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2003   January-March   Vol. 19   No. 1

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Link to ArticleTox Town: A New Approach to Presenting Toxic Chemical and Environmental Health Information.
Link to ArticleCatch the WAVE. MLA '03 in San Diego
List of programs.
Link to ArticleHealth Librarian "On the Street" -- Bringing in the Bucks: Library Support and Fundraising.

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Tox Town: A New Approach to Presenting Toxic Chemical and Environmental Health Information

Colette Hochstein, D.M.D., MLS
Technical Information Specialist
Cindy Love
Technical Information Specialist
Division of Specialized Information Services,
National Library of Medicine

Have you ever been asked to provide "non-technical" information about the health effects of radon, about what can be done about asbestos in homes, or about how to identify the symptoms of carbon monoxide poisoning?

Now there's a free, web-based resource to help you: Tox Town (, from the National Library of Medicine's Division of Specialized Information Services (SIS) ( Released this past October, Tox Town helps users take a look at an ordinary town to identify its common environmental hazards. Specific locations (like the school, home and office building) can be selected for cutaway views and for more detailed information about the toxic chemicals that might be found, as well as for links to selected Internet resources. Tox Town also has some resources available in Spanish (

As the world's largest library of the health sciences, the National Library of Medicine/NLM ( has provided a popular set of databases for toxicologists and other scientists for years ( Tox Town's target audience, however, is students above elementary-school level, educators, and the general public. In addition to information about "everyday" locations where toxic chemicals can be found and easy-to-understand descriptions of chemicals, Tox Town provides links to authoritative chemical information and to Internet resources on environmental health topics (primarily NLM's MEDLINEplus, It aims to help the user make connections between chemicals, the environment and human health. Chemical descriptions are based on TOXNET ( and are reviewed by NLM's toxicology staff.

Using Tox Town, a high school student writing a school paper about the health effects of lead could choose "Lead" from the chemical list below the town graphic for resources explaining what lead and lead poisoning are, for health questions about lead, and for information from the Centers for Disease Control and Prevention (CDC) concerning how to prevent lead poisoning in children.

A concerned citizen with questions about organisms in her local river could click on the town's river and choose information on drinking water, parasitic diseases, beaches, and chemicals in water.

Tox Town's use of color, graphics, sounds and animation adds special appeal for its intended audience. As a recent focus-group participant noted, this format helps to provide "a positive approach to a negative problem." Although a text-only version is available (,Tox Town's special effects require Macromedia Flash, which can be downloaded for free from Macromedia at

NLM plans to expand Tox Town to include more chemicals and new locations such as an urban community and a farming region.

For more information about Tox Town, contact Cindy Love, Office of Outreach and Special Populations, SIS, NLM:, 301-496-5306.

Comments on Tox Town may also be sent to:

Catch the WAVE. MLA '03 in San Diego

CAPHIS Program's

Session: "The Crest of the Wave: Cool New Health Information Resources for Consumers"
Primary Section Sponsor: CAPHIS
Secondary Section/ SIG Sponsors: Public Services, Health Association Libraries, Chiropractic Information Services, Public Health/Health Administration

Moderator: Naomi C. Broering, MLS, MA, CAPHIS Chair-elect, Director, Dr. William C. Herrick Community Health Care Library, Grossmont Healthcare District, La Mesa, CA

An exciting session on the latest library services for consumers will include an invited speaker from the NLM who will address The NN/LM Electronic Access to Health Information Projects and timely contributed papers on E-Reference for Consumers, Informed Medical Decision Making, and Resources for Diverse and Minority Populations.
Libraries have reached the next stage of consumer health services. Vibrant new electronic resources and library services for patients and their families are here today. Papers will cover innovative resources, delivery systems, avant-garde services and web-based NLM funded projects as they relate to consumer health information. What are some experiences and outcomes of e-reference services, informed medical decision making services and resources suitable for diverse and minority populations? Join us to hear and learn the latest trends.

Invited Speaker

Title: "Electronic Access to Health Information for the Public: Analysis of 53 NN/LM-Funded Projects"

Speaker: Angela B. Ruffin, PhD, Head, National Network of Libraries of Medicine Office, Library Operations Division of the National Library of Medicine.

Fifty-three health information outreach projects funded through NLM's National Network of Libraries of Medicine (NN/LM) were conducted in 2000 and 2001. These projects implemented a variety of approaches to achieve the common goal of improving access to electronic health information for consumers. The institutions conducting the projects included hospitals, academic health sciences centers, public libraries and other community-based organizations across the United States. In order to understand the relative success of the approaches taken, the investigators extracted data from the final reports of the projects and conducted follow-up telephone interviews with the project directors. In addition to descriptive information about the projects, this presentation highlights the common barriers encountered and lessons learned.

Contributed Papers

1. Abstract Title: " Bringing evidence to patients"

Author: Tamara M. Rader, MLIS, Information Specialist, Unified Ltd., BMJ Publishing Group, London, , United Kingdom; Andrea K. Lane, MSc, Information Specialist, Unified Ltd., BMJ Publishing Group, London, United Kingdom;

2. Abstract Title: "What Do Consumers Really Want? Planning for a Regional Consumer Health Website"

Authors: Julia F. Sollenberger, M.L.S., AHIP, Director, Health Science Libraries and Technologies, and Assistant Professor of Medical Informatics, Edward G. Miner Library, University of Rochester Medical Center, Rochester, NY ; Bernie L. Todd Smith, M.S.L.S., AHIP, Health Information Consultant, Werner Library, ViaHealth, Rochester, NY;

3. Abstract Title: "Health Information Hispanic Outreach: New Resources along the Rio Grande"

Authors: Virginia M. Bowden, PhD, Library Director, Library, University of Texas HSC SA, San Antonio, TX ; Debra G. Warner, Library Director, Medical Library, Regional Academic Health Center, University of Texas HSC SA, Harlingen, TX ; Evelyn R. Olivier, Deputy Library Director, Library, University of Texas HSC SA, San Antonio, TX ; Cynthia Olney, PhD, Evaluation Specialist, Academic Informatics Services, University of Texas HSC SA, San Antonio, TX ; Frederick B. Wood, PhD, Special Expert, Office of Special Programs, National Library of Medicine, Bethesda, MD.

Session: "Through Tempests and Storms: Vaccines, Biological, Patient Education, and Environmental Health"
Primary Section Sponsor: CAPHIS
Secondary Section/SIG Sponsors: Cancer Librarians, Pharmacy and Drug Information, Molecular Biology and Genomics SIG, Public Health/Health Administration, Chiropractic Libraries

Moderator: Lucy B. Thomas, AHIP & CAPHIS Chair, Librarian, Reeves Medical Library, Cottage Hospital, Santa Barbara, CA

Papers on issues of vaccines, biologicals, and environmental health, as they relate to health care, library services, collections, consumer and patient health information, and informatics.

What are the latest issues and historical background of the current resurgence of interest in vaccines? What effects has this had on consumers and patients? How do biological agents and research show promise for medical uses and threat for military ones? How do both of these relate to environmental toxicology and health? Most importantly, what do they have to do with your library? The papers will showcase creation and sources of on vaccines and immunization, biologicals, patient education and environmental health issues. Find out more by attending the program on Vaccines, Biologicals, Patient Education and Environmental Health.

Invited Speaker Presentations:

1. "Is the Environment Hazardous to Our Health? Toxics: Where We Work, in Our Neighborhoods, and Homes."

Speaker: Dr. Ruth M Heifetz, Senior Lecturer in the Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego.

This presention provides an overview of the current environmental health problems (childhood lead poisoning, asthma, cancer, infertiltiy) and the common exposures (air pollution, pesticides, metals like chromium, lead and mercury). The groups at greatest risk for these problems and exposures will be identified (the very young and old, pregnant women, individuals living in poverty). The focus will be on the prevention and control of environmental health problems. The importance of education and the availability of complete and accurate information for poth professionals and the general public well be discussed, examples data sources will be provided. The primacy of implementing Pollution Prevention programs and utilizing the Precautionary Principle to set policy will be underlying themes.

2. "Biodiversity, Conservation and Utilization: Patient Empowerment."

Speaker: Marian Hicks, MLIS, Director of Learning Resources at Cleveland Chiropractic College, Los Angeles

Education on natural resources is necessary and people are demanding more information and trying to find the causes and cures of human illness. The public is now demanding and requiring librarians to become more knowledgeable about complementary health care. Some of the answers can be found in the ecosystem. The preservation of biodiversity is vital to humanity. An estimated 40% of modern drugs come from the wild and is worth some US $40 billion a year in over-the counter and prescription sales. The study of medicinally active plants is one of the most active and potentially beneficial areas of inquiry into the benefits of preserving biodiversity. Some of the most powerful and effective methods for curing human illness are found in plants. This paper will cover information on patient education and the importance of the conservation of species and plants.

3. "The Influenza Vaccine: The Eternal Battle"

Speaker: Jennifer Lyon, MS, MLIS, Coordinator of Eskind Biomedical Library's (EBL) Research Informatics Consult Service (RICS), Vanderbilt University Medical Center, Nashville

For most healthy adults, influenza is a seasonal nuisance that causes about a week's worth of misery. Yet, this virus caused more deaths during the 1918-1919 years than World War I and remains one of the most deadly illnesses in the world today. In order to provide protection against influenza, scientists study the prevalent strains of influenza throughout the world and make a yearly prediction about which strains will be most likely to spread during the following year. Those strains are then used to make a vaccine that can be distributed to vulnerable populations. However, unlike other vaccines that can provide protection for many years up to a lifetime, the influenza vaccine must be prepared and inoculated every year. This is due to the shifting antigenic nature of the virus. Thus, the success of the influenza vaccine is a yearly struggle between the ability of scientists to make an educated guess and the virus' ability to 'fool' them. This talk will discuss the history of influenza, the process of predicting and developing the yearly vaccine, potential side effects of the vaccine, and the effectiveness of the vaccine over time, and issues for the future. Current vaccination issues also may be highlighted.

Contributed Paper:

Abstract Title "Historic or cutting edge? Consumer and practitioner interest in public health information"

Author: Kristine M. Alpi, AHIP, Library Manager, Public Health Library, NYC Dept of Health & Mental Hygiene, New York, NY

Health Librarian "On the Street" -- Bringing in the Bucks: Library Support and Fundraising.

This is the first in a series of articles that will briefly look at issues relevant to consumer health libraries and information services. The survey is small and unscientific, but knowing what colleagues do may be a source of inspiration

As the economy continues to contract, so often goes the library budget. Unfortunately the cost of books, journals and other materials continue to rise, albeit not as rapidly as it did through much of the last decade. Some libraries, in order to maintain their collection and services, spend more time fundraising. Other libraries have always independently raised money as part of their operating budget.

One of the question's your editors thought would be interesting was "How is your consumer health library funded?" Specifically we were interested in what percent parent institutions funded libraries as opposed to private donations and other fundraising efforts. The results are in and this is what we found. Karen Halverson, Director of the consumer library at Washington Community Hospital in Fremont, California, Mary Ann Howie of the Wellness Information Center ,Rochester General Hospital, Rochester, New York, and the John & Nettie Mooney Health Resource Center at Gunderson Lutheran Hospital in La Crosse, Wisconsin stated their hospital provided 99.9%, 100% and 98% of their respective budgets with some additional funding provided by private donors.

Libraries were also asked about their fundraising activities and who, within their organization, was responsible for the library fundraising. Melanie Jones of the Kittitas Valley Community Health Library in Ellensburg, Washington says her parent institution contributes 60% of her budget and the library must raise the remaining 30%. Jones raises funds from "grants and donations from business and individuals." Jones goes on to state that the library has "developed a number of community partnerships and participates in local events. For the past several years, we have held a 'Duck Derby' which has been quite successful and fun."

Nora Cain, Director of the Stanford Health Library in Palo Alto, California states her parent institution, Stanford Hospital & Clinics, contributes about 75% of their operating budget and the remaining 25% is brought in through private donations and fundraising campaigns. Cain further stated "we fundraise through direct appeal via a letter campaign and by applying for grants. The Library Director and a hospital development officer are responsible for fundraising."

All of the above consumer health libraries, and many others, can be found in the MEDLINEplus "Other Resources".

Book Reviews




New Editors for Consumer Connections

Stanford Health Library librarians Howard Fuller and Nancy Dickenson are new co-editors for Consumer Connections.

"We want this newsletter to be relevant to the work of all CAPHIS members," said Fuller. "With that in mind, we invite your ideas and suggestions. Tell us your stories."

Contact Fuller and Dickenson by telephone at (650) 725-8100, fax (650) 725-1444 or by e-mail: or



CAPHIS Section Business Meeting

To be held in Garden Salon 2. Eva Marie La Croix from the NLM will provide a MedlinePlus update.

CAPHIS Communications Meeting

All involved members to discuss CAPHIS message and various vehicles we use to get that across (Top 100 list, Newsletter, Brochure, MLA Column, Discussion list, etc.)

CAPHIS Executive Committee

New and retiring officers and committee chairs.


Publication Information


Consumer Connections (ISSN 1535-7821) is the newsletter of the Consumer and Patient Information Section of the Medical LibraryAssociation and is published quarterly.

Content for each issue is cumulated online at, primarily during the first two months of the quarter; the issue is considered complete at the end of the quarter. Notification of publication is sent quarterly via the CAPHIS listserv. Newsletter articles and book reviews are copyrighted; please contact the editor for reprint permission.


Please submit items for Consumer Connections during the third quarter for publication in the following quarter.

Submit by this month:
For publication in this issue:
March April-June
June July-September
September October-December
December January-March

Please send submissions in electronic format to the editors:

Howard Fuller
E -mail:
Telephone: (650) 725-3308
Nancy Dickenson
E -mail:
Telephone: (650) 725-8100
Fax: (650) 725-1444

2003   January-March   Vol. 19   No. 1
ISSN 1535-7821

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CAPHIS, the Consumer and Patient Health Information Section, is a section of the Medical Library Association, an association of health information professionals with more than 5,000 individual and institution members. MLA fosters excellence in the professional achievement and leadership of health sciences library and information professionals to enhance the quality of health care, education, and research.

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