Incinerator facility-Planning 1967 appropriation estimate- $270,000 In 1967, funds of $270,000 are requested for the planning of a municipaltype incinerator plant rated at an approximate burning capacity of 12 tons per hour, to be sited on the NIH Reservation at Bethesda, Md. The total cost, including planning, is estimated at $3,540,000. (a) Incinerator plant.-This facility will consist of three incinerator units, each having a rated capacity of 4 tons per hour. The design of these units will provide for drying grates ahead of the combustion hearths to facilitate complete incineration of the NIH refuse mix. (b) Appurtenances.-Materials handling and storing facilities will provide for unloading of refuse from GI cans or Dempster Dumpster bins, washing facilities for cans or bins, and storage areas permitting segregation of wet and dry refuse. (c) Siting.-The site tentatively selected for the new facility is in the area west of building 14A. This facility is needed for the following reasons: 1. The existing incinerator facilities, even if operated at the maximum burning rate presently attainable (0.92 tons/hour for each of the two existing incinerators, or a combustion efficiency of 46 percent), will not be able to handle the NIH refuse load by the time buildings 35, 36, and 37 are completed in 1968. At that time the refuse load is expected to be 972 tons per month, while the existing plant can burn only 845 tons per month under the best operating conditions. 2. By 1975, the NIH refuse load is expected to be approximately 1,400 tons per month; nearly twice the capacity of the existing plant. 3. Consideration has been given to hauling a portion of NIH refuse off the NIH reservation for disposal. Discussions have been held with local authorities and they have reservations on accepting potentially infectious waste containing dead animals. Therefore, we believe that on-site disposal must be planned. (a) Continuation of major alterations to eliminate fire and 335,000 (b) Renovation of air conditioning system in building 21 80,000 2. Rocky Mountain Laboratory, Hamilton, Mont--- 85,000 OFFICE OF THE SURGEON GENERAL Facilities planning 1967 appropriation estimate____ $125,000 During the past 20 years the Congress has appropriated almost $300 million for construction of facilities for the Public Health Service. Most of this construction was designed to meet the immediate needs of a particular program with little consideration for total current or projected space requirements for other Service programs. Frequently the program lacked resources in the architectural and engineering skills essential to proper predesign planning, site evaluation, and administration of a construction program. Two steps are proposed for the purpose of bringing about more orderly planning for future construction needs as well as more effective and economical utilization of architectural and engineering resources of the Service: (1) A Division of Buildings and Facilities is proposed within the Office of the Surgeon General in which would be consolidated all facilities planning personnel except those at the National Institutes of Health, which already has a highly skilled staff that is responsive to its needs, and (2) the $125,000 requested in this estimate would be used for the purpose of contracting with a firm of architect-engineers to begin development of a master plan covering geographical locations and space requirements of all PHS programs. THURSDAY, FEBRUARY 10, 1966. INJURY CONTROL WITNESSES DR. PAUL V. JOLIET, CHIEF, DIVISION OF ACCIDENT PREVENTION DR. AARON W. CHRISTENSEN, DEPUTY CHIEF, BUREAU OF STATE SERVICES BACEL E. LONG, EXECUTIVE OFFICER, DIVISION OF ACCIDENT PREVENTION EUGENE L. LEHR, DEPUTY CHIEF, DIVISION OF ACCIDENT PREVENTION JOHN W. HAMBLETON, FINANCIAL MANAGEMENT OFFICER FOR DR. WILLIAM H. STEWART, SURGEON GENERAL JAMES B. CARDWELL, DEPARTMENT DEPUTY COMPTROLLER 1 Includes capital outlay as follows: 1965, $13,000; 1966, $24,000; 1967, $42,000. 2 Selected resources as of June 30 are as follows: Unpaid undelivered orders, 1964, $580,000; 1965, $395,000; 1966, $395,000; 1967, $395,000. Mr. FOGARTY. Go ahead, Dr. Joliet. GENERAL STATEMENT Dr. JOLIET. Thank you, Mr. Chairman. Mr. Chairman and members of the committee, we are most encouraged this year as we come before this committee to present our program and request for funds. This committee, several years ago, recognized the need for a stronger injury control program and has always sought increased appropriations for this purpose. Through this support the Public Health Service has been able to analyze the problem and develop a program that will lead to a substantial reduction in the number of deaths and the number and severity of injuries. I shall discuss that program. We are pleased and further encouraged this year by the strong support the President has given by approving an increase of 23 positions and $1.410,400 for this program in 1967. The President has also expressed his intention of reducing highways deaths and injuries by proposing a Highway Safety Act in 1966. We welcome this action by the President and we are ready to carry out with the best of our ability any new responsibilities that may be assigned to the Public Health Service under this act. Very briefly I would like to present the major elements of our program and our plans for 1967. GRANTS Our grants program supports private or independent research related to injury control; institutional based training to develop or improve research competence; and individual training in research through research fellowships. Research grants are a well-established well-recognized, and a growing aspect of our operations. As national interest increases, the scope of independent research can be expected to broaden and the search for injury control knowledge can be expected to become more penetrating. Research training and research fellowship grants are new activties for which funds were appropriated for the first time only last year. We expect their programs to expand rapidly in 1967 and have provided for their expansion. SURVEILLANCE In 1967 we will intensify our search for the real causes of injuries and ways to prevent them or lessen their severity. The central core of our epidemiology and surveillance programs will be a national network of epidemiology and surveillance teams. We hope to establish 9 or 10 teams in selected geographic areas to provide a representative view of the national injury problem and to identify injury causes. One team of investigators was established in Denver, Colo., in 1966. In 1967 we propose to establish one additional team and also intensify our efforts to learn how to control burn and fall injuries. Although the Denver team has been in operation only a few months they have identified for action the increasing problems of injuries associated with motocycles and the potential problem of increased use of truck campers. EXPERIMENTAL RESEARCH Most of our experimental research to date has been associated with motor vehicle injuries-particularly drivers and passengers. Over the past 4 or 5 years we have been able to develop some important devices for studying drivers. With the additional staff and funds provided in 1966 we have established a driver research center which we hope will eventually give some long-sought answers to questions as to how drivers contribute to highway accidents. In 1967 a major part of the increase will be directed to strengthening the capacity of this center and carrying out other studies on motor vehicle injuries. The increase in 1967 will also permit us to extend and expand our experimental research into nontraffic injuries. Particularly, we hope to explore more fully injuries that occur to children and old people. EMERGENCY MEDICAL SERVICES Our emergency medical services program is directed toward getting people with an acute condition the best possible care in the shortest possible time. This includes getting word to a properly equipped ambulance unit with well trained attendants, providing on-the-scene aid, and transporting victims to a place where they can get the necessary medical care. I know of no medical program that directly touches so many people, is so well known, and is so strongly endorsed, yet about which we have so little factual information on a national basis. The increase in this activity will be directed primarily to improving and extending surveys of existing programs and to conducting demonstrations of coordinated programs covering training, facilities and equipment, communication systems, and the organization and management of emergency medical services. POISON CONTROL In 1967 we hope to improve our poison control services by the staffing of a regional poison control center. The feasibility of such a center was studied in 1965. Experimental operation of a center is being carried out under a contract in 1966. The feasibility study and operational experience to date indicate a need for the direct assignment of a full-time staff to operate this center. The positions and funds requested would provide for this regional center and for a stronger edu cational program on poison control. COMMUNITY SERVICES The ultimate control of injuries will depend upon our ability to bring useful knowledge and to extend protective measures to the general pub lic. This we do primarily through established State and local agen cies, usually health agencies. The increase for this activity provide for additional education and training of States and local health work ers, the development of educational materials and aid, and for th assignment of additional injury control consultants to State health de partments to assist in the development of efficient health oriented in jury control programs. I have used no statistics in this statement. I believe these are a ready well known to most of this committee. For your use, howeve or for the record if you wish, I have here some statistics giving th essential data on the extent and nature of the injury problem. Mr. Chairman, I will be glad to answer any questions you or the oth committee members may have. (The statistics chart follows:) Major facts about accidental injuries and deaths It is estimated that the prevalence of physical impairments caused by inj in the noninstitutionalized population of the United States is over 11 mil |