NOTICE OF FILING
CERTIFICATE OF SERVICE
TESTIMONY OF MARC GORELICK, MD
I. Introduction
II. Qualifications
III. The Limits of Epidemiological Research
B. Asymptomatic infections
CURRICULUM VITAE
Office Address:
E-Mail:
Home Address:
Place of Birth:
Citizenship:
Postgraduate Training:
Faculty Appointments:
Administrative Appointments:
Membership in Professional Societies:
Editorial Positions:
Regional/Local Appointed Leadership and Committee Positions
National Elected/Appointed Leadership and Committee Positions
National:
Editorials, Letters to the Editor, Other:
Media Contacts:

•••••••••••••••••••••••••

MWRDGC monitoringpoints
- 63 sample locations
Calumet WRP EffluentFecal Coliform rv1av to October 2002
1. Source: rvlWROOC. Sarrples collected weekly.

BEFORE THE ILLINOIS POLLUTION CONTROL BOARD

IN THE MATIER OF:

WATER QUALITY STANDARDS AND

EFFLUENT LIMITATIONS

FOR THE

CHICAGO AREA WATERWAY SYSTEM

AND THE LOWER DES PLAINES RIVER:

PROPOSED AMENDMENTS TO 35 ILL..

ADM. CODE PARTS 301, 302, 303 and 304

)

) R08-9

) (Rulemaking - Water)

)

NOTICE OF FILING

To: see attached Service List

PLEASE TAKE NOTICE that on the 4

Day of August, 2008, I filed with the Office of

the Clerk of the Illinois Pollution Control Board the attached Prefiled Testimony of Marc

H. Gorelick, M.D., a copy

of which is hereby served upon you.

By:

--:--

Ann Alexander, Natural Resources Defense Council

Dated: August 4, 2008

Ann Alexander

Senior Attorney

Natural Resources Defense Council

101 North Wacker Drive, Suite 609

Chicago, Illinois 60606

312-780-7427

312-663-9920 (fax)

Electronic Filing - Received, Clerk's Office, August 4, 2008

CERTIFICATE OF SERVICE

Ann

Alexander, the undersigned attorney, hereby certify that I have served the attached

Prefiled Testimony

of Marc H. Gorelick on all parties of record (Service List attached),

by depositing said documents

the United States Mail, postage

pr~aid,

from 227 W.

Monroe, Chicago, IL 60606, before the hour of5:00 p.m., on this 4 Day of August,

2008.

Ann

Alexander, Natural Resources Defense Council

Electronic Filing - Received, Clerk's Office, August 4, 2008

Richard J. Kissel and Roy M. Harsch

Drinker, Biddle, Gardner, Carton

191 N. Wacker Drive, Suite 3700

Chicago, IL 60606-1698.

Deborah J. Williams and Stefanie N. Diers

Assistant Counsel, Division

ofLegal Counsel

Illinois Environmental Protection Agency

1021 North Grand Avenue East

P.O. Box 19276

Springfield, IL 62794-9276

Kevin G. Desharnais, Thomas W. Diamond

and Thomas V. Skinner

Mayer, Brown LLP

71 South Wacker Drive

Chicago, IL 60606-4637

Robert VanGyseghem

City

of Geneva

1800 South Street

Geneva, IL 60134-2203

Matthew J. Dunn,

Chief

Office of the Attorney General

Environmental Bureau North

69 West Washington, Suite 1800

Chicago, IL 60602

Charles

W. Wesselhoft and James T. Harrington

Ross

Hardies

150 North Michigan Avenue

Suite 2500

C~icago,

IL 60601-7567

Service List

Bernard Sawyer and Thomas Granto

Metropolitan Water Reclamation District

600 I West Pershing Road

Cicero, IL 60650-4112

James

L. Daugherty, District Manager

Thorn Creek Basin Sanitary District

700 West End Avenue

Chicago Heights, IL 60411

Tracy Elzemeyer, General Counsel

American Water Company Central Region

727 Craig Road

St. Louis, MO 63141

Claire Manning

Brown, Hay

Stephens LLP

700 First Mercantile Building

205 South Fifth St., P.O. Box 2459

Springfield, IL 62705-2459

Katherine

D. Hodge and Monica T. Rios

Hodge Dwyer Zeman

3150 Roland Avenue

P.O. Box 5776

Springfield, IL 62705-5776

Margaret P. Howard

Hedinger Law Office

2601 South Fifth Street

Springfield, IL 62703

Electronic Filing - Received, Clerk's Office, August 4, 2008

Jerry Paulsen and Cindy Skrukrud

McHenry County Defenders

132 Cass Street

Woodstock, IL 60098

William Richardson,

Chief Legal Counsel

Illinois Department

ofNatural Resources

One Natural Resources Way

Springfield, IL 62702

Lisa Frede

Chemical Industry Council

of Illinois

2250 E. Devon Avenue

Suite 239

Des Plaines, IL 60018-4509

Sharon Neal

Commonwealth Edison Company

125 South Clark Street

Chicago, IL 60603

James Huff, Vice-President

Huff & Huff, Inc.

915 Harger Road, Suite 330

Oak Brook, IL 60523

Cathy Hudzik

city of Chicago, Mayor's Office of Intergovemmental Affairs

121 North LaSalle Street

City

Hall- Room 406

C?icago, IL 60602

Irwin Polls

Ecological Monitoring and Assessment

3206 Maple

LeafDrive

Glenview, IL 60025

Marc Miller, Senior Policy Advisor

Jamie

S. Caston, Policy Advisor

Office

of Lt. Governor Pat Quinn

Room 414 State House

Springfield, IL 62706

Keith

Harley and Elizabeth Schenkier

Chicago Legal Clinic, Inc.

205 West Monroe, 4

Floor

Chicago, IL 60606

Fred L. Hubbard

Attorney

at Law

16 West Madison

P.O. Box

Danville, IL 61834

W.C. Blanton

Blackwell Sanders LLP

4801 Main Street

Suite 1000

Kansas City, MO 64112

Traci Barkley

Prairie Rivers Networks

1902 Fox Drive

Suite 6

Champaign, IL 61820

Georgie Vlahos

Naval Training Center

2601A Paul Jones Street

Great Lakes, IL 60088-2845

Dennis L. Duffield

Director

of Public Works

Utilities

City

of Joliet, Department of Public Works

Utilities

921 E. Washington Street

Joliet, IL 60431

Ann Alexander, Senior Attorney

Natural Resources Defense Council

101 North Wacker Drive, Suite 609

Chicago, IL 60606

Beth Steinborn

2021 Timberbrook

Springfield, IL 62702

Electronic Filing - Received, Clerk's Office, August 4, 2008

Frederick D. Keady, P.E., President

Vermillion Coal Company

1979 Johns Drive

Glenview, IL 60025

Susan M. Franzetti

Nijman Franzetti LLP

10 S. LaSalle Street, Suite 3600

Chicago, IL 60603

Vicky McKinley

Evanston Environmental Board

223 Grey Avenue

Evanston, IL 60202

Albert Ettinger, Senior

Staff Attorney, and Jessica Dexter

Environmental

Law and Policy Center

35 E. Wacker Drive, Suite 1300

Chicago, IL 60601

TomMuth

Fox Metro Water Reclamation District

682 State Route 31

Oswego, IL 60543

Jack Darin

Sierra Club, Illinois Chapter

70 E. Lake Street, Suite 1500

Chicago,IL 60601-7447

Kay Anderson

American Bottoms RWTF

One American Bottoms Road

Sauget,

IL 6220 1

Kristy A.N. Bulleit and Brent Fewell

Hunton

Williams LLC

1900 K. Street,

Washington, DC 20006

Jeffrey C. Fort and Ariel Tescher

Sonnenschein

Nath

Rosenthal LLP

7800 Sears Tower

233 S. Wacker drive

Chicago, IL 60606-6404

Dr. Thomas

1. Murphy

DePaul University

2325 N. Clifton Street

Chicago, IL 60614

Marie Tipsord, Hearing Officer

John Therriault, Assistant Clerk

Illinois Pollution Control

Board

100 West Randoph, Suite 11-500

Chicago, IL 60601-7447

Stacy Myers-Glen

Openlands

25 East Washington, Suite 1650

Chicago, IL 60602

Susan Hedman and Andrew Armstrong, Environmental Counsel

Environnmental Bureau

Office

ofthe Illinois Attorney General

69 West Washington, Suite 1800

Chicago, IL 60602

Kenneth W. Liss

Andrews Environmental Engineering

3300 Ginger Creek Drive

Springfield, IL 62711

Bob Carter

Bloomington Normal Water Reclamation District

P.O. Box 3307

Bloomington, IL 61702-3307

Ronald M. Hill and Margaret T. Conway

Metropolitan Water Reclamation District

of Greater Chicago

100 East Erie Street, Room 301

Chicago, IL 60611

Frederic P. Andes, Carolyn S. Hesse and David T. Ballard

Barnes

Thornburg

LLP

One North Wacker Drive, Suite 4400

Chicago, IL 60606

Electronic Filing - Received, Clerk's Office, August 4, 2008

BEFORE THE ILLINOIS POLLUTION CONTROL BOARD

IN THE MATTER OF:

WATER QUALITY STANDARDS AND

EFFLUENT LIMITATIONS FOR THE

CHICAGO AREA WATERWAY SYSTEM

AND THE

LOWER DES PLAINES RIVER:

PROPOSED AMENDMENTS TO 35 ILL.

ADM. CODE PARTS 301, 302, 303, AND 304

)

R08-9

(Rulemaking - Water)

TESTIMONY OF MARC GORELICK, MD

I. Introduction

My name is Marc H. Gorelick, M.D. I am a Professor of Pediatrics and

Population Health and

Chief ofthe Section on Emergency Medicine at the Medical

College

of Wisconsin, and Jon E. Vice Chair in Emergency Medicine at Children's

Hospital

of Wisconsin. I have extensive expertise in clinical epidemiology, and have

published more than 50 peer-reviewed original research papers

in that field.

I am testifying today on behalf ofNatural Resources Defense Council,

Environmental Law and Policy Center, Sierra Club - Illinois Chapter, Friends

of the

Chicago River, and Openlands

support of the regulation proposed by the Illinois

Environmental Protection Agency ("IEPA") that would require the Metropolitan Water

Reclamation District ("MWRD") to disinfect the effluent from its three wastewater

treatment plants ("WWTPs") that discharge into the Chicago Area Waterway System

("CAWS"). Disinfection is nearly universal in major cities in the United States and

prevalent

in most smaller communities, for the simple reason that it is widely recognized

as necessary to protect public health. While I support the "CHEERS" epidemiological

study being conducted by researchers at the University of Illinois - Chicago School of

Public Health, supported by the MWRD, and have no reason to believe that it will be

anything other than top-notch science, a single study

of this nature is simply not a sound

basis for bucking that vast consensus and allowing a heavy pathogen load in recreational

waters. Simply put, we do not need further study to know that germs in the water can

make people sick.

I urge the Board to be very cautious in its approach to the epidemiological study,

because placing excessive and undeserved weight

on it could set a dangerous precedent

for other communities around the nation. It would potentially encourage communities to

discontinue a basic health precaution that they have, appropriately, been taking for

decades.

Electronic Filing - Received, Clerk's Office, August 4, 2008

II. Qualifications

I am. an expert in epidemiology and public health. A copy of my curriculum vitae

is attached as Exhibit

1. A biographical sketch summarizing my work and expertise in

epidemiology is attached as Exhibit 2.

My current professional positions include the following:

•

Professor, Departments

of Pediatrics and Public Health, Medical College of

Wisconsin (2004-present).

•

Chief, Section

of Emergency Medicine, Department of Pediatrics, Children's

Hospital

of Wisconsin (2000-present).

•

John E. Vice Chair in Pediatric Emergency Medicine, Children's Hospital

Wisconsin.

•

Associate Director, Children'sResearch Institute, 2007-present.

I have had numerous faculty appointments in the field

of epidemiology, including the

following:

•

Assistant Professor, Departments of Pediatrics and Epidemiology, University

of Pennsylvania School of Medicine (1994-1998).

•

Senior Scholar, Center for Clinical Epidemiology and Biostatistics,

University of Pennsylvania School of Medicine (1994-98).

•

Adjunct Assistant Professor, Department

of Epidemiology, University of

Pennsylvania School of Medicine (1998-2000).

•

Associate Professor, Departments

of Pediatrics and Epidemiology, Medical

College

of Wisconsin (2000-2004).

I have conducted extensive published research in the area

of epidemiology. I

have co-authored more than 50 peer-reviewed original research papers publications in

different areas

of clinical epidemiology, including case-control and cohort studies,

controlled clinical trials, and meta-analyses. Some representative publications include:

Gorelick

MH, Shaw KN, Murphy KO. Validity and reliability of clinical signs in the

diagnosis

of dehydration in children.

Pediatrics

1997;99(5):e6.

Gorelick

MH, Shaw KN. Clinical decision rule to identify young febrile children at

risk for UTI.

Archives ofPediatrics and Adolescent Medicine 2000;154:386-390.

Gorelick

MH, Brousseau DC, Stevens MW. Validity and responsiveness of a brief

asthma-specific quality

of life instrument in children with acute asthma.

Ann Asthma

Allerg Immunol2004; 92:47-51.

Gorelick

MH, Meurer J, Walsh-Kelly C, Brousseau DC, Cohn J, Kuhn E, Grabowski

L, Kelly

Controlled trial of two emergency department-based follow-up

interventions to improve asthma outcomes in children.

Pediatrics

2006;117:S127-

S134.

Electronic Filing - Received, Clerk's Office, August 4, 2008

Gorelick MH. Bias arising from missing data in predictive models.

Clin Epidemiol

2006;59:1115-23

Gorelick MH, Yen K. The kappa statistic was representative of empirically-

observed inter-rater agreement for physical findings.

Clin EpidemioI2006;59:859-

861.

Gorelick MH, Alessandrini EA, Cronan K, Shults J. Revised Pediatric Emergency

Assessment Tool [RePEAT]: a severity index for pediatric emergency care.

Acad

Emerg Med2007;14;316-323.

Redman R, Nenn C, Eastwood D, Gorelick MH. ED visits for diarrheal illness

increased after release ofundertreated sewage.

Pediatrics

2007;120:e1472-1475.

Gorelick MH, Wagner D, McLellan S. Validation of a questionnaire to evaluate

water exposures in children. E-PAS 2007:618407.21 [abstract; manuscript submitted

for publication].

The last two items are particular relevant to the subject matter at issue here, as they

concern evaluating illness in children exposed to waterborne pathogens. Also relevant is

my current research concerning epidemiology

of diarrheal illness in children (funding

from Children'sResearch Institute), a nested case-control study

of approximately 1600

children to evaluate association between water exposures and diarrheal illness.

I have extensive teaching experience in the area

of epidemiology. Course I have

taught in that area include the following:

•

University

of Pennsylvania: Course developer and director, Advanced Topics

in Clinical Epidemiology (elective course for Master

of Science in Clinical

Epidemiology Program); taught in Critical Appraisal workshop for MSCE

students.

•

Jefferson Medical College: developed and taught course in Evidence-Based

Medicine for senior pediatric residents.

•

Medical College

of Wisconsin: Annual Introduction to Research Design

seminar for pediatric fellows; taught in Protocol Development course for

MCW fellows and junior faculty.

II. Risks Associated with Sewage Wastewater Pathogens

Waterborne pathogens associated with sewage are hazardous to

human health

has been well understood for over a century that pathogens (disease-causing

organisms) contained in human sewage can cause illness in humans, sometimes severe

and fatal. Some

ofthe worst plagues in history have been caused by untreated sewage

being discharged into water sources used by humans - cholera and typhoid fever being

two chiefexamples. Although modem primary and secondary sewage treatment remove

Electronic Filing - Received, Clerk's Office, August 4, 2008

many pollutants and solids from sewage, the pathogens will remain in the final

discharged effluent unless the sewage is disinfected.

Most historical disease outbreaks associated with waterborne pathogens have

been caused by contaminated drinking water. However, similar risks attend recreational

use

of contaminated water, because many recreational activities can result in swallowing

water -

accidentally falling out of a boat. Even swallowing small amounts of

contaminated water in this manner can lead to illness.

is also conceivable, if not likely,

that one could become infected

if contaminated water entered the body through a cut in

the skin.

There are dozens

of types of pathogens that are generally associated with sewage-

contaminated wastewater. These include bacteria, viruses, and protozoa. The EPA

recently estimated that there are 16.4 million cases of gastrointestinal illness each year in

the United States from drinking water alone.

average of23 waterborne disease

outbreaks sufficiently severe to warrant investigation are reported annually in the US.

The following is a brief summary of some of the more prevalent and/or hazardous types

of human pathogens generally associated with sewage-contaminated water:

1. Cryptosporidium. This is a protozoan that was responsible for the largest

water-borne disease outbreak in US history in 1993, when over 400,000

people in Milwaukee became ill, and dozens died.

2. Norovirus. Causes severe diarrhea and abdominal cramping. This is best

known as the cause of recent disease outbreaks on cruise ships, but is now one

of the most common causes of waterborne outbreaks from regular drinking

water.

addition, it has been identified in samples of both surface (river) and

well water during routine monitoring.

3. Giardia. Another protozoan, this is a common cause

of diarrhea in children in

day care centers, and is frequently found in sewage effluent. This one is

particularly problematic because it is relatively resistant to disinfection, and

can cause illness with exposure to a very small number

of organisms. In

addition, many people exposed to Giardia develop asymptomatic infections,

allowing them to spread the infection to household contacts. Up to 20% of

people may be Giardia carriers.

Sampling data indicate high levels of pathogens

In preparation for my testimony, I have reviewed a summary of indicator

pathogen sampling data collected

by MWRD and posted to its web site,

http://www.mwrdgc.dstil.us/. I have also reviewed charts summarizing this and related

indicator bacteria data prepared by the United States Environmental Protection Agency

("USEPA") Region 5, attached as Exhibit

I note that the sampling data provides

1 I have also reviewed the

Dry

and Wet Weather Risk Assessment of Human Health Impacts of

Disinfection or No Disinfection ofthe Chicago Area Waterway System (CWS)" prepared by Geosyntec

Consultants (the "Risk Assessment") prepared for MWRD by Geosyntec Consultants. A full analysis

Electronic Filing - Received, Clerk's Office, August 4, 2008

results for two indicator bacteria, fecal coliform and RColi. (Because E. coli is one type

of fecal coliform bacteria, I will use the generic term fecal coliform for simplicity.) Fecal

coliforms are generally not pathogenic (i.e., disease-causing) in themselves, but are used

by regulatory agencies and others to determine the presence

of fecal contamination and

therefore the likely presence

of pathogenic organisms.

As an overall matter, the high levels

of indicator bacteria present in many parts of

the CAWS, as set forth in the summaries, demonstrate the probable presence of

substantial and hazardous levels of waterborne pathogens, including bacteria, viruses, and

parasites. Although it can be difficult to draw a bright line between safe and unsafe

levels

of pathogens based on indicator bacteria levels, the high levels at some CAWS

locations - which are far higher than the level

of indicator bacteria generally allowed at

swimming beaches (200 colonies

fcliOO ml) - are quite clearly evidence of the presence

of a substantial level of pathogenic organisms. Several of the water samples in the

CAWS have levels

of E. coli that, if found in a urine sample of an infant, would be

considered a sign

of a urinary tract infection requiring antibiotic treatment.

Indicator organisms are not a perfect measure

of the presence of pathogens in

sewage-contaminated wastewater. Rather, they are like footprints indicating the presence

of fecal contamination. There has been ongoing discussion and scientific inquiry as to

whether fecal coliform count is an adequate indictor, and there are efforts afoot in

USEPA to identify a more accurate indicator organism. However, fecal coliform levels

provide at minimum a rough ballpark indication

of the likely level of pathogens in the

sampled water.

If anything, these indicators more often significantly under-predict than

over-predict the level

of pathogens present. First, the vast majority of disease in humans

is caused by viruses, not bacteria. This is especially true for children, but true for adults

as well. Just as there may be an intruder even in the absence

of footprints, even if fecal

coliforms are absent, viruses can still be present in substantial numbers.

Organisms differ in their susceptibility to treatment and disinfection and to

environmental conditions.

is unlikely, on the other hand, that one would find high

levels

of indicator bacteria correlated with low levels of viruses because the latter tend to

persist in the environment for longer periods

of time. Several studies have shown

recovery

of pathogenic viruses from water samples that were free of indicator organisms.

In addition, there are a number

of pathogens, most notably protozoa, that can cause

illness in very low levels. Thus, even

if indicator bacteria levels were low, there might

be sufficient levels

of these types of pathogens present to be dangerous. Finally, as a

general matter, even low levels

any

human pathogen can be dangerous for sensitive

populations - children, the elderly, and persons with compromised immune systems

(such as people in chemotherapy). Thus, an overall low level

of indicator organisms

the Risk Assessment is beyond the scope of my testimony. However, I noted in my review that there were

significant methodological flaws and inappropriate assumptions that likely skewed the results

ofthat study

toward a lower fmding

of risk. Among other things, the Risk Assessment limits itselfto evaluation of a

small subset

of known waterborne pathogens; extrapolates from nearly non-existent data on risk of illness

in secondary contact recreational use; and evaluates only gastrointestinal illness, which

is only one of many

types

of illnesses that can be contracted from waterborne pathogens.

Electronic Filing - Received, Clerk's Office, August 4, 2008

cannot be interpreted to mean that the level of waterborne pathogens is safe for such

people.

III. The Limits

of Epidemiological Research

Epidemiological studies are an important and time-tested tool for assessing health

risk. The concept

of an epidemiological study is to track a study population believed to

be at potential risk

of harm from an environmental or behavioral factor - for instance,

exposure to workplace chemicals, living near a polluting facility, or eating junk food -

and comparing that population to a control population (i.e., an otherwise comparable

group

of people who are not exposed to the risk being studied). The two populations are

tracked for a period

of time to determine whether there is a statistically significant

difference in adverse health impacts associated with the risk being studied.

I have researched and co-authored more than 50 peer-reviewed epidemiological

studies, and have participated in the peer review

of many more. I have published articles

concerning ways to more accurately understand and interpret epidemiological statistics,

and taught numerous graduate and medical school courses on epidemiology (please see

my biographical information above). Recently, I completed a peer-reviewed study

diarrheal illness rates in children following a release ofundertreated sewage (which

found a positive correlation, i.e. more children in the exposed group

of children were

sickened by a statistically significant margin), and I am currently involved in a similar

study

of 1,600 children to review the correlation between water exposures and diarrheal

illness, funded by the Children'sResearch Institute. I am a very strong believer in the

value

of epidemiological studies as a means of identifying risk.

I am, however, also aware

of the limits of epidemiological research.

Epidemiology cannot provide proof

of a cause and effect relationship; it can only provide

evidence - sometimes stronger, sometimes weaker -

of an association. Since

epidemiological study populations are not isolated from the general population or

otherwise tightly controlled in their behavior and exposures, it can be extremely difficult

to isolate the factor that is causing any observed effect, calling into question the strength

of the evidence.

attempt to separate out an at-risk population for study (say, heavy

sunbathers being studied for cancer) many unwittingly capture a population that also is

more likely to engage in another type

of risky behavior that is not the subject of the study

(say, excessive consumption

ofpina coladas); or, conversely, may be less likely to

engage in behavior causing a similar risk (say, smoking cigarettes in indoor venues).

The difficulty in drawing conclusions from epidemiological results is particularly

great when those results are negative. As described in more detail below, there are

numerous variables and factors at play in epidemiological study that can easily render a

negative result notwithstanding the real presence

of a significant risk, particularly when

waterborne pathogens are at issue. These include insufficient size

of the study sample

and relevant subcategories

of the sample

different types of recreators on the

CAWS); negative results associated with asymptomatic infections (i.e., people who

become infected and pass the disease on to others but do not get sick themselves); and

Electronic Filing - Received, Clerk's Office, August 4, 2008

widely-varying conditions in the environment whereby high illness rates in one set of

conditions are cancelled out by lower rates

a different set of conditions. Any or all of

these factors can render a negative epidemiological result essentially meaningless.

Given the inherent uncertainty

of epidemiological research, it is essential that

results

ofany kind be reproduced in at least one more study. This is part and parcel of

the more fundamental principle applicable to all scientific research that results must be

replicated in order to

be valid - indeed, a substantial part of scientific inquiry consists of

attempts to reproduce the published results of others in order to determine their validity.

While a single positive epidemiological study may provide sufficient evidence to justify

preliminary action, it is absolutely critical to reproduce negative research results before

drawing actionable conclusions, given the potential pitfalls

of such findings described

below.

For these reasons, it would be highly inappropriate to set policy

of any kind based

upon one negative outcome

of an epidemiological study - particularly one concerning

waterborne pathogens, whose effects are very difficult to isolate in a study setting. There

is no way predict, as

of today, what the results ofthe ongoing CHEERS study of risks to

CAWS recreational users will be. However, we have today - even without those results

- sufficient information to know that sewage-related pathogens are harmful to human

health, and that those pathogens are present at elevated levels in the

CAWS. Simply put,

we already

know that germs are bad for people, and MWRD WWTPs are putting those

germs in the water. That, standing alone, is sufficient information on which to base a

requirement that

WWTPs disinfect their effluent - as, indeed, WWTPs do in virtually

every other major city in the country and most smaller communities in Illinois as well.

The following subsections describe numerous reasons why epidemiological

results - and particularly negative results - can be

of limited predictive value of the risk

being studied. Particularly in the context at issue here, there are numerous factors at play

that may mask the presence

of a very real risk in a negative result.

Sample

size

Critical to the predictive value an epidemiological study is the size ofthe study

sample. This is because epidemiology is, by its essence, a statistical endeavor. Much

like a political poll, one surveys a large group

of people to determine whether any

patterns emerge that may be predictive for the larger population. And like a political

poll, since one is reviewing only a sample and not the whole population, it is necessary to

interpret the results with a "margin

of error." That is, if one finds that out of 1,000

people surveyed that 50 of them will get sick, one cannot then make a straightforward

extrapolation that in a population of 1,000,000, 50,000 people will get sick. The proper

way to understand the result is that 50,000 people plus

or minus X percent (the margin

for error) will get sick.

The margin for error - X - is inversely correlated with the size

of the sample.

That is, the more people involved in the study, the more precise your results will be, and

Electronic Filing - Received, Clerk's Office, August 4, 2008

the smaller X will be. But if you do not have enough people in your study, your results

will have a much larger margin

of error. Thus, if you survey only 100 people and find

that 5

of them got sick, this five percent positive finding is less reliable, and needs to be

understood as a broad range

of possible illness rates, ranging far above and far below 5

percent. X, the percentage margin for error, is necessarily very large.

If you survey only

10 people, your results are essentially meaningless.

For this same reason, very little can reliably be concluded from negative results

based on a small sample. There may be a small but significant percentage

ofthe

population that is becoming ill from the risk being screened for, but too small a sample

may well miss all such people merely be chance. In other words,

if approximately 50 out

of every 1,000 people are getting sick, but you survey only 100 ofthose 1,000 people,

there is a substantial possibility that you will not find among those random 100 even one

of the 50 in 1,000 who are actually getting sick.

Compounding the problem

of sample size is the problem of risk subcategories,

which effectively reduce the sample size even further.

If one surveys 1,000 people, but

those people are subject to varying levels and variants

of the risk being screened for, then

you really have a much smaller sample

of each risk category. Taking the example of the

sunbathers again,

if you screen 1,000 sunbathers for ill effects, but only 30 of those are

actually going out for long periods without sunscreen, you really do not have a large

enough sample to determine the risk specifically

of going out for long periods without

sunscreen. You may end up with a negative result for your overall sample

of 1,000, but it

will be because the very real risk

of sunscreen-free sunbathing will be diluted by the

much larger sample

ofpeople exposed to only very minimal risk.

All

of these issues with sample size appear to be present in the CHEERS

epidemiological study being conducted with respect to recreational users

of the CAWS.

First off, the University

of Illinois at Chicago ("VIC") School of Public Health, which is

conducting the study for MWRD, has reported difficulty enrolling study participants, so

as to require an additional outlay

of funds to

try

to attract more. In the 2007 season, 811

eligible participants were enrolled in the study overall, less than 10% of the desired

sample size

of over 9,000. Results from a sample group of this size would need to be

interpreted with a very significant margin

of error.

More importantly, the study participants represent a broad range

of recreational

uses, which vary greatly in terms

of the associated risk. The study is enrolling those

engaged in all manner

of secondary contact use - including kayaking, canoeing, rowing,

fishing, and other activities that do not involve full-body contact. These activities differ

greatly in the likelihood that a participant will end up swallowing a mouthful

contaminated water, which is the primary exposure pathway for waterborne pathogens.

is quite unlikely (although certainly possible) that a power boater will fall into the water,

but far more likely that a kayaker will. Thus, to determine the risk

of kayaking, one

needs to separate out the much smaller sub-group

of kayakers and look specifically at

their illness rate. Even that subgroup may be too broadly defmed, as the real relevant risk

category is kayakers who fall in the water.

is unknown at this time how many of each

Electronic Filing - Received, Clerk's Office, August 4, 2008

subcategory of recreational users have enrolled in the study, but it is safe to say that the

number

of kayakers (and canoers, also at higher risk) is substantially less than the overall

number

of study participants.

Similarly, since sewage-related waterborne pathogens are more dangerous for

sensitive populations such as children, those sensitive populations need to be considered

as a risk subgroup. Thus, for example, even

if there are a substantial number of overall

participants,

if there are only a few children involved in the study, it will not provide an

adequate basis to assess the specific risk

of these pathogens for children.

The number

of study participants who have actually fallen out of their boats is

presumably far smaller even than that, so small as to be a meaningless sample. The same

may

be said for the number of children who actively participate in kayaking (of course,

the number

of children who fall in will be an even smaller, if not nonexistent, subset).

While one might be inclined to interpret that fact as an indication that falling out

kayaks and canoes is not very likely, and/or that children do not really kayak much, such

an interpretation would in inappropriate. The fact that during the limited course

of one

study, looking at only a relatively small group

of users, most of them were adults who

were able to stay in their boats does not mean the risk is not there. Over the course

years, a small but substantial number of people - some of them children - are likely to

have such accidents. And it is entirely possible that the people having them may more

likely be beginning or occasional kayakers, who may be more likely to fall in but less

likely to enroll in an epidemiological study

of river users.

is impossible to know one

way or the other at the present time who will

fallout of their kayaks in future years and

how often. But the very nature

of that uncertainty suggests that risks due to secondary

contact recreation will be extremely difficult to characterize in a single epidemiologic

study.

B. Asymptomatic infections

The CHEERS epidemiological study is based upon self-reported symptoms of

illness. That is, recreational users are asked to fill out a questionnaire describing any

symptoms

of illness. This works well with types of pathogens that cause symptoms in

most or all

of people who are infected by them. It does not work as well, however, for

pathogens that infect a large number

of people asymptomatically, and make only a small

fraction

of infected people actually sick.

Many

of the more harmful and prevalent types of waterborne pathogens

associated with sewage-contaminated wastewater are in the latter category, i.e., they can

infect large numbers

of people but actually result in illness in only a small number of

them. Infections with these pathogens can thus spread asymptomatically to many

different people before one

of those - perhaps several degrees removed from the person

who originally contracted the pathogen from contaminated wastewater - actually

becomes ill.

Electronic Filing - Received, Clerk's Office, August 4, 2008

Thus, survey results may reflect very few illnesses among recreational users, or

even none at

all- a negative epidemiologic result. But that does not mean that there was

no risk

of infection to those recreational users. Many ofthem may very well have

become infected, but it is not they themselves facing the risk

of illness. It is the people

who are

in contact with them - their families and perhaps others - and the people in

contact with those people, and so on down the line.

epidemiological study such

as the

one being performed on the CAWS will, quite simply, not reflect this chain

of infection.

Varying conditions

The level of sewage-related waterborne pathogens varies widely over time and

distance. The levels

ofany given pathogen will vary with such ever-changing factors as

water temperature, sunlight, and distance from the source. Each

of these factors may

affect different pathogens in a different manner. For instance, some pathogens survive

much longer and hence can be harmful further downstream than others. Some pathogens

may be more sensitive to temperature than others.

Thus, it is entirely possible that there is a set

of conditions in which the pathogen

levels will be very dangerous -

a hot day with no sunlight near the pathogen source

- but there will be no way to know from the results

of the epidemiological study how

many,

if any, participants were actually exposed to those conditions. Once again, this

factor has the potential to create false negative results. The recreators who encountered

the more hazardous conditions may report higher levels

of illness, while those who

encountered the less hazardous conditions will report lower levels

of illness; and the

results from the two groups will effectively cancel each other out.

Multiple causes of symptoms

As an overall matter, it is very difficult to conduct epidemiological research

concerning illnesses that have multiple causes. That problem is very much in place with

respect to the CAWS study.

The types

of waterborne pathogens associated with sewage frequently cause

diarrhea and stomach upset, and occasionally fever. These types

of symptoms are, of

course, extremely common. Millions of cases of diarrhea, fever, and vomiting occur

every year in this country that having nothing to do with waterborne pathogens. All

these symptoms have dozens of potential causes. Thus, it is an extreme challenge to try

to separate out water recreation as a cause

of any ofthem - it is looking a needle in a

haystack.

As an example, assume that 1

of every 100 recreators became ill as a result of

their activity in the CAWS. With thousands of such exposures each year, even this low

rate would be a substantial public health hazard with many cases

of preventable illness.

During the course

of the study, with 3000 people in the CAWS group, and 3000 in the

control group, there would be an additional 30 cases

of illness in the CAWS group.

However, there would be a background rate

of illness due to all the other causes in both

Electronic Filing - Received, Clerk's Office, August 4, 2008

groups. Among the general population, you would expect about 10 of every 100 people

to develop

symptoms in a given month;

other words, 300 people would be sick in

each group for reasons having nothing to do with their exposure to CAWS. So you

would need to find those additional 30 cases out

of 330. But for at-risk populations, such

as children, the problem is worse, since they have a higher rate

of background illness.

For this important group, the needle is a little bigger, but the haystack is much bigger.

E. Differing behavior in contaminated waters

is important to note that when the risk under study can be changed by the

individual, and

it is known or suspected to be hazardous, the magnitude of that risk is

likely to be underestimated in an epidemiological study because people may conduct

themselves more cautiously in hazardous conditions and self-limit their risk. Here, the

public is generally aware that the CAWS waters contain pathogens that pose a risk

infection. Those using the water recreationally are likely being more careful to avoid

contact with the water. This may be especially true when water conditions are thought to

be ore hazardous (e.g., immediately after a heavy rain).

Thus, at best, the CAWS epidemiology study is measuring the risk

of illness to

people who use the water in a conservative manner -

who refrain from rolling their

kayaks, take extra precautions not to

fallout of their boats, and decline to engage in water

fights with their companions. It does not measure the risk to the public

of the sort of

free-wheeling splashing around that takes place in water bodies known to be

fundamentally clean, such as Lake Michigan. When secondary contact recreators know

that a body

of water is suitable for swimming, they will be inherently much more likely

to want to get wet in it.

IV. Conclusions

I am deeply committed to scientific inquiry, particularly epidemiology. I

therefore applaud the joint efforts

of MWRD and VIC School of Public Health to conduct

an epidemiological study

of the CAWS to help assess the risks to users. I believe this

study, which is ambitious, well-conceived, and generally well-designed, is likely to yield

useful information about potential health risks

of water recreation. I look forward to the

results

of the study, as I am personally very interested in the impact ofundisinfected

sewage on public health, an interest reflected in my own recent research.

However, I believe it would be a serious mistake to delay disinfection

of the

CAWS any longer pending the outcome

of this study. Its results, no matter what they

are, will be inconclusive the first time around - particularly

ifthose results are negative,

given the severe limitations

the significance of negative epidemiological results in a

study

of this nature.

The fact

of the matter is, epidemiological research is simply not an adequate tool

to inform a decision concerning CAWS disinfection. The risks to users

of the CAWS are

not uniform for all users. Rather, this is a situation where there are potentially severe

Electronic Filing - Received, Clerk's Office, August 4, 2008

risks to a small but significant subcategory of users (i.e., those who accidentally swallow

water, and sensitive populations such as children). For the reasons I have described, it is

extremely difficult,

if not impossible, to isolate a large enough sample of the most at-risk

subcategories and obtain meaningful risk statistics for them. Rather, the problem

waterborne pathogens in the CAWS needs to be understood as a situation that we know is

inherently dangerous, and that is bound over time to result in severe injury to someone

even

if that injury cannot be captured in the narrow window of a scientific study.

Imagine approaching an intersection with four traffic signals in your direction:

three

of them are red and one is not working. To continue driving through the

intersection would be incredibly reckless. Even

if the fourth signal turned green, it would

be foolish to ignore the overwhelming evidence

of the other three signals. That is the

situation here: we have several strong warning signs about the risks

of recreation in the

CAWS, and it makes no sense to continue full speed ahead with undisinfected water in

hopes that an isolated green light might eventually appear.

Epidemiology has its limits, and the CAWS study is bumping up against them. I

believe that sound science and public health policy call for promptly disinfecting WWTP

effluent as IEPA

has

proposed, and as virtually every other major city in the country

already does.

Marc

H. Gorelick, M.D.

Electronic Filing - Received, Clerk's Office, August 4, 2008

EXHIBIT 1

Electronic Filing - Received, Clerk's Office, August 4, 2008

updated: May 5, 2008

CURRICULUM VITAE

Marc Harris Gorelick, MD, MSCE

Professor

of Pediatrics (Emergency Medicine)

Chief, Section

ofEmergency Medicine

Office Address:

E-Mail:

Home Address:

Place

of Birth:

Citizenship:

Section of Emergency Medicine

Children'sCorporate Center Suite 550

PO Box 1997

999 N. 92

St.

Milwaukee, WI 53201-1997

(414) 266-2648 (phone)

(414) 266-2635 (FAX)

mgorelic@mcw.edu

537 N.

tl1

St.

Wauwatosa, WI 53213

(414) 771-8367

New York,

USA

Education:

1983 A.B.

1987 M.D.

1996 M.S.C.E.

Princeton University (history)

Duke University

University

of Pennsylvania (clinical epidemiology)

Postgraduate Training:

1987-90

1990-91

1991-94

Pediatric Residency (PL-l - PL-3)

Children'sNational Medical Center

Washington, DC

Chief Pediatric Resident

Children'sNational Medical Center

Washington,

Fellow, Pediatric Emergency Medicine

Children'sHospital

of Philadelphia

Philadelphia, P

Faculty Appointments:

1990-91

Clinical Instructor in Pediatrics

Electronic Filing - Received, Clerk's Office, August 4, 2008

George Washington University School of Medicine

Washington, DC

1991-94

Instructor in Pediatrics

University

of Pennsylvania School of Medicine

1994-98

Assistant Professor

of Pediatrics

University

of Pennsylvania School of Medicine

1995-98

Assistant Professor

of Epidemiology

University

ofPennsylvania School of Medicine

1996-98

Assistant Professor

of Emergency Medicine

University

of Pennsylvania School of Medicine

1994-98

Senior Scholar

Center for Clinical Epidemiology and Biostatistics

University

of Pennsylvania School of Medicine

1998- 2000

Assistant Professor

of Pediatrics

Jefferson Medical College

1998- 2000

Adjunct Assistant Professor

of Epidemiology

University

of Pennsylvania School of Medicine

1998- 2000

Adjunct Scholar

Center for Clinical Epidemiology and Biostatistics

University

of Pennsylvania School of Medicine

2000- 2004

Associate Professor

of Pediatrics (Emergency Medicine)

Medical College

of Wisconsin

2001- 2004

Associate Professor

of Epidemiology

Medical College

of Wisconsin

2004-present Professor

ofPediatrics (Emergency Medicine)

Medical College

of Wisconsin

2004-2006

Professor

of Epidemiology

Medical College

of Wisconsin

2006- present Professor

of Population Health

Medical College

of Wisconsin

Administrative Appointments:

1996-98

Co-Director of Research, Division of Emergency Medicine

Children'sHospital

of Philadelphia

1998- 2000

Director

of Research, Division of Emergency Medicine

duPont Hospital for Children

2000-present Chief, Section

of Pediatric Emergency Medicine

Medical College

of Wisconsin

2000-2006

Medical Director, Emergency Department

Jon Vice Endowed Chair in Pediatric Emergency Medicine

Children'sHospital

of Wisconsin

2006-present Associate Director, Children'sResearch Institute

2007-present

Electronic Filing - Received, Clerk's Office, August 4, 2008

Hospital Staff Privileges

1994-1998

Children'sHospital of Philadelphia

Philadelphia, PA

1998-2000

AI duPont Hospital for Children

Wilmington, DE

2000-present Children's Hospital

of Wisconsin

Milwaukee, WI

Specialty Boards and Certification:

Board Certified

American Board

of Pediatrics

ABP-Subboard

of Pediatric Emergence Medicine

Issue Date

11/1990

8/1994

Expiration

12/2011

12/2008

Certificates

PALS

ATLS

Licensure

Wisconsin

Delaware

Pennsylvania

District

of Columbia

Awards and Honors:

Issued by

AHA

ACS

Number

42366-020

0005352

MD-044060-L

17815

Issue Date

1990

Issue Date

7/21/2000

6/1998

4/1991

1/1990

Expiration

2007

Expiration

10/31/2009

inactive

Teaching Awards (includes both group and individual awards):

1992

1994

1995

1996

1998

1999

2000

2003

Other Awards:

1983

Jean A. Cortner Divisional Teaching Award (to the Division

of Emergency

Medicine) for Excellence in and Commitment to Resident Education

Jean A. Cortner Divisional Teaching Award (to the Division

of Emergency

Medicine) for Excellence in and Commitment to Resident Education

Jean

Cortner Divisional Teaching Award (to the Division of Emergency

Medicine) for Excellence in and Commitment to Resident Education

Jean A. Cortner Divisional Teaching Award (to the Division

of Emergency

Medicine) for Excellence in and Commitment to Resident Education

Jean A. Cortner Divisional Teaching Award (to the Division

of Emergency

Medicine) for Excellence in and Commitment to Resident Education

AI duPont Hospital for Children HousestaffDivisional Teaching Award

(to the Division

of Emergency Medicine)

AI duPont Hospital for Children Faculty Teaching Award

Faculty Teaching Award in Pediatrics, Department

of Emergency

Medicine, Medical College

of Wisconsin

Phi Beta Kappa

Electronic Filing - Received, Clerk's Office, August 4, 2008

1985-86

1987

2001

2003

2006,2007

2006

Eugene Stead Research Scholarship

Alpha Omega Alpha

Best Faculty Research Presentation, Ninth Annual Emergency Medicine

Research Forum, Medical College of Wisconsin

Clinician'sClinician Award, Department of Pediatrics, Medical College of

Wisconsin

Best Doctors in America®

Outstanding Reviwer,

Academic Emergency Medicine

Membership in Professional Societies:

Ambulatory Pediatric Association

Pediatric Emergency Medicine Special Interest Group

American Academy of Pediatrics

Section on Pediatric Emergency Medicine

PEM Collaborative Research Committee

American College of Emergency Physicians

Society for Academic Emergency Medicine

Society for Pediatric Research

Editorial Positions:

1993- 1998

Reviewer, Pediatric Emergency Care

1996- present Reviewer, Pediatrics

1997- present Evidence Based Emergency Medicine Task Force, Annals of Emergency

Medicine

1998-2003

Reviewer, Annals

of Emergency Medicine

1998- present Editorial Board, Pediatric Emergency Care

1999- present Reviewer, Pharmacoepidemiology and Drug Safety

200l-present Associate Editor, PEM Database On-Line (http://www.pem-database.org)

2002-present Reviewer, Archives ofPediatrlc and Adolescent Medicine

2003-present Reviewer, Journal

of Pediatrics

2003-present Consulting Editor, Annals of Emergency Medicine

2004-present Reviewer, JAMA

~004-present

Reviewer, Academic Emergency Medicine

2005-present Editorial Board, Ambulatory Pediatrics

Regional/Local Appointed Leadership and Committee Positions

Wisconsin Chapter AAP

2002-2005

co-Chair, Committee on Pediatric Emergency Medicine

National Elected/Appointed Leadership and Committee Positions

American Academy of Pediatrics

Electronic Filing - Received, Clerk's Office, August 4, 2008

2000-present

2000-2005

2004-present

2006

Member, Review Committee, Ken GraffYoung Investigator

Award

Chair, Pediatric Emergency Medicine Collaborative Research

Committee, Section of Emergency Medicine

Member, Executive Committee, Section of Emergency Medicine

Editor, Secton of Emergency Medicine 25

Anniversary

Commemorative Booklet

American Board of Pediatrics

2003-present Member, Sub-Board of Pediatric Emergency Medicine

2005-present Chair, Credentials Committee, Sub-Board of Pediatric Emergency

Medicine

Pediatric Emergency Care Applied Research Network

2001-present Member, Steering Committee

Chair, Grants and Publications Committee

Grant Review Positions

1996-97

Consultant/Ad Hoc Reviewer, Colciencias (National Program for

Health Science and Technology, Colombia)

2001

Consultant/Ad Hoc Reviewer, Alberta Children'sHospital

Foundation

2003

Consultant/Ad Hoc Reviewer, Maternal Child Health Bureau,

Emergency Medical Services for Children Program

2008

Consultant/Ad Hoc Reviewer, Hospital for Sick Children

F~)Undation

Data Safety and Monitoring Boards

2003-2006

DSMB member. The effectiveness of oral dexamethasone for

acute bronchiolitis: A multicenter randomized controlled trial.

(Maternal and Child Health Bureau/HRSA R40MC04298-01-00).

Research Grants, Contracts, Awards, Projects (direct costs only):

Ttile:

Source:

Role:

Dates:

Amount:

Title:

Source:

Role:

Dates:

Performance

of clinical signs in the diagnosis of dehydration in children

Emergency Medicine Foundation

Principal Investigator

7/1/1994-6/30/1995

$9680

Cost-effective ED screening for UTI in febrile children

Bureau ofMaternal and Child Health, Health Resources and Services

Administration

Co-principal investigator

10/1/1994-9/30/1997

Electronic Filing - Received, Clerk's Office, August 4, 2008

Amount:

Title:

Source:

Role:

Dates:

Amount:

Title:

Source:

Role:

Dates:

Amount:

Title:

Source:

Role:

Dates:

Amount:

Title:

Source:

Role:

Dates:

Amount:

Title:

Source:

Role:

Dates:

Amount:

Title:

Source:

Role:

Dates:

Amount:

Title:

Source:

Grant

Role:

Dates:

Amount:

$330,827 (MCJ 420648)

Predicting need for hospitalization in acute childhood asthma.

Bureau

ofMaternal and Child Health, Health Resources and Services

Administration

Principal Investigator

10/1/1997-3/31/2000

$364,599 (R40 MC00097)

PEAT: Pediatric Emergency Assessment Tool.

Nemours Foundation

Principal Investigator

1/1/1999-6/30/2000

$17,489

Asthma Education in the Emergency Department

Nemours Foundation

Principal Investigator

7/1/1999-6/30/2001

$4349

Predictors

of Patient Complaints in a Pediatric Emergency Department

Nemours Foundation

Co-Principal Investigator

7/1/1999-6/30/2000

$5474

PEAT: Pediatric Emergency Assessment Tool

Agencyfor

Health Care Research and Quality

Principal Investigator

10/1/2000-9/30/2002

$50,000 (R03-HS 11395)

Emergency Department Allies: Managing Pediatric Asthma (ED ALLIES)

Robert Wood Johnson Foundation

Co-Investigator

10/1/2001-9/30/2004

$875,000

Emergency Medical Services for Children (EMSC) Network Development

Demonstration Project

Maternal and Child Health Bureau (subcontract from UC Davis)

U03MCOOOOI

site Principal Investigator (15% effort)

10/1/2001-9/30/2008

$971,438

Electronic Filing - Received, Clerk's Office, August 4, 2008

Title:

Source:

Role:

Dates:

Amount:

Title:

Source:

Grant#:

Role:

Dates:

Amount:

Title:

Source:

Grant#:

Role:

Dates:

Amount:

Title:

Source:

Role:

Dates:

Amount:

Title:

Source:

Grant#:

Role:

Dates:

Amount:

Title:

Source:

Grant#:

PI:

Role:

Childhood Head Trauma: A Neuroimaging Decision Rule

Maternal and Child Health Bureau (subcontract from UC Davis)

site Principal Investigator (5% effort)

12/1/03-11/30/06

$50,088

Developing a Diagnosis Grouping System for Child Emergency

Department Visits

Maternal and Child Health Bureau (subcontract from Children'sHospital

of Philadelphia)

H34 MC02457-01-00

site Principal Investigator (5% effort)

3/1/04-2/28/07

$22,476

Predicting Cervical Spine Injury (CSI) In Children: A Multi Centered,

Case Control Analsysis

Maternal and Child Health Bureau (subcontract from Washington

University)

H34 MC03472-01-00

site Principal Investigator (2% effort)

3/1/04-4/28/07

$6,250

Occurrence

of acute diarrheal illness in children following release of

undertreated and partially treated sewage into Lake Michigan

Children'sResearch Institute

Principal Investigator (20% effort)

5/1/2006-10/30/2007

$69,995

Defining Quality Performance Measures for Pediatric Emergency Care

Maternal and Child Health Bureau (subcontract from Children'sHospital

of Philadelphia)

H34MC02547

site Principal Investigator (5% effort)

9/1/07-8/31/10

$36,666

Institutional National Research Service Award! Academic Fellowship in

Primary Care Research

Health Resources and Services Administration

HRSA 2-T32-PE-1 0030-11

Linda N. Meurer, MD, MPH

Research Faculty (pm FTE)

Electronic Filing - Received, Clerk's Office, August 4, 2008

Dates:

Total funds:

7/1/2008 - 6/30/2011

$1,191,581 ($364,116 annual direct costs)

Invited LecutreslWorkshopslPresentations/Site Visits:

International:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

9/1996

Predicting Clinical Outcomes - Pitfalls and Promises

Third Annual LatinCLEN Scientific Assembly, Huatulco, Mexico

7/1997

AnaIisis de decisiones (Decision Analysis)

Curso Modular de Epidemiologia Clinica y Bioestadistica, Universidad

Javeriana,

Bogota, Colombia

7/1997

AnaIisis de datos en experimentos clinicos (Data Analysis

Randomized

Clinical Trials

Curso Modular de Epidemiologia Clinica y Bioestadistica, Universidad

Javeriana,

Bogota, Colombia

7/1997

Lectura critica de experimentos clinicos (Critical Reading

Of Clinical Trials)

Curso Modular de Epidemiologia Clinica y Bioestadistica, Universidad

Javeriana,

Bogota, Colombia

3/1998

Emergency Management

Of Seizures In Children

Emergency Care in Pediatrics, Salzburg Medical Seminars, Salzburg, Austria

3/1998

Acute Childhood Asthma: Update

On Management

Emergency Care in Pediatrics, Salzburg Medical Seminars, Salzburg,

Austria

3/1998

Bums and Smoke Inhalation

Emergency Care

in Pediatrics, Salzburg Medical Seminars, Salzburg, Austria

3/1998

Evaluation and Management

of Dehydration in Children

Electronic Filing - Received, Clerk's Office, August 4, 2008

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date

Title:

Location:

Date

Title:

Location:

Date

Title:

Location:

Date

Title:

Location:

Emergency Care in Pediatrics, Salzburg Medical Seminars, Salzburg,

Austria

6/2002

Pediatric cardiac cases: issues in diagnosis and management

Emergency Medicine Between the Continents, Reykjavik, Iceland

6/2002

Issues in maangement

of acute childhood wheezing

Emergency Medicine Between the Continents, Reykjavik, Iceland

6/2002

Minor head trauma in infants and children

Emergency Medicine Between the Continents, Reykjavik, Iceland

6/2002

Common pediatric infections

Emergency Medicine Between the Continents, Reykjavik, Iceland

3/2007

The Emergency Department in the Continuum

of Asthma Care

Grand Rounds, Hopital Ste. Justine, Montreal, Canada

3/2007

Anatomy

ofa Research Career

Annual Canadian PEM Fellows' Conference, Mont Tremblant, Quebec

4/2008

Pediatric Minor Head Injury: Who Needs a Head CT?

Annual Spring Conference on Pediatric Emergencies, Symposia

Medicus, Barbados

4/2008

Fever in the Era ofPneumoccoccal Vaccine

Annual Spring Conference on Pediatric Emergencies, Symposia

Medicus, Barbados

4/2008

Contemporary Management

of Pediatrics Respiratory Emergencies

Annual Spring Conference on Pediatric Emergencies, Symposia

Medicus, Barbados

4/2008

Challenging Cases from the Pediatric Emergency Department

Annual Spring Conference on Pediatric Emergencies, Symposia

Medicus, Barbados

Electronic Filing - Received, Clerk's Office, August 4, 2008

National:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

4/1994

Burn Injury In Children

Emergency Care

ofthe Very III Child, Orlando, FL

4/1994

Evaluation

Of The Child With Altered Mental Status

Emergency Care

ofthe Very III Child, Orlando, FL

4/1994

Emergency Evaluation And Management

Of Seizures In Children

Emergency Care

of the Very III Child, Orlando, FL

5/1995

Don'tBelieve Everything You Read -- Teaching HousestaffAnd Students

To Read With A Critical Eye

Annual Meeting

of the Ambulatory Pediatric Association, Seattle, WA

5/1995

Caught In The Crossfire: Preventing Further Injury To Pediatric Victims

Of Violence

Annual Meeting

ofthe Ambulatory Pediatric Association, Seattle, WA

6/1995

Evaluation

And Management Of Dehydration In Children

Emergency Care

of the Very III Child, Hilton Head, SC

6/1995

Evaluation

Of The Child With Altered Mental Status

Emergency Care

of the Very III Child, Hilton Head, SC

3/1996

Randomized Clinical Trials In Pediatric Emergency Medicine

Third Annual Pediatric Emergency Medicine Fellows' Conference, Miami,

3/1997

Randomized Clinical Trials In Pediatric Emergency Medicine

Fourth Annual Pediatric Emergency Medicine Fellows' Conference, Miami,

6/1997

Electronic Filing - Received, Clerk's Office, August 4, 2008

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Evaluation

And Management Of Dehydration In Children

Emergency Care

ofthe Very III Child, Hilton Head, SC

6/1997

Burn Injury In Children

Emergency Care

ofthe Very III Child, Hilton Head, SC

6/1997

Evaluation

And Management Of Dehydration In Children

Emergency Care

of the Very III Child, Hilton Head, SC

6/1997

Acute Asthma In Children:

An Update On Management

Emergency Care

of the Very III Child, Hilton Head, SC

3/1998

Non-experimental Study Designs in Pediatric Emergency Medicine

Fifth Annual Pediatric Emergency Medicine Fellows' Conference,

Washington,

6/1998

Evaluation And Management

Of Dehydration In Children

Emergency Care

ofthe Very III Child, Hilton Head, SC

6/1998

Acute Asthma In Children:

An Update On Management

Emergency Care

ofthe Very III Child, Hilton Head, SC

4/1999

Non-Experimental Studies In Pediatric Emergency Medicine

Sixth Annual National

PEM Fellow'sConference, Los Angeles, CA

4/2000

Burns And Smoke Inhalation

Pediatric Emergency Medicine 2000, Orlando, FL

4/2000

Asthma

And Bronchiolitis: An Update On Management

Pediatric Emergency Medicine 2000, Orlando, FL

4/2000

The Dehydrated Child

Pediatric Emergency Medicine 2000, Orlando, FL

5/2000

Electronic Filing - Received, Clerk's Office, August 4, 2008

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Consent And Confidentiality: Teaching HousestaffTo Respect The Rights

Of Others

Annual Meeting

of the Ambulatory Pediatric Association, Boston, MA

3/2001

Severity

of Illness Measures in PEM

EMSC Outcomes Research Conference, Reston,

4/2001

UTI in Children

Pediatric Emergency Medicine 2001, Orlando, FL

4/2001

Asthma

And Bronchiolitis: An Update On Management

Pediatric Emergency Medicine 2001, Orlando, FL

4/2001

The Dehydrated Child

Pediatric Emergency Medicine 2001, Orlando, FL

4/2001

Consent

And Confidentiality: Teaching HousestaffTo Respect The Rights

Of Others

Annual Meeting

of the Association of Pediatric Program Directors, Baltimore,

4/2002

UTI in Children

Ninth Annual Clinical Advances in Pediatric Emergency Medicine, St.

Louis,

4/2002

The Role

ofthe ED in Asthma Prevention and Control

Ninth Annual Clinical Advances in Pediatric Emergency Medicine, St.

Louis,

11/2002

Evaluation and Management

of Dehydration in Children

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

1112002

Bronchiolitis and Croup

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

Electronic Filing - Received, Clerk's Office, August 4, 2008

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11/2002

Pediatric Asthma

I: Update on Acute Management

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

11/2002

Pediatric Asthma

II: The ED in the Continuum ofAsthma Care

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

11/2002

Evaluation

of the Child with Altered Mental Status

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

11/2002

Head Trauma in Infants and Young Children

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

11/2002

Visual Diagnosis

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

11/2002

The Year

in Review: Selections from the Literature

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

11/2002

Pediatric Presentations

of Cardiac Disease

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

11/2002

Approach to the Poisoned Child

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

5/2003

William Bradford Visiting Professor

Children'sMercy Hospital, Kansas City, MO

8/2003

Anatomy

of a Research Career

Electronic Filing - Received, Clerk's Office, August 4, 2008

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Date

Title:

Location:

Date

Title:

AAP Pediatric Emergency Medicine Leadership Coference, Albuquerque,

8/2003

Obtaining Research Funding

AAP Pediatric Emergency Medicine Leadership Coference, Albuquerque,

112004

Evaluation and Management of Dehydration in Children

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

112004

Bronchiolitis and Croup

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

112004

Pediatric Asthma: Update on Acute Management

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

112004

Fever in the Infant and Toddler

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

112004

Evaluation ofthe Child with Altered Mental Status

American Medical Seminars, Review and Update

ofPediatric Emergency

Medicine, Sarasota, FL

1/2004

Pediatric Abdominal Emergencies

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

112004

Visual Diagnosis

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

112004

The Year in Review: Selections from the Literature

Electronic Filing - Received, Clerk's Office, August 4, 2008

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Title:

American Medical Seminars, Review and Update of Pediatric Emergency

Medicine, Sarasota, FL

112004

Pediatric Presentations

of Cardiac Disease

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota,

112004

Approach to the Poisoned Child

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota,

2/2004

The Year in Review: Selections from the Literature

PEM 2004, Park City,

2/2004

Pediatric Presentations

of Cardiac Disease

PEM 2004, Park City,

2/2004

Looking Out For Number

1: Screening For UTI

Febrile Young Children

PEM 2004, Park City, UT

3/2004

Obtaining Research Funding

Annual National PEM Fellowship Conference, St. Louis, MO

3/2005

The Emergency Department in the Continuum

of Asthma Care

Grand Rounds, Children'sHospital Medical Center, Cincinnati, OH

4/2005

Evaluation and Management

of Dehydration in Children

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

4/2005

Bronchiolitis and Croup

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

4/2005

Pediatric

Asthma: Update on Acute Management

Electronic Filing - Received, Clerk's Office, August 4, 2008

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American Medical Seminars, Review and Update of Pediatric Emergency

Medicine, Sarasota,

4/2005

Fever in the Infant and Toddler

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota,

4/2005

Evaluation

ofthe Child with Altered Mental Status

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota,

4/2005

Pediatric Abdominal Emergencies

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota,

4/2005

Visual Diagnosis

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota,

4/2005

The Year in Review: Selections from the Literature

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota,

4/2005

Pediatric Presentations

of Cardiac Disease

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota,

4/2005

Medicolegal Issues in Pediatric Emergency Medicine

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota,

9/2005

The Emergency Department in the Continuum

of Asthma Care

Helen L. DeRoy Distinguished Visiting Professor, Children'sHostpial

Michigan, Detroit, MI

9/2005

Fever in the Infant and Toddler

Electronic Filing - Received, Clerk's Office, August 4, 2008

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Pediatric Grand Rounds, Children'sHostpial of Michigan, Detroit, MI

10/2005

Visual Diagnosis

Annual Conference on Pediatric Emergencies, Symposia Medicus,

Kawai, Hawaii

10/2005

Pediatric Minor Head Injury: Who Needs a Head CT?

21 st Annual Conference on Pediatric Emergencies, Symposia Medicus,

Kawai, Hawaii

10/2005

Fever in the Era ofPneumoccoccal Vaccine

21 st Annual Conference on Pediatric Emergencies, Symposia Medicus,

Kawai, Hawaii

10/2005

Contemporary Management

of Pediatrics Respiratory Emergencies

21 st Annual Conference on Pediatric Emergencies, Symposia Medicus,

Kawai, Hawaii

3/2006

Evaluation and Management

of Dehydration in Children

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota,

3/2006

Bronchiolitis and Croup

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2006

Pediatric

Asthma: Update on Acute Management

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2006

Fever in the Infant and Toddler

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2006

Evaluation

of the Child with Altered Mental Status

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

Electronic Filing - Received, Clerk's Office, August 4, 2008

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Title:

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Title:

Location:

Date

Title:

Location:

Date

3/2006

Pediatric Abdominal Emergencies

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2006

Visual Diagnosis

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2006

Evidence-Based Pediatric Emergency Medicine: A Practical Approach for

Clinicians

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2006

Pediatric Presentations

of Cardiac Disease

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota,

3/2006

Medicolegal Issues in Pediatric Emergency Medicine

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

4/2006

Urinary Tract Infections in Children

Pediatric Emergency Medicine 2006: Advances and Controversies for the

Clinician, Orlando, FL

www.pedseducation.org/online_education/20061102/index.html

4/2006

Altered Mental Status

Pediatric Emergency Medicine 2006: Advances and Controversies for the

Clinician, Orlando, FL

www.pedseducation.org/online_education/20061109/index.htm

4/2006

Non-traumatic Abdominal Emergencies

Pediatric Emergency Medicine 2006: Advances and Controversies for the

Clinician, Orlando, FL

www.pedseducation.org/online_education/20060903/index.htm

4/2006

Electronic Filing - Received, Clerk's Office, August 4, 2008

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Title:

Location:

Date

Title:

Location:

Date

Title:

Location:

Date

Title:

Developing Valid and Relevant Outcome Measures for Pediatric

Emergency Medicine

Pediatric Academic Societies

Annual

Meeting, San Francisco, CA

2/2007

Research on a Budget

Annual

PEM Fellows Conference, Miami, FL

3/2007

Evaluation and Management

of Dehydration in Children

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2007

Bronchiolitis and Croup

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2007

Pediatric

Asthma: Update on Acute Management

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2007

Fever in the Infant and Toddler

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2007

Evaluation

of the Child with Altered Mental Status

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2007

Pediatric Abdominal Emergencies

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2007

Common Acute dermatologic Problems in Children

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2007

Psychiatric and Behavioral Emergencies iin Children

Electronic Filing - Received, Clerk's Office, August 4, 2008

Location:

Date

Title:

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Title:

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Location:

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Title:

Location:

Date

Title:

Location:

Date

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American Medical Seminars, Review and Update of Pediatric Emergency

Medicine, Sarasota, FL

3/2007

Pediatric Presentations

of Cardiac Disease

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2007

Emergencies in the Office: Being Prepared to Stabilize and Transfer

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2008

Evaluation and Management

of Dehydration in Children

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2008

Bronchiolitis and Croup

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2008

Pediatric

Asthma: Update on Acute Management

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2008

Fever in the Infant and Toddler

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2008

Evaluation

of the Child with Altered Mental Status

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2008

Pediatric Abdominal Emergencies

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2008

Common Acute dermatologic Problems in Children

Electronic Filing - Received, Clerk's Office, August 4, 2008

Location:

Date

Title:

Location:

Date

Title:

Location:

Date

Title:

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Regional:

Date:

Title:

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Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

American Medical Seminars, Review and Update ofPediatric Emergency

Medicine, Sarasota, FL

3/2008

Psychiatric and Behavioral Emergencies iin Children

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2008

Pediatric Presentations

of Cardiac Disease

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

3/2008

Emergencies in the Office: Being Prepared to Stabilize and Transfer

American Medical Seminars, Review and Update

of Pediatric Emergency

Medicine, Sarasota, FL

2/1995

Evaluation And Management

Of Dehydration

Children

York Hospital, York, PA

5/1996

Evaluation And Management

Of Dehydration

Children

Burlington Memorial Hospital, Mt. Holly,

10/1996

Pediatric Trauma

York Hospital, York,

4/1999

Pediatric Asthma And Bronchiolitis: The Latest From The Literature

Pennsylvania ACEP Scientific Assembly, Harrisburg, PA

2/2001

Looking Out For Number

1: Screening For UTI

Febrile Young Children

Grand Rounds, Department

of Emergency Medicine, Christ Hospital, Oak

Lawn,IL

2/2001

Evaluation and Management

of Dehydration in Children

Grand Rounds, Department

of Emergency Medicine, Christ Hospital, Oak

Lawn, IL

10/2001

Electronic Filing - Received, Clerk's Office, August 4, 2008

Title:

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Location:

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Title:

Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Looking Out For Number 1: Screening For UTI In Febrile Young Children

Pediatric Emergencies in the New Millenium, Wisconsin Dells, WI

10/2001

Asthma And Bronchiolitis: An Update On Management

Pediatric Emergencies in the

New Millenium, Wisconsin Dells, WI

10/2002

Update

on Bronchiolitis

Pediatric Emergency Medicine: Challenges and Controversies, Wisconsin

Dells, WI

10/2002

Cardiac Emergencies

Pediatric Emergency Medicine: Challenges and Controversies, Wisconsin

Dells, WI

10/2002

Evaluation and Management

of Dehydration in Children

Pediatric Emergency Medicine: Challenges and Controversies, Wisconsin

Dells, WI

12/2002

Bronchiolitis: Management Update

Grand Rounds, Appleton Medical Center, Appleton, WI

112003

Evaluation and Management of Dehydration in Children

Annual Winter Refresher Course for Family Practice, Waukesha, WI

10/2004

Fever in the Infant and Toddler

Pediatric Emergency Medicine: Challenges and Controversies, Wisconsin

Dells, WI

10/2004

Pediatric Presentations

of Cardiac Disease

Pediatric Emergency Medicine: Challenges and Controversies, Wisconsin

Dells, WI

10/2004

Pediatric Abdominal Emergencies

Pediatric Emergency Medicine: Challenges and Controversies, Wisconsin

Dells, WI

11/2004

Electronic Filing - Received, Clerk's Office, August 4, 2008

Title:

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Date:

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Location:

Date:

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Local:

Date:

Title:

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Date:

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Location:

Date:

Title:

Location:

Date:

Title:

Location:

Date:

Title:

Looking out for Number 1: Screening For UTI In Febrile Young Children

Pediatric Grand Rounds, Condell Medical Center, Libertyville, IL

2/2005

Update

in Management of Bronchiolitis

St. Therese Medical Center, Waukegan, IL

6/2005

Severity

of illness measures for pediatric emergency care.

University

of Chicago Grand Rounds, Chicago, IL

11/1993

Burn Injury In Children

Intensive Course in Pediatric Emergency Medicine, Philadelphia,

11/1993

Workshop

on Acute Asthma

Intensive Course in Pediatric Emergency Medicine, Philadelphia,

11/1994

Burn Injury In Children

Intensive Course in Pediatric Emergency Medicine, Philadelphia,

11/1994

Fluid and Electrolyte Workshop

Intensive Course in Pediatric Emergency Medicine, Philadelphia,

11/1995

Burn Injury In Children

Intensive Course in Pediatric Emergency Medicine, Philadelphia, PA

11/1995

Fluid

and Electrolyte Workshop

Intensive Course in Pediatric Emergency Medicine, Philadelphia, PA

11/1996

Acute Asthma In Children:

An Update On Management

Intensive Course in Pediatric Emergency Medicine, Philadelphia, PA

11/1996

Fluid and Electrolyte Workshop

Intensive Course in Pediatric Emergency Medicine, Philadelphia, PA

7/1997

Primer

on Research Funding

Electronic Filing - Received, Clerk's Office, August 4, 2008

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Date:

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Fundamentals of Clinical Research, Allegheny University of the Health

Sciences, Philadelphia, PA

11/1997

Acute Asthma In Children:

An Update On Management

Intensive Course in Pediatric Emergency Medicine, Philadelphia,

11/1997

Fluid and Electrolyte Workshop

Intensive Course in Pediatric Emergency Medicine, Philadelphia,

7/1998

Primer

on Research Funding

Fundamentals

of Clinical Research, Allegheny University ofthe Health

Sciences, Philadelphia, PA

11/1998

Asthma

And Bronchiolitis: An Update On Management

Intensive Course in Pediatric Emergency Medicine, Philadelphia, PA

11/1998

Fluid and Electrolyte Workshop

Intensive Course in Pediatric Emergency Medicine, Philadelphia,

1/1999

Acute Asthma In Children:

An Update On Management

Pediatric Advanced Practice Nurse program, University

of Pennsylvania

School

ofNursing, Philadelphia, PA

3/1999

Looking

Out For Number 1: Screening For UTI In Febrile Young Children

Grand Rounds, AI duPont Hospital for Children, Wilmington,

4/1999

Looking

Out For Number 1: Screening For UTI In Febrile Young Children

Grand Rounds, Department

of Family Medicine, Jefferson Medical

College, Philadelphia, PA

10/1999

The Role

Of The ED In Asthma Prevention

STAR Program Community Forum, Albert Einstein Medical Center,

Philadelphia, PA

11/1999

Evaluation

And Management Of Dehydration In Children

Electronic Filing - Received, Clerk's Office, August 4, 2008

Location:

Date:

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Location:

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Title:

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Intensive Course in Pediatric Emergency Medicine, Philadelphia, PA

1111999

Management Of The Febrile Young Child: Panel Discussion

Intensive Course in Pediatric Emergency Medicine, Philadelphia,

112000

Acute Asthma In Children: An Update On Management

Pediatric Advanced Practice Nurse program, University

of Pennsylvania

School

ofNursing, Philadelphia, PA

10/2000

Looking Out For Number 1: Screening For UTI In Febrile Young Children

Grand Rounds, Department

of Pediatrics, Children'sHospital of

Wisconsin, Milwaukee, WI

3/2001

Short term outcomes of acute asthma in children

Department

of Pediatrics research conference, Children'sHospital of

Wisconsin, Milwaukee, WI

4/2001

Short term outcomes of acute asthma in children

Keynote Address, 9

Annual EM Research Day, Medical College of

Wisconsin, Milwaukee, WI

1112001

An ounce of prevention: how do we keep asthmatics out of the ED?

Starkey Davis Conference, Milwaukee, WI

6/2005

Effectively diagnosing and treating "bellyaches" and appendicitis

Editor'sChoice Conference, Milwaukee, WI

6/2006

Dealing with common office emergencies

Editor's Choice Conference, Milwaukee, WI

Administrative Activities:

Children'sHospital of Wisconsin

Trauma Multidisciplinary Committee

Trauma Peer Review/QI Committee

Joint Patient Care Committee

Department

of Medicine Patient Care Committee

Electronic Filing - Received, Clerk's Office, August 4, 2008

Emergency Department Multidisciplinary Committee (co-chair)

Physician Quality Advisory Committee

Children'sResearch Institute

Scientific Advisory and Policy Committee

Clinical Research Subcommittee (co-chair)

Medical College

of Wisconsin

Search Committee, Department

of Surgery Chair

Injury-related Research and Education Advisory Committee

Department

of Pediatrics Clinical Research Strategic Planning Committee (co-

chair)

Department

of Pediatrics Mentorship Task Force

Children's Specialty Group

Group Practice Committee

Finance Committee (co-chair)

Radiology Chief Search Commmittee

Medical College of Wisconsin Teaching Activities:

Medical Student Education:

2000-present

MS III pediatric rotation - supervision/bedside teaching of

junior medical students assigned to ED as part of their pediatric

rotation

2000-present

MS IV pediatric emergency medicine elective -

supervision/bedside teaching

of senior medical students doing

elective rotation in PEM at CHW

ResidentlFellow Education:

2000-present

Resident clinical rotations - supervision/bedside teaching of

residents in pediatrics, emergency medicine, and family

medicine rotating in the ED at CHW.

2000-present

2002-2005

Resident core lecture series in PEM - provide clinical lectures

2-4 times per year for pediatric residents at CHW and

emergency medicine residents at Froedtert Hospital

Fellow core lecture series - provide 8-10 lectures per year for

pediatric emergency medicine fellows, on clinical,

administrative, and research issues

Introduction to Research Design - serve as faculty for course

(small group discussion leader and occasional lectures), run by

Electronic Filing - Received, Clerk's Office, August 4, 2008

the Program in Epidemiology, for fellows from the entire

MCWsystem

2003-present

2005-present

Curriculum

Evidence-Based Medicine - serve as co-

coordinator

of curriculum in evidence-based medicine for PEM

fellows; includes providing 2-3 lectures per year and

supervising a fellow on an EBM project

Pediatrics Joint Fellowship Curriculum - provide lectures in

statistical analysis and research design for fellows in Dept.

Pediatrics

Pediatric Resident Jounral Club - faculty facilitator for

monthly PL-2 journal club

Faculty DevelopmentlContiuing Medical Education:

2000-present

Pediatric Emergency Medicine Update - established and serve

as co-director for regional CME program offered annually in

the Wisconsin Dells, featuring faculty from the Section

Pediatric Emergency Medicine

MCW Students, Residents, Fellows, and Faculty Mentored:

2000-present

2001-2003

200l-present

2001-2004

2004-2007

David Brousseau - associate professor

ongoing mentorship

of research projects as junior faculty member;

named mentor for Clinical Research Scholars Program

Kenneth Yen -assistant professor

research mentor during fellowship; thesis advisor for Master

Science in Epidemiology; ongoing mentorship of research projects

as junior faculty member

Duane Jensen - fellow

research mentor during fellowship

Molly Stevens - assistant professor

ongoing mentorship

of research projects as junior faculty member

David Blackwell - fellow

research mentor during fellowship

Maria Kwok

- fellow

research mentor during fellowship

Ryan Casper - fellow

Electronic Filing - Received, Clerk's Office, August 4, 2008

research mentor during fellowship; thesis advisor for Master of

Science in Epidemiology

2004-present

2004-2007

2006-present

2007-present

Lisa Uherick - fellow

research co-mentor during fellowship

Corey Philpot - fellow

research co-mentor during fellowship

Sabreen Akhter - fellow

research co-mentor during fellowship

Frank Petruzella - fellow

research mentor during fellowship

MCW Scholarship Oversight Committees:

2004-2007

2006-2007

2006-present

2007-present

Bibliography:

Greg Rebella, Emergency Medicine

Lisa Uherick, Emergency Medicine

Corey Philpot, Critical Care

Ryan Casper, AllergylImmunology

Sabreen Akhter, Emergency Medicine

Frank Petruzella, Emergency Medicine

Refereed Journal Publications/Original Papers:

1. Gorelick MH, Bishop GA, Haughton G, Pisetsky DS. Cyclosporine inhibition of CH

series murine B-celllymphomas.

Cellular Immunology

107: 219-226, 1988.

2. Gorelick MH, Owen WC, Seibel N, Reaman GR. Lack of association between

neutropenia and the incidence

of bacteremia associated with indwelling central venous

catheters in febrile pediatric cancer patients.

Pediatr Infect Dis

10: 506-510, 1991.

3. Gorelick MH, Powell CM, Rosenbaum

KR,

Saal HM, Conry J, Fitz CR. Progressive

occlusive cerebrovascular disease in a patient with neurofibromatosis type

C/in Pediatr

31: 313-315, 1992. (Selected for 1993

Year Book ofNeurology and Neurosurgery.

Philadelphia: Mosby-Year Book, Inc.)

4. Gorelick MH, Shaw KN, Baker MD. Effect of ambient temperature on capillary refill in

healthy children.

Pediatrics 1993;92:699-702.

5. Gorelick MH, Baker MD. Epiglottitis in children 1979-1992: effects of

Haemophi/us

influenzae

type b immunization.

Arch Pediatr Adolesc Med 1994;148:47-50.

Electronic Filing - Received, Clerk's Office, August 4, 2008

Gorelick

MH, Shaw KN, Murphy KO. Validity and reliability of clinical signs in the

diagnosis

of dehydration in children.

Pediatrics

1997;99(5):e6. (URL:

http://www.pediatrics.org/cgi/content/ful1l99/5/e6)

Gorelick

MH, Shaw KN, Murphy KO, Baker MD. Effect of fever on capillary refill

time.

Pediatr Emerg Care

1997;13:305-7. (Selected for 1998

Yearbook ofPediatrics.

Philadelphia: Mosby-Year Book, Inc.)

8. Shaw KN, McGowan KL,

Gorelick

MH, Schwartz JS. Screening for UTI in infants in

the ED: which test is best?

Pediatrics

1998; 101(6):el. (URL:

http://www.pediatrics.org/cgi/content/fuIVl01/6/el)

9. Shaw KN,

Gorelick

MH, McGowan KL, McDaniel-Yakscoe N, Schwartz JS. Prevalence

of UTI in febrile young children in the emergency department.

Pediatrics

1998;102:eI5

(URL: http://www.pediatrics.org/cgi/content/fulVI02/2/eI5)

10. Fein JA, Callahan JM, Boardman CR,

Gorelick

MH. Predicting the need for topical

anesthetic in the pediatric emergency department.

Pediatrics

1999; 104(2):eI9 (URL:

http://www.pediatrics.org/cgi/content/fuIVI04/2/eI9)

11.

Gorelick MH,

Shaw KN. Screening tests for UTI in children: a meta-analysis.

Pediatrics

1999; 104(5):el (URL: http://www.pediatrics.org/cgi/content/fulVI04/5/e54)

12.

Gorelick

MH, Shaw KN. Clinical decision rule to identify young febrile children at risk

for UTI.

Archives ofPediatrics and Adolescent Medicine 2000;154:386-390.

13. Macartney KK,

Gorelick

MH, Manning ML, Hodinka RL, Bell LM. Nosocomial

respiratory syncytial virus infections: the cost-effectiveness and benefit

of infection

control.

Pediatrics

2000; 106:520-526.

14. Kost S, Cronan K,

Gorelick

Arruca J. Ambulance use by high-acuity patients in a

pediatric emergency department.

Emerg Med

2000;18:679-682.

15.

Gorelick

MH, Lee C, Cronan K, Kost K, Palmer

Pediatric emergency assessment

tool (PEAT): a risk-adjustment measure for pediatric emergency patients.

Acad Emerg

Med 2001;8:156-162.

16. Stevens MW,

Gorelick

MH. Short term outcomes after acute treatment of pediatric

asthma.

Pediatrics 2001;107:1357-1362

17.

Gorelick MH,

Stevens MW, Schultz TR. Comparability of acute asthma severity

assessments by parents and respiratory therapists.

Arch Pediatr Adolesc Med.

2002;156:1199-1202

18.

Gorelick MH,

Hoberman A, Kearney D, Wald EW, Shaw KN. Validation

ofa decision

rule identifying febrile young girls at high risk for urinary tract infection.

Pediatr Emerg

Care 2003;19:162-164.

19. Stevens MW,

Gorelick

MH, Schultz T. Interrater agreement in the clinical evaluation of

acute pediatric asthma.

J Asthma 2003;40:311-315.

20. Shaw KN, Ruddy RM,

Gorelick

MH. Pediatric emergency department directors'

benchmarking survey: fiscal year 2001.

Pediatr Emerg Care 2003;19:143-147.

Electronic Filing - Received, Clerk's Office, August 4, 2008

21. Yen K, Kim M, Stremski E,

Gorelick

MH. The effect of ethnicity and race on the use of

pain medications in children with long bone fractures in the emergency department.

Ann

Emerg Med2003;42:41-47.

22.

Gorelick

MH, Scribano PV, Stevens MW, Schultz TR. Construct validity and

responsiveness

of the Child Health Questionnaire in children with acute asthma

Ann

Asthma Allerg Immunol2003;90:622-628.

23. The Pediatric Emergency Care Applied Research Network. The Pediatric Emergency

Care Applied Research Network (PECARN): Rationale, Development, and First Steps.

Acad Emerg Med2003;

10: 661-668.

24.

Gorelick

MH, Stevens MW, Schultz TR, Scribano PV. Difficulty in obtaining peak

expiratory flow measurements in children with acute asthma.

Pediatr Emerg Care 2004

20: 22-26.

25.

Gorelick

MH, Stevens MW, Schultz TR, Scribano PV. Performance ofa novel clinical

score, the Pediatric Asthma Severity Score (PASS), in the evaluation

of acute asthma.

Acad Emerg Med

2004;11:10-18.

26. Brousseau DC, Bergholte J,

Gorelick

MH. The effect ofprior interactions on emergency

department visits for nonurgent conditions.

Arch Pediatr Adolesc Med 2004;158:78-82.

27. Beckmann KR, Melzer-Lange MD,

Gorelick

MH. Emergency department management

of sexual transmitted infections in US adolescents: results from the National Hospital

Ambulatory Medical Care Survey.

Ann Emerg Med2004;43:333-338.

28. Brousseau DC, Meurer JR, Isenberg ML, Kuhn EM,

Gorelick

MH. The association

between infant continuity

of care and pediatric emergency department utilization.

Pediatrics 2004;113:738-741

29.

Gorelick

MH, Brousseau DC, Stevens MW. Validity and responsiveness of a brief

asthma-specific quality

of life instrument in children with acute asthma.

Ann Asthma

Allerg Immunol2004; 92:47-51.

30. Jensen DM, Brousseau DC, Tumpach EA,

Gorelick

MH. Intervention to improve

interobserver agreement in the assessment

of children with pharyngitis.

Pediatr Emerg

Care 2005;21:238-241.

31.

Gorelick

MH, Yen K, Yun HJ. Effect of an in-room registration system on emergency

department length

of stay.

Ann Emerg Med

2005;45: 128-133.

32. Yen K, Karpas A, Pinkerton HJ,

Gorelick

MH. Inter-examiner reliability in physical

examination

of pediatric patients with abdominal pain.

Arch Pediatr Adolesc Med 2005;

159:373 - 376.

33.

Gorelick

MH, Alpern ER, Alessandrini EA. A system for grouping presenting

complaints: the Pediatric Emergency Reason for Visit Clusters (PERC).

Acad Emerg Med

2005; 12:723-731.

34. Bandyopadhyay S, Hennes H,

Gorelick

MH, Wells RO, Walsh-Kelly CM. Serum

neuron-specific enolase as a predictor

of short-term outcome in children with closed

traumatic brain injury.

Acad Emerg Med2005;12:732-738.

Electronic Filing - Received, Clerk's Office, August 4, 2008

35.

Gorelick

MH, Alpern ER, Singh T, Snowdon D, Holubkov R, Dean JM, for the Pediatric

Emergency Care Applied Research Network. Availability

ofpediatric emergency visit

data from existing data sources.

Acad Emerg Med2005;

12: 1195-1200.

36. Fein JA,

Gorelick

MH. The decision to use topical anesthetic for

insertion in the

pediatric ED.

Acad Emerg Med2006;13:264-268.

37.

Gorelick

MH, Meurer J, Walsh-Kelly C, Brousseau DC, Cohn J, Kuhn E, Grabowski L,

Kelly K. Controlled trial

of two emergency department-based follow-up interventions to

improve asthma outcomes in children.

Pediatrics

2006;117:S127-S134.

38. Kelly KJ, Walsh-Kelly C, Christenson P, Rogalinski

Gorelick

MH, Barthell EN,

Grabowski

Emergency Department Allies: a Web-based multihospital pediatric asthma

tracking system.

Pediatrics

2006;117:S63-S70.

39. Kwok M,

Gorelick

MH, Walsh-Kelly C, Grabowski L, Kelly

National Asthma

Education and Prevention Program severity classification as a measure

of disease burden

in children with acute asthma.

Pediatrics

2006;117:S71-S77.

40. Drendel AL, Brousseau DC,

Gorelick

MH. Pain assessment for pediatric patients in the

emergency department.

Pediatrics

2006;117:1511-8.

41.

Gorelick

MH, Yen

The kappa statistic was representative of empirically-observed

inter-rater agreement for physical findings.

Clin Epidemio12006;59:859-861.

42.

Gorelick

MH. Bias arising from missing data in predictive models.

Clin Epidemiol

2006;59:1115-23

43. Alpern ER, Stanley RM,

Gorelick

MH, Donaldson A, Knight S, Teach SJ, Singh T,

Mahajan P, Goepp JO, Kuppermann

N, Dean JM, Chamberlain JM for the Pediatric

Emergency Care Applied Research Network. Epidemiology

of a Pediatric Emergency

Medicine Research Network: The Pediatric Emergency Care Applied Research Core Data

Project.

Pediatr Emerg Care 2006;22:689-699.

44. Blackwell CD,

Gorelick

MH, Holmes JF, Bandyopadhyay S, Kuppermann N. Pediatric

head trauma: changes

in use of computed tomography in emergency departments in the

United States over time.

Ann Emerg Med 2007;49:320-324.

45. Mistry R, Stevens MW,

Gorelick

MH. Outcomes of febrile children discharged from the

emergency department.

Pediatr Emerg Care 2007;23:617-623.

46.

Gorelick

MH, Alessandrini EA, Cronan K, Shults J. Revised Pediatric Emergency

Assessment Tool [RePEAT]: a severity index for pediatric emergency care.

Acad Emerg

Med

2007;14;316-323.

47. Stevens MW, Scribano PV, Shultz TR,

Gorelick

MH. Screening for short-term

outcomes

of acute asthma in children.

Ann Asthma Allergy Immuno12007;98:432-439.

48. Philpot C, Day S, Marcdante K,

Gorelick

MH. Pediatric interhospital transport:

diagnostic concordance and hospital mortality.

Pediatr Crit Care Med2007

[accepted for

publication]

49. Redman R, Nenn C, Eastwood D,

Gorelick

MH. ED visits for diarrheal illness increased

after release ofundertreated sewage.

Pediatrics

2007;120:eI472-1475.

Electronic Filing - Received, Clerk's Office, August 4, 2008

50. Yen K, Riegert A, Gorelick MH. Derivation of the DIVA score: a clinical prediction rule

for identification

of children with difficult IV access.

Pediatr Emerg Care

2008;24: 143-

147.

51.

Gorelick MH, Scribano PV, Stevens MW, Schultz TR, Shults J. Predicting need for

hospitalization in acute pediatric asthma.

Pediatr Emerg Care

2008 [accepted for

publication]

Books, Chapters, Reviews:

1. Gorelick MH, Klein BL, Einhorn A. Iron poisoning.

Emergency Pediatrics

4: 98-9,

1991.

Gorelick MH. Thermal injury, in Schwartz W, ed.

Clinical Handbook ofPediatrics.

Baltimore: Williams and Wilkins, 1995; 629-634.

3. Gorelick MH. Abdominal masses, in Schwartz W, ed.

Clinical Handbook ofPediatrics.

Baltimore: Williams and Wilkins, 1995; 68-73.

Gorelick MH. Abdominal masses, in Barkin R (ed.):

Pediatric Emergency Medicine:

Concepts

and Clinical Practice.

ed. St. Louis: Mosby-Year Book Inc., 1997: 795-797.

5. Gorelick MH. Gastric emptying, in Dieckmann R, Fiser D, Selbst S, eds.:

fllustrated

Textbook

ofPediatric Emergency and Critical Care Procedures.

St Louis: Mosby-Year

Book, Inc., 1997; 557-562.

6. Gorelick MH. Gastrointestinal decontamination, in Dieckmann R, Fiser D, Selbst S,

eds.:

Rlustrated Textbook ofPediatric Emergency and Critical Care Procedures.

Louis: Mosby-Year Book, Inc., 1997; 563-566.

7. Gorelick MH. Dialysis and hemofiltration, in Dieckmann R, Fiser D, Selbst S, eds.:

Rlustrated Textbook ofPediatric Emergency and Critical Care Procedures.

St Louis:

Mosby-Year Book, Inc., 1997; 567.

8. Shaw KN, Gorelick MH. Bum management, in Henretig FM, King C, eds.

Textbook of

Pediatric Emergency Procedures.

Baltimore: Williams and Wilkins,1997; 1189-1198.

9. Maller J, Gorelick MH. ED monitoring devices, in Henretig FM, King C, eds.

Textbook

ofPediatric Emergency Procedures.

Baltimore: Williams and Wilkins, 1997; 33-38.

10. Loiselle,

J, Gorelick MH. Dehydration, in Schwartz MW, ed.

Pediatric Primary Care:

A Problem OrientedApproach,

3rd ed. Philadelphia: Mosby- Year Book, Inc.,1997; 409-

415.

11. Gorelick MH. Neurologic emergencies, in Fleisher GR, Ludwig S, eds. Textbook of

Pediatric Emergency Medicine, 4

ed. Baltimore: Williams and Wilkins, 1999;701-723.

12. Gorelick MH. Dehydration, in Schwartz MW, ed.

The Five Minute Pediatric Consult.

ed. Baltimore: Williams and Wilkins, 2001; 308-309.

13. Shaw KN, Gorelick MH. Urinary tract infection.

Pediatr Clin North Am

1999;46: 1111-

1124.

Electronic Filing - Received, Clerk's Office, August 4, 2008

14. Shaw KN,

Gorelick

MH. Fever as a sign of UTI.

Clin Pediatr Emerg

Med2000;1:117-

123.

15.

Gorelick

MH, Singh SB. Respiratory emergencies.

Pediatric Emergency Medicine

Secrets.

Philadelphia: Hanley and Belfus, Inc., 2001; 241-252.

16. Yen

Gorelick

MH. Ultrasound Applications for the Pediatric Emergency Department:

Review

of current literature.

Pediatr Emerg Care 2002;18:226-234.

17.

Gorelick

MH. Rapid IV rehydration in the emergency department: a systematic review.

PEM-Database.Org [PEM Web site]. Available at:

http://researchinpem.homestead.com/files/rapid iv hydration 23.07.doc. Accessed

8/5/02

18.

Gorelick

MH. Dehydration, in Schwartz MW, ed.

The Five Minute Pediatric Consult.

ed. Baltimore: Williams and Wilkins, 2003; 308-309.

19. Kwok MY, Kim MK,

Gorelick

MH. Evidence-based approach to the diagnosis of

appendicitis in children.

Pediatr Emerg Care 2004;20:690-698.

20.

Gorelick

MH, Blackwell CD. Neurologic emergencies, in Fleisher GR, Ludwig S, eds.

Textbook ofPediatric Emergency Medicine,

ed. Baltimore: Lippincott Williams and

Wilkins, 2005;759-782.

21.

Gorelick

MH. Thermal injury, in Schwartz W, ed.

Clinical Handbook ofPediatrics.

ed. Baltimore: Williams and Wilkins, 2003; 629-634.

22.

Gorelick

MH. Abdominal masses, in Schwartz

W, ed.

Clinical Handbook ofPediatrics.

ed. Baltimore: Williams and Wilkins, 2003; 68-73.

23.

Gorelick

MH. Dehydration, in Schwartz MW, ed.

The Five Minute Pediatric Consult.

ed. Baltimore: Lippincott Williams and Wilkins, 2005; 316-317.

24. Mistry R,

Gorelick

MH. Urinary tract infection, in Baren J, Rothrock SG, Brennan JA,

Brown

L, eds.

Pediatric Emergency Medicine.

Philadelphia: Saunders, 2007;299-305.

25. Yen K,

Gorelick

MH. Strategies to improve flow in the pediatric emergency department.

Pediatr Emerg Care 2007;23:745-749.

26. Yen K,

Gorelick

MH. ED monitoring devices, in Henretig FM, King C, eds.

Textbook of

Pediatric Emergency Procedures.

ed. Baltimore: Williams and Wilkins, 2007;32-38.

27. Shaw KN,

Gorelick

MH. Burn management, in Henretig FM, King C, eds.

Textbook of

Pediatric Emergency Procedures.

ed. Baltimore: Williams and Wilkins, 2007:1070-

1079.

28.

Gorelick

MH, ed. Fluids and electrolytes, in Zaoutis LB, Chiang VW, eds.

Comprehensive Pediatric Hospital Medicine.

Philadelphia: Mosby Elsevier, 2007;291-

307.

29.

GorelickMH,

Nagler J, Losek

JD, Bajaj L, Green SM, Luhmann J, Kennedy R, Sacchetti

A, Nelson D, Miner J, Pereira F. Pediatric sedation pearls.

Clin Pediatr Emerg Med

2007;8:268-278.

Editorials, Letters to the Editor, Other:

Electronic Filing - Received, Clerk's Office, August 4, 2008

1. Schwartz MD, Gorelick MH. Safety hazard with intravenous pumps [letter].

Dis

Child

1989;143: 1390-1391.

2. Rosenberg NM, section editor. Gorelick MH, Scribano PV, Teach SJ, discussants.

Controversies in pediatric emergency medicine: what you see is not always what you get

(or want).

Pediatr Emerg Care 1999;15:294-297.

3. Gorelick MH. Severity of illness measures for pediatric emergency care: are we there

yet? [editorial].

Ann Emerg Med2003;41:639-643.

4. Brousseau DC,

Gorelick MH. Emergency department wait times. [letter]

Pediatrics

2005;116:295.

5. Gorelick MH. Pediatric primary care in the ER: Is it better than waiting for an

appointment? [commentary]

Virtual Mentor.

2006;8:717-722. Available at:

http://www.ama-assn.orglamal/pub/upload/mml384/cc2 16931.pdf.

6. Brousseau DC. Gorelick M. Emergency department wait times. [letter]

Pediatrics 2005;

116:295.

7. Gorelick MH. Sedation and analgesia [commentary].

Clin Pediatr Emerg Med

2007;8:221-222.

8. Gorelick MH, guest editor. Advances in sedation and analgesia,

Clin Pediatr Emerg

Med 2007;8(4).

Abstracts:

1. Gorelick MH, Shaw KN, Murphy KO, Baker MD. Effect of fever on capillary refill

time. (Presented

at the Ambulatory Pediatric Association annual meting, San Diego, May

1995).

Gorelick MH, Shaw KN, Murphy KO. Validity and reliability of clinical signs in the

diagnosis

of dehydration in children. (Presented at the Ambulatory Pediatric Association

annual meeting, Washington, DC, May 1996, and the Society for Academic Emergency

Medicine annual meeting, Denver, 1996).

3. Shaw KN, GorelickMH, McGowan KL, McDaniel-Yakscoe N, Schwartz JS.

Prevalence

of urinary tract infection and occult bacteremia in febrile young children in the

emergency department. (Presented at the Pediatric Academic Societies' annual meeting,

Washington, DC, May 1996, and the Society for Academic Emergency Medicine annual

meeting, Denver, May 1996).

4. Shaw KN, McGowan KL, Gorelick MH, Schwartz JS. Screening for urinary tract

infection in young febrile children in the emergency department: which test is best?

(presented at the Pediatric Academic Societies' annual meeting, Washington, DC, May

1996, and the Society for Academic Emergency Medicine annual meeting, Denver, May

1996).

5. Gorelick MH, Shaw KN. Schwartz JS. Cost-effective screening for UTI in febrile young

girls. (presented

at the Pediatric Academic Societies' annual meeting, Washington DC,

Electronic Filing - Received, Clerk's Office, August 4, 2008

May 1997, and the Society for Academic Emergency Medicine annual meeting,

Washington DC, May 1997).

6. Shaw KN,

Gorelick

MH, McGowan KA, Boardman C, Schwartz JS. Predicting UTI in

febrile young children in the emergency department. [abstract] (presented at the Pediatric

Academic Societies' annual meeting, Washington DC, May 1997, and the Society for

Academic emergency Medicine annual meeting, Washington DC, May 1997).

7. Stevens M,

Gorelick

MH. Short-term outcomes after outpatient therapy in acute

pediatric asthma. (presented at the Pediatric Academic Societies' annual meeting,

Washington DC, May 1997, and the Society for Academic Emergency Medicine annual

meeting, Washington DC, May 1997).

8. Macartney KK,

Gorelick

MH, Hodinka RL, Manning ML, Bell LM. Cost-effectiveness

of an infection control program to reduce nosocomial respiratory syncytial virus

infection. (presented at the Pediatric Academic Societies' annual meeting, New Orleans

LA, May 1998).

Gorelick

MH, Shaw KN. Screening tests for detection of UTI in children: a meta-

analysis. (Presented at the Annual Meeting

of the American Academy of Pediatrics, San

Francisco, CA, October 1998.)

10. Stevens M,

Gorelick MH

Schultz T. Interater agreement in the assessment ofpediatric

asthma severity.

Pediatr Res

2000;47:227A. (Presented at the Annual Meeting

ofthe

Ambulatory Pediatric Association, San Francisco, CA, May 1999, and the Annual

Meeting

of the Society for Academic Emergency Medicine, Boston, MA, May 1999.)

11.

Gorelick

MH, Attia MA, Zaoutis T, Klein J. Interobserver Reliability of Clinical

Assessment

of Children with Pharyngitis.

Pediatr Res

2000;47:227A (Presented at the

Annual Meeting

of the Ambulatory Pediatric Association, Boston, MA, May 2000, and

the Annual Meeting

ofthe Society for Academic Emergency Medicine, San Francisco,

May 2000)

12.

Gorelick

MH, Cronan K, Kost S, Palmer K, Lee C. PEAT: Pediatric Emergency

Assessment Tool. (Presented at the Annual Meeting

of the Ambulatory Pediatric

Association, Boston, MA, May 2000, and the Annual Meeting

ofthe Society for

Academic Emergency Medicine, San Francisco, May 2000

13.

Gorelick

MH, Stevens MW, Schultz TR, Scribano PV. Predicting short term outcomes

of acute asthma.

Pediatr Res

2001 ;49:769A. (Presented at the Annual Meeting of the

Pediatric Academic Societies, Baltimore, MD, April 2001)

14.

Gorelick

MH, Stevens MW, Schultz TR. Difficulty in obtaining peak flow

measurements in children with acute asthma.

Pediatr Res

2001;49:457A. (Presented at

the Annual Meeting

of the Pediatric Academic Societies, Baltimore, MD, April 2001)

15.

Gorelick

MH, Scribano PV, Schultz TR, Stevens MW. Construct validity ofthe Child

Health Questionnaire in children with acute asthma.

Pediatr Res

2001;49:77A (Presented

at the Annual Meeting

of the Pediatric Academic Societies, Baltimore, MD, April 2001)

16.

Gorelick

MH, Scribano PV, Stevens MW, Schultz TR, Shults J. Predicting need for

hospitalization in acute pediatric asthma.

Acad Emerg Med

2001;8:416. (Presented at the

Electronic Filing - Received, Clerk's Office, August 4, 2008

Annual Meeting ofthe Society for Academic Emergency Medicine, Atlanta, GA, May

2001).

17. Singh SB,

Gorelick

MH. Asthma education in the emergency department.

Pediatr Res

2001;49:79A. (Presented at the Annual Meeting

of the Pediatric Academic Societies,

Baltimore, MD, April 2001 and the Annual Meeting

ofthe Society for Academic

Emergency Medicine, Atlanta, GA, May 2001).

18. Cronan KM, Wu AC,

Gorelick

MH. Predictors ofpatient complaints in a pediatric

emergency department.

Pediatr Res

2001;49:85A. (Presented at the Annual Meeting

the Pediatric Academic Societies, Baltimore, MD, April 2001)

19. Yen K, Kim M, Stremski ES,

Gorelick

MH. The effect of ethnicity and race on the use

of pain medications in children with long bone fractures in the emergency room: use of a

national database.

Pediatr Res

2001;49:195A. (Presented at the Annual Meeting

ofthe

Pediatric Academic Societies, Baltimore, MD, April 2001 and the Annual Meeting

of the

Society for Academic Emergency Medicine, Atlanta, GA, May 2001).

20. Beckmann KR,

Gorelick

MH, Melzer-Lange MD. Emergency department management

of sexually transmitted diseases in US adolescents using a national database. (presented at

the Annual Meeting

of the Pediatric Academic Societies, Baltimore, MD, May 2002)

21.

Gorelick

MH, Stevens MW, Schultz TR. Home care validation of parental report of

acute asthma severity. (presented at the Annual Meeting ofthe Pediatric Academic

Societies, Baltimore, MD, May 2002)

22.

Gorelick

MH, Stevens MW, Schultz TR, Scribano PV. Performance of a novel clinical

score, the Pediatric Asthma Severity Score (PASS) in the evaluation

of acute asthma.

Pediatr Res

2001

;51 :212A (Presented at the Annual Meeting ofthe Pediatric Academic

Societies, Baltimore, MD, May 2002)

23.

Gorelick

MH.

Bias arising from missing data in predictive models.

Acad Emerg Med

2002; 9:483-484. (Presented at the Annual Meeting ofthe Pediatric Academic Societies,

Baltimore, MD, May 2002, and the Annual Meeting

of the Society for Academic

Emergency Medicine, St. Louis, MO, May 2002)

24.

Gorelick

MH, Brousseau DC, Stevens MW. Validity and responsiveness of a brief,

disease-specific quality

of life instrument in children with acute asthma.

Pediatr Res

2003;53:22A. (Presented at the Annual Meeting

ofthe Pediatric Academic Societies,

Seattle, WA, May 2003)

25. Fein JA,

Gorelick

MH. Triage application of topical anesthetic for IV placement in the ED:

comparing a prediction model to nurse judgment

Pediatr Res

2003;53:116A. (Presented at

the Annual Meeting

ofthe Pediatric Academic Societies, Seattle, WA, May 2003)

26. Arnold LD,

Gorelick

MH. Screening tests for bacterial gastroenteritis: a decision

analysis.

Pediatr Res

2003;53:108A. (Presented at the Annual Meeting

of the Pediatric

Academic Societies, Seattle, WA, May 2003)

27. Brousseau DC, Meurer JR, Isenberg ML, Kuhn EM,

Gorelick

MH. Increased infant

continuity

of care is associated with decreased subsequent emergency department

Electronic Filing - Received, Clerk's Office, August 4, 2008

utilization.

Pediatr Res

2003;53:220A. (Presented at the Annual Meeting of the Pediatric

Academic Societies, Seattle, WA, May 2003)

28. Brousseau DC, Bergholte J,

Gorelick

MH. Decreased primary care satisfaction is associated

with nonurgent emergency department utilization.

Pediatr Res

2003;53:267A. (Presented at

the Annual Meeting

of the Pediatric Academic Societies, Seattle, WA, May 2003)

29. Jensen DM, Brousseau DC, Tumpach EA,

Gorelick

MH. Intervention to improve

interobserver agreement in the assessment

of children with pharyngitis. (presented at the

Annual Meeting

of the Section of Emergency Medicine ofthe American Academy of

Pediatrics, New Orleans, LA, November 2003)

30. Yen K, Karpas A, Pinkerton H,

Gorelick

MH. Interexaminer reliability in physical

examination

ofpediatric patients with abdominal pain. (Presented at the Annual Meeting

of the Section of Emergency Medicine of the American Academy of Pediatrics, New

Orleans, LA, November 2003)

31. Bandypadhyay S, Hennes

Gorelick

MH, Wells R, Walsh-Kelly C. Serum neuron-

specific enolase as predictor

of short-term outcome in children with closed traumatic

brain injury.

Pediatr Res

2004;55:105A. (presented at the Annual Meeting ofthe

Pediatric Academic Societies, San Francisco, CA, May 2004.)

32. Kwok M, Walsh-Kelly C, Bergholte J,

Gorelick

MH. The role

of exhaled nitric oxide in

evaluation

of acute asthma exacerbation in the pediatric emergency department.

Pediatr

Res

2004;55:114A. (Presented at the Annual Meeting ofthe Pediatric Academic

Societies, San Francisco, CA, May 2004.)

33. Kwok M,

Gorelick

MH, Walsh-Kelly C, Grabowski L, Kelly K. NAEPP severity

classification as a measure

of disease burden in children with acute asthma.

Pediatr Res

2004;55:115A. (Presented at the Annual Meeting ofthe Pediatric Academic Societies,

San Francisco, CA, May 2004.)

34. Chamberlain J, Stanley R, Teach S,

Gorelick

MH, Dean JM, for the Pediatric Emergency

Care Applied Research Network. Practice pattern variation in ancillary diagnostic testing

for acute asthma exacerbations in emergency departments.

Pediatr Res

2004;55:114A.

(Presented at the Annual Meeting

of the Pediatric Academic Societies, San Francisco,

CA, May 2004.)

35. Mistry R, Stevens MW,

Gorelick

MH. Outcomes of febrile children discharged from the

emergency department.

Pediatr Res

2004;55:121A. (Presented at the Annual Meeting of

the Pediatric Academic Societies, San Francisco, CA, May 2004.)

6. Yen K, Riegert A,

Gorelick

MH. Predictors of successful peripheral IV placement in a

pediatric emergency department (PED): development

of the DIVA score, part

Pediatr

Res

2004;55: 120A. (Presented at the Annual Meeting ofthe Pediatric Academic

Societies, San Francisco, CA, May 2004.)

37.

Gorelick

MH, Yen K, Yun HJ. Effect ofan in-room registration system on throughput

time in a pediatric emergency department.

Pediatr Res

2004;55:118-119A. (presented at

the Annual Meeting

ofthe Pediatric Academic Societies, San Francisco, CA, May 2004.)

Electronic Filing - Received, Clerk's Office, August 4, 2008

38.

Gorelick MH,

Alpern ER, Alessandrini EA. A system for grouping pediatric emergency

department complaints, the Pediatric Emergency Reason for Visit Clusters (PERC).

Pediatr Res

2004;55:119A. (Presented at the Annual Meeting of the Pediatric Academic

Societies, San Francisco, CA, May 2004.)

39.

Gorelick MH,

Alpern ER, Singh T, Snowdon D, Holubkov R, Dean JM, for the Pediatric

Emergency Care Applied Research Network. Availability

ofpediatric emergency visit

data from existing data sources.

Pediatr Res

2004;55: 120A. (Presented at the Annual

Meeting

ofthe Pediatric Academic Societies, San Francisco, CA, May 2004.)

40. Alpern ER, Chamberlain J, Dean JM,

Gorelick MH,

Goepp J, Singh T, Stanley R, Teach

S, Donaldson A, Knight S, for the Pediatric Emergency Care Applied Research Network

The PECARN Core Data Project: epidemiology

of a pediatric emergency medicine

research network.

Pediatr Res

2004;55:119A. (Presented at the Annual Meeting ofthe

Pediatric Academic Societies, San Francisco, CA, May 2004.)

41. Dean JM, Chamberlain J,

Gorelick MH,

Stanley R, Snowdon D, Mahajan P, Alpern ER,

for the Pediatric Emergency Care Applied Research Network. The PECARN Core Data

Project: benchmarking hospitals in a pediatric emergency medicine research network.

Pediatr Res

2004;55:119A. (Presented at the Annual Meeting of the Pediatric Academic

Societies, San Francisco, CA, May 2004.)

42. Brousseau DC, Meurer JR, Kuhn EM, Mayme L Isenberg ML,

Gorelick

MH. The effect

ofprimary care practice characteristics on pediatric emergency department utilization.

Pediatr Res

2004;55:283A. (Presented at the Annual Meeting ofthe Pediatric Academic

Societies, San Francisco, CA, May 2004.)

43. Blackwell CD,

Gorelick MH,

Kuppermann N, Holmes J, Bandyopadhyay S. Pediatric

head trauma: evaluation and management in US emergency departments.

Pediatr Res

2004;55:105A. (presented at the Annual Meeting ofthe Pediatric Academic Societies,

San Francisco, CA, May 2004.)

44.

Gorelick

MH., Holubkov R, Alessandrini EA, Stanley RM, Chamberlain JM, Alpern

ER, for the PECARN. Lack

of agreement in pediatric emergency department discharge

diagnoses from clinical and administrative data sources.

PAS

2005: 57: 2343 (Presented

at the Annual Meeting

ofthe Pediatric Academic Societies, Washington, DC, May 2005.)

45. Alpern ER, Donaldson A, Alessandrini EA,

Gorelick MH,

Stanley RM, Teach S,

Chamberlain JM, for the PECARN. Epidemiology

ofpediatric emergency department

recurrent visits.

PAS

2005: 57: 1862. (Presented at the Annual Meeting of the Pediatric

Academic Societies, Washington, DC, May 2005.)

46.

Gorelick MH,

Cronan K, Bergholte J, Shults J. Revised Pediatric Emergency

Assessment Tool (RePEAT): a risk-adjustment index for pediatric emergency care.

PAS

2005: 57: 2888 (Presented at the Annual Meeting ofthe Pediatric Academic Societies,

Washington, DC, May 2005.)

47. Mistry RM, Stevens M,

Gorelick

MH. Validity and responsiveness ofthe Peds QL 4.0

for emergency department febrile illnesses.

PAS

2005: 57: 777. (Presented at the Annual

Meeting

of the Pediatric Academic Societies, Washington, DC, May 2005.)

Electronic Filing - Received, Clerk's Office, August 4, 2008

48. Yen K, Pawar S, Brousseau DC,

Gorelick

MH. Time and motion study before

computerized physician order entry in a pediatric emergency department.

PAS

2005: 57:

338 (Presented at the Annual Meeting

of the Pediatric Academic Societies, Washington,

DC, May 2005.)

49. Alessandrini EA, Alpern ER, Chamberlain JM,

Gorelick

MH, for the PECARN.

Creating a diagnosis grouping system for child ED visits.

PAS

2005: 57: 2344.

(presented

at the Annual Meeting ofthe Pediatric Academic Societies, Washington, DC,

May 2005.)

50. Beckmann KR, Melzer- Lange M, Dettinger D,

Gorelick

MH. Focus groups as an

adjunct to OSCE's in teaching sexual history taking to third year medical students.

PAS

2005: 57: 978. (Presented at the Annual Meeting ofthe Pediatric Academic Societies,

Washington, DC, May 2005.)

51. Redman R, Nenn C, Eastwood D,

Gorelick

MH. ED visits for diarrheal illness increased

after release ofundertreated sewage. E-PAS 2006:59:3135.8 (Presented at the Annual

Meeting

of the Pediatric Academic Societies, San Francisco, CA, April 2006.)

52. Uherick L,

Gorelick

MH, Biechler R, Melzer-Lange M. Validation of a booster seat

survey. E-PAS 2006:59:2615.4 (presented at the Annual Meeting

ofthe Pediatric

Academic Societies, San Francisco, CA, April 2006.)

53. Alessandrini EA, O'ReillyA, Alpern ER, Chamberlain

1M,

Gorelick

MH. Assessing the

validity

ofthe Diagnosis Grouping System. E-PAS 2006:59:5550.275 (Presented at the

Annual Meeting

of the Pediatric Academic Societies, San Francisco, CA, April 2006.)

54. Alessandrini EA, O'ReillyA, Alpern ER, Chamberlain JM,

Gorelick

MH. Comparing

the Diagnosis Grouping System to the Clinical Classification System. E-PAS

2006:59:5550.276 (presented at the Annual Meeting

of the Pediatric Academic Societies,

San Francisco, CA, April 2006.)

55. Yen K, Shane EL, Pawar SS, Schwendel ND, Zimmanck RJ,

GorelickMH.

Time and

motion study in a pediatric emergency department (PED) before after computer physician

order entry (CPOE). E-PAS 2007:618055.8 (Presented at the Annual Meeting

ofthe

Pediatric Academic Societies, Toronto, Ontario, May 2007.)

56.

Gorelick

MH, Atabaki S, Hoyle JD, Dayan PS, Holmes JF, Holubkov R, Momoe D,

Callahan J, Kuppermann

Nand PECARN. Interobserver agreement in assessment of

clinical variables in children with blunt head trauma. E-PAS 2007:618412.4 (Presented at

the Annual Meeting

ofthe Pediatric Academic Societies, Toronto, Ontario, May 2007,

and the Annual Meeting

ofthe Society for Academic Emergency Medicine, Chicago, IL,

May 2007.)

57.

Gorelick

MH, Wagner D, McLellan S. Validation of a questionnaire to evaluate water

exposures in children. E-PAS 2007:618407.21 (Presented at the Annual Meeting

ofthe

Pediatric Academic Societies, Toronto, Ontario, May 2007.)

58. Beckmann KR, Melzer-Lange MD, Dettinger D,

Gorelick

MH. Observed Structural

Clinical Exam (OSCE) Sexual History Project. E-PAS 2007:615289.7 (presented at the

Annual Meeting

of the Pediatric Academic Societies, Toronto, Ontario, May 2007.)

Electronic Filing - Received, Clerk's Office, August 4, 2008

59. Weisgerber M, Lye P, Gedeit R, Bakalarski D, Xiang Q,

Gorelick

MH. Early factors

predictive

of prolonged hospital stay for infants with bronchiolitis. E-PAS

2007:615888.12 (Presented at the Annual Meeting

ofthe Pediatric Academic Societies,

Toronto, Ontario, May 2007.)

60. Weisgerber M, Lye P, Gedeit R, Preston MB, Krank K, Xiang Q,

Gorelick

MH.

Relationship between nutrition and length of stay in infants hospitalized with

bronchiolitis. E-PAS 2007:617902.12 (Presented at the Annual Meeting

of the Pediatric

Academic Societies, Toronto, Ontario, May 2007.)

61. Alessandrini EA, Alpern ER, Chamberlain JM,

Gorelick

MH. Developing a diagnosis-

based severity classification system for use in emergency medical systems for children.

E-

PAS 2007:616710.5 (Presented at the Annual Meeting ofthe Pediatric Academic

Societies, Toronto, Ontario, May 2007.)

62. Brousseau DC, Hoffmann RG, Nattinger AB, Flores G, Zhang

Gorelick

MH. Quality

ofprimary care and subsequent pediatric emergency department utilization. E-PAS

2007:616710.8 (Presented at the Annual Meeting

of the Pediatric Academic Societies,

Toronto, Ontario, May 2007.)

63. Uherick LA,

Gorelick

MH, Biechler R, Melzer-Lange MD. A clinical trial of emergency

department-based booster seat education. E-PAS 2007:617909.19 (Presented at the

Annual Meeting

of the Pediatric Academic Societies, Toronto, Ontario, May 2007.)

64. Kelly BT,

Gorelick

MH, Brousseau DC, Drendel AL.

intervention to improve

analgesic administration in the pediatric emergency department. E-PAS 2007:616313.35

(presented at the Annual Meeting

of the Pediatric Academic Societies, Toronto, Ontario,

May 2007.)

65. Nelsen LM, Norquist JM, Zhu X, Gumer DM,

Gorelick

MH. Measuring severity of

acute asthma in pediatric patients. (To be presented at the Annual Meeting ofthe

American Academy

of Allergy, Asthma, and Immunology, Philadelphia, PA, March 16,

2008)

66. Stanley RM, Hoyle J, Dayan PS, Atabaki SM, Lee L, Lillis KA,

Gorelick

MH, Holubkov

R, Holmes JF, Kuppermann N, for the PECARN TBI Study Group. Practice pattern

variation in head CT use in children with minor blunt head trauma evaluated in the

emergency department (ED): Is there an association with physician training? E-

PAS2008:634845.5 (presented at the Annual Meeting

ofthe Pediatric Academic

Societies, Honolulu, HI, May 2008.)

67. Drendel AL,

Gorelick

MH, Lyon R, Weisman SJ, Kim MK. Ibuprofen vs.

acetaminophen with codeine for the outpatient treatment

of arm fracture pain. E-

PAS2008:636425.2 (Presented at the Annual Meeting

of the Pediatric Academic

Societies, Honolulu, HI, May 2008.)

68. Brousseau DC,

Gorelick MH,

Hoffmann RG, Flores G, Nattinger A. Quality of primary

care and subsequent pediatric emergency department utilization in a statewide Medicaid

program. E-PAS2008:636720.2. (Presented at the Annual Meeting

ofthe Pediatric

Academic Societies, Honolulu, HI, May 2008.)

Electronic Filing - Received, Clerk's Office, August 4, 2008

Media Contacts:

"Diagnosing UTI in Children," Reuters Health News, November 1999

"Sledding Safety," Wilmington News Journal, February 2000

"Scooter Injuries", WITI-TV 6, Milwaukee, 9/7/2000

"Scooter Injuries," Milwaukee Journal Sentinel, 12/8/2000

''NewbornSafe Harbor Legislation", WUWM-FM, Milwaukee, 2/5/2001

''NewbornSafe Harbor Legislation", WISN-TVI2,

Milwaukee, 4/2/2001

"Dog Bite Injuries", WUWM-FM, Milwuakee, 1/21/02

"Summer injuries," WITI-TV 6, Milwaukee, 6/5/2002

"Playground safety," WTMJ-TV 4, Milwaukee, 7/2/2002

"Pediatric emergency medicine," "At Ten," WUWM-FM, Milwaukee, 7/3/2002

"Sports Injuries," WISN-TV 12, Milwaukee, 10/27/03

"Emergency: A No-Panic Guide to Saving Your Child'sLife", Parenting, 5/2006

"Top Ways to Keep Your Children out

of the Emergency Room," Toy Tips, 1/2007.

Electronic Filing - Received, Clerk's Office, August 4, 2008

EXHIBIT 2

Electronic Filing - Received, Clerk's Office, August 4, 2008

BIOGRAPHICAL SKETCH

Marc H. Gorelick

Education:

Princeton University: AB, History, 1983

Duke University: M.D., 1987

University

of Pennsylvania School of Medicine: MSCE (Clinical Epidemiology), 1995

House Staff and Fellowship Training: Children's National Medical Center, Washington, DC 1987-1991

Internship (1987-88), Residency (1988-90) and Chief Residency (1990-91)

in Pediatrics. Children's Hospital of

Philadelphia, 1991-1994, Fellowship

in Pediatric Emergency Medicine.

Faculty Positions: Instructor, Department of Pediatrics, George Washington University School of Medicine,

1990-91. Instructor, Department of Pediatrics, University

of Pennsylvania School of Medicine, 1991-1994.

Assistant Professor, Departments

of Pediatrics and Epidemiology, University of Pennsylvania School of

Medicine, 1994-1998. Senior Scholar, Center for Clinical Epidemiology and Biostatistics, University of

Pennsylvania School of Medicine, 1994-98. Assistant Professor, Department of Pediatrics, Thomas Jefferson

University School

of Medicine, 1998-2000. Adjunct Assistant Professor, Departments of Epidemiology,

University

of Pennsylvania School of Medicine, 1998-2000. Associate Professor, Departments of Pediatrics

and Epidemiology, Medical College

of Wisconsin, 2000-2004.

Current Positions: Professor, Departments of Pediatrics and Population Health, Medical College of

Wisconsin, 2004-present. Chief, Section of Emergency Medicine, Department of Pediatrics, 2000-present. Jon

E. Vice Chair in Pediatric Emergency Medicine, Children's Hospital of Wisconsin, 2000-present. Associate

Director, Children's Research Institute, 2007-present.

Society Memberships: Ambulatory Pediatric Association, American Academy of Pediatrics, American

College

of Emergency Physicians, Society for Academic Emergency Medicine, Society for Pediatric Research.

Leadership Positions: Member, Subboard of Pediatric Emergency Medicine, American Board of Pediatrics.

Editorial Boards: Ambulatory Pediatrics, Annals

of Emergency Medicine (consulting editor), Pediatric

Emergency Care. Member, Executive Committee, Section

of Emergency Medicine, American Academy of

Pediatrics. Member, Steering Committee, Pediatric Emergency Care Applied Research Network.

Research

Interests: Short-term outcomes of acute care (especially for asthma); clinical effectiveness

(especially development

of clinical prediction rules, evaluation and management of acute gastroenteritis);

environmental health.

Epidemiology Teaching Experience: University of Pennsylvania: Course developer and director, Advanced

Topics

in Clinical Epidemiology (elective course for Master of Science in Clinical Epidemiology Program);

taught in Critical Appraisal workshop for MSCE students. Jefferson Medical College: developed and taught

course in Evidence-Based Medicine for senior pediatric residents. Medical College

of Wisconsin: Annual

Introduction to Research Design seminar for pediatric fellows; taught

in Protocol Development course for

MCW fellows and junior faculty

Epidemiology Research Experience: Over 50 peer-reviewed original research publications in different areas

of clinical epidemiology, including case-control and cohort studies, controlled clinical trials, and meta-analyses.

Some representative publications include:

Gorelick MH, Shaw KN, Murphy KO. Validity and reliability of clinical signs in the diagnosis of dehydration

in children.

Pediatrics

1997;99(5):e6.

Gorelick MH, Shaw KN. Clinical decision rule to identify young febrile children at risk for UTI.

Archives of

Pediatrics and Adolescent Medicine 2000;154:386-390.

Electronic Filing - Received, Clerk's Office, August 4, 2008

Gorelick MH, Brousseau DC, Stevens MW. Validity and responsiveness of a brief asthma-specific quality

of life instrument in children with acute asthma.

Ann Asthma AI/erg Immuno/2004;

92:47-51.

Gorelick MH, Meurer J, Walsh-Kelly C, Brousseau DC, Cohn J, Kuhn E, Grabowski L, Kelly

Controlled

trial

of two emergency department-based follow-up interventions to improve asthma outcomes in children.

Pediatrics

2006;117:S127-S134.

Gorelick MH. Bias arising from missing data in predictive models.

J Clin Epidemio/2006;59:1115-23

Gorelick MH, Yen K. The kappa statistic was representative of empirically-observed inter-rater agreement

for physical findings.

J Clin Epidemio/2006;59:859-861.

Gorelick MH, Alessandrini EA, Cronan K, Shults

Revised Pediatric Emergency Assessment Tool

[RePEAT]: a severity index for pediatric emergency care.

Acad Emerg Med 2007;14;316-323.

Redman R, Nenn C, Eastwood 0, Gorelick MH. ED visits for diarrheal illness increased after release of

undertreated sewage.

Pediatrics

2007;120:e1472-1475.

Gorelick MH, Wagner 0, McLellan S. Validation of a questionnaire to evaluate water exposures in

children. E-PAS 2007:618407.21 [abstract; manuscript submitted for publication).

Current research activities include:

Epidemiology

of Diarrheal Illness in Children (funding from Children's Research Institute). Nested case-

control study

of approximately 1600 children to evaluate association between water exposures and diarrheal

illness.

Childhood Head Trauma: A Neuroimaging Decision Rule (funding from HRSA/Matemal and Child Health

Bureau). Multicenter, prospective cohort study to develop and validate a predictive model for intracranial injury

in children with mild blunt head trauma.

Symptom Duration In Infants Evaluated In The Emergency Department With First-Time Bronchiolitis (funding

from

MCW Clinical and Translational Science Institute). Prospective cohort study to define the natural history

of acute bronchiolitis in infants.

Electronic Filing - Received, Clerk's Office, August 4, 2008

EXHIBIT 3

Electronic Filing - Received, Clerk's Office, August 4, 2008

•••••••••••••••••••••••••

279

I-

VV\NTP

II WQ rronitoring station I

125

Mississippi River

Twin Cities, MN

(10)

North Shore,

North Branch Chicago

(3)

Urban Rivers Analysis: Comparison of Focus Areas

VV\NTP

effluent data and dow nstream WQ rronitoring stations

19,538 10,950

Chicago area watetways

Little Calumet.

Cal-Sag Channel

(2)

8,231

2000

1500

E..J

-::l

C.)~

1000

caLL

500

illinois Water Quality Standards:

,~j~\~~D sr-1~<l'

Note: WVVTP results - effluent; wa station results - ambient

••••••

General Use

SS%

• Fecal coliform monitoring results are expressed in the

number of colony forming units (CFU) per 100mL

Fecal coliform:

• Samples were taken monthly, May-October

30 day geometric mean 200 per 100mL limit

~(PRcftt.~

(#) - Distance downstream of monitoring station from WVVTP

Electronic Filing - Received, Clerk's Office, August 4, 2008

North Shore Channel and North Branch Chicago River

Ambient May to October 2002 Geometric Mean Fecal

Coliform

Northside =19,538

12,000

10000

...J

8,000 I

::: C)

6,000 I

-..

n;~

uu-

:. 0 4,000 I

2000 I

Central Dempster Oakton

Source: MWRDGC

General Use 30 day aeorretric rrean 200 oer 100ni. Iirrit

Touhy

0.75

Foster

Wilson

Diversey

Grand

3.25

4.2

6.75

10.5

Sampled Monthly

# -

Distance downstream of monitoring station from WlNTP

Electronic Filing - Received, Clerk's Office, August 4, 2008

Little Calumet River and Cal-8ag River

May to October 2002 Geometric Mean Fecal Coliform

Calumet =8,231

2,000 I

T-------------------------,

...•••..............•..••••••...•••..••...

1,500

E..,J

'I-

o E

:=0

1,000

~LL

CDO

500

Indiana

Halsted

1.3

Ashland

2.3

Cicero

6.3

Route 83

17.2

Source: MWRDGC

•••.••.•••.••

General Use 30 day geometric mean 200 per 100mL limit

Sampled Monthly

# - Distance downstream of monitoring station from WWTP

Electronic Filing - Received, Clerk's Office, August 4, 2008

• MWRDGC sample

locatio

MWRDGC monitoring

points

- 63 sample locations

\.,,-~

"'-'

.......

Source: MWRDGC

Electronic Filing - Received, Clerk's Office, August 4, 2008

....

E..Jg

o E

=o~

CJ~a

-::::)a

caLLa

(I)

Northside WRP Effluent May to October 2002

Geometric Mean Fecal Coliform

May

June

July

Aug.

Sept.

Oct.

Source: MWRDGC

Electronic Filing - Received, Clerk's Office, August 4, 2008

Northside WRP Effluent

Fecal Coliform May to October 2002

140,000

120,000

ilOO,OOO

000

(,)~

- 5

60,000

CUU.

40,000

20,000

•I I

I I

~~~~

~:~

~'V

(\.~

~'V

w'V

~C),

'\'\

c8-~

~C);

c:8-~

c:8-

~t;§

~~rv

Source: MvVRDGC. Sarmles collected weeki" .

Electronic Filing - Received, Clerk's Office, August 4, 2008

Calumet WRP Effluent May to October 2002

Geometric Mean Fecal Coliform

20,000 i

...J

15 000 I

'I-

-:::)

10,000

-+-1-------------,

~LL.

5,000 1

LL.

-+1-

tvlay

June

July

Aug.

Sept.

Oct.

Source: MWRDGC

Electronic Filing - Received, Clerk's Office, August 4, 2008

Calumet WRP Effluent

Fecal Coliform rv1av to October 2002

70000

-1-1-------------

60000

-+--1-.-------------

50000

-4-1------------

It-

g 40000

~------------1

CJ~

30000

-<-I--------j

LL 20000

-1-1--

10000

'+-1----

~ ~ ~ ~ ~ ~ ~ ~ ~

~ ~ ~

Source: rvlWROOC. Sarrples collected weekly.

Electronic Filing - Received, Clerk's Office, August 4, 2008