MONTANA BUNKER HILL MEDICAL MONITORING DATABASE



The Montana Bunker Hill Medical Monitoring Program is a service for residents of Montana who were exposed to high levels of lead while working at Bunker Hill mining facility or while living or going to school in the Silver Valley between the years of 1973 to 1981. Services include outreach to locate eligible participants, screening for diseases related to lead exposure, referrals to health care providers, and assistance with access to treatment for those who do not have health insurance. Some goals of the program include estimating exposure to lead from living or working in the Silver Valley, or from other sources not associated with the area; estimating disease outcomes resulting from exposure to lead, cadmium, arsenic, or other conditions such as genetics or lifestyle factors that may increase the risk for diseases of concern, and linking to historical data addressing lead exposure to provide further depth to the data. The Montana Department of Health and Human Services is working with Montana State University’s College of Nursing, which will be conducting telephone surveys to collect responses from individuals. Eligible participants will be determined by the survey process and referred to regional health care providers who will evaluate participants’ health.

TerraGraphics developed a database using Microsoft Access 2000® multiple cross-linked tables to logically and concisely store the information gathered from the survey questionnaires. A graphical interface was designed to facilitate and validate data entry to make it possible to record data into the tables while the survey is being conducted. The graphical interface, or “forms”, display much like a hard copy of the survey would appear, including scripts to follow during the course of the interview. The forms are driven by programming code that directs the interviewer to the proper sections, calculates a participant’s level of eligibility based on a complex matrix of requirements determined by answers to several sections of questions, and incorporates a calculator that converts height and weight into a participant’s body-mass index.

The database was then transferred to a secure Internet site, which encrypts all data sent to and from the site to ensure strict confidentiality, so that it could be accessed from each regional office in the state and by the participants’ physicians. The forms were reprogrammed using Microsoft’s Active Server Pages and input validation was coded in JavaScript. The site was designed with levels of accessibility, protected by logon and password, to allow controlled access to the confidential data. The access hierarchy, for example, allows physicians to print completed surveys, but not add or edit any information.