100. If a difference is statistically significant, it is not likely due to random chance.

SuppressionSuppression refers to the practice of withholding data values in order to prevent indirect identification of individuals and thereby preserve confidentiality. Data are suppressed according to Maine CDC’s Privacy Policy, which stipulates that health event counts (affected individuals) and derived rates will not be reported when either:  i) the underlying population is less than 50; ii) the specific health event counts are less than 6 and the underlying population is less than 2,000 persons; or iii) the difference between underlying population and heath events counts is less than 6. For example, if there were 3 persons hospitalized for asthma in a particular county, age group, and time period, having an underlying population less than 2,000 for same, the count would be reported as either “<6” or “1-5” and the rate would not be reported. Note that these suppression procedures only apply to populations defined by geographic areas or organizations within the State.

Surveillance - Systematic method for continuous monitoring of diseases in a population, in order to be able to detect changes in disease patterns and then to control them.

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T

Tickborne Disease - A disease or illness transmitted by ticks.

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U

Uranium - A naturally and commonly occurring radioactive element.

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W

Water Test - A test conducted by a certified laboratory on a water sample, usually to identify and measure levels of harmful contaminants.

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