Outdoor Air Quality Impacts at Hydraulic Fracturing (“Fracking”) Sites in Fort Worth

Natural gas production has been increasing in recent years across the United States, in part due to advances in drilling and extraction technology. One such technology, hydraulic fracturing—or “fracking”—is being extensively used in the Barnett Shale region in north central Texas, and more than 400 active natural gas production sites are located within the City of Fort Worth. To address concerns about air quality impacts, the City sponsored the Fort Worth Natural Gas Air Quality Study to characterize how natural gas production activities affect outdoor air quality and to evaluate whether the minimum setback provisions for these sites are adequately protective to nearby residents.



This presentation will review the main findings from this study, in which two approaches were taken to characterize air quality impacts. First, ambient air monitoring occurred at eight locations throughout the City over a 2-month period in late 2010, with one-in-three day sampling for nearly 140 pollutants. Second, emissions were measured at, or estimated for, nearly 400 different natural gas production and processing sites between 2010 and 2011. The emission rates were then entered into a dispersion model to estimate air quality impacts at locations where, and times when, ambient air monitoring did not occur.

The study identified three pollutants—benzene, formaldehyde, and acrolein—as being most important from a risk perspective, but did not find any significant health threats associated with air quality beyond the City’s setback distances. Several recommendations were provided for further study of outdoor air quality impacts and to reduce emissions from the gas production sites found throughout the City.

Legionnaire’s Disease Outbreak at a Long Term Care Facility: Environmental Health Considerations

In summer of 2011, Columbus Public Health (CPH) began investigating an outbreak of legionnaire’s disease that was linked to a long-term care facility. This lecture will describe the environmental assessment performed by Columbus Public Health at the facility and the obstacles that were encountered during the investigation.

Legionnella spp. has been typically associated with stagnant water from point sources such as cooling towers, but can also be cultured from potable water systems. As part of the environmental assessment, all water systems in the facility were evaluated for possibility of contamination. The potable water distribution system consisted of two boilers, mixing valves at each boiler, and essentially two distinct and independent loops. The potable water system was assessed for chlorine, pH, and temperature, and sampling was performed at the distill ends, boiler, mixing valve and selected rooms based on exposure by affected individuals. One hundred (100) mL samples were taken based on guidance from the Environmental Legionella Isolation Techniques Evaluation (ELITE) approved lab that was closest in proximity to the site. The Centers for Disease Control (CDC) was contacted for assistance with epidemiologic case studies and a follow up assessment.

Lab samples of the potable water system were shown to culture legionella at several points in the potable water system, thus implicating the water supply as the outbreak vehicle. Remediation efforts that took place included heating of the water system (according to ASHRAE guidelines), soaking of shower heads in bleach solution and follow up testing of the water system.

In closing, the management of legionnaire’s outbreaks in these types of settings are can stretch the resources of local public health and the long-term care facilities and this presentation is designed to educate attendees as to a local health department’s perspective and lessons learned.

Effective Strategies to Reduce Motor Vehicle Injuries in Native American Communities

Motor vehicle crashes are the leading cause of deaths in American Indian/Alaskan Native (AI/AN) communities. Research shows that the AI/AN motor vehicle (mv) fatality rates are one of the highest among other groups in the United States. In September 2004, the Centers for Disease Control (CDC) provided direct funding to AI/AN Tribes/Tribal Organizations for prevention of motor vehicle crash (mvc) injuries using evidence-based effective strategies. This presentation describes the efforts to increase the use of seat belts, child passenger safety seats and reducing drinking and driving.

“Why Don’t People Walk?!” – A Case Study of Active Travel at a Sustainable University

More and more people in the western world have a sedentary lifestyle that is likely to be damaging their health and active travel is a potential solution to this problem. This is because active travel involves activities like walking, running, or cycling for at least some of a person’s journey to work, school or play. It could also involve other modes of transport, however there still needs to be substantial part of the journey that requires physical activity.

This presentation is based on a case study in Nottingham Trent University (NTU) in the United Kingdom (UK); NTU is the #1 University in the UK’s University Green League. The work identifies the importance of understanding current behaviors, specifically those issues that act as barriers and those that can be harnessed as facilitators to change personal habits with the goal of achieving positive health, well-being and sustainability-focused outcomes.

The research is innovative as, in order to achieve the above outcomes, it combines the ‘Stages of Change’ model (Prochaska & DiClemente, 1986) with another respected theoretical models within the psychology of behavior change, namely the ‘Theory of Planned Behavior’ (Ajzen, 1991).  The key premise of the paper is that, having identified barriers and facilitators to lifestyle changes and embedded behavior that have significant health implications associated with them. Lessons learned can then be drawn upon to increase the effectiveness of specific well-being and sustainability initiatives for healthy communities.

This talk could be of interest to practitioners involved in initiatives that seek to change behavior through environmental health interventions in communities or in a wider sustainability context.

Cell Phone Usage: More, More, More or Less, Less, Less? [LEARNING LAB]

Recently, several studies evaluating the impact of cell phone usage on brain tumor and other health impacts have appeared in the literature. Some studies conclude long-term cell phone usage is a health risk and some conclude the opposite. Some studies evolve from large-scale international efforts to understand the health impact of cell-phone usage. Other studies are more independent, while additional studies review a combination of these studies. The purpose of this roundtable session is to look at each type of published study and assess health risk within the context of the experimental approach and risk factors. Given that different types of studies reach different conclusions regarding the risk of cell phones, what is the appropriate action to take? Who is at most risk from cell-phone usage? Are cordless phones more or less of a risk than cell phones? What action makes the most sense to reduce risk of brain tumors and brain cancer from cell phone usage? Are there any other potential health impacts posed by cell phones? This roundtable not only looks at the current epidemiological studies and reviews of cell phone usage but offers strategies to critically assess the evolving body of literature on the immediate and future risks posed by cell phone usage.

Arsenic in the U.S. Beverage Supply: A Curiosity or a Danger?

A flurry of studies originated by a broad range of people from researchers at universities to popular TV personalities like Dr. Oz have presented an often conflicting view of how much arsenic is found in what kinds of beverages at what risk to children. Arsenic, like lead, can have both development and neurological effects in young children, leading to substantial drops in IQ for consistent or chronic exposures. Arsenic can also cause multiple types of cancer, including that of the lungs and bladder, over long term exposures for both children and adults.

The purpose of this lecture is to review the past three years of experimental studies on arsenic in various beverages and to assess the health risk that arsenic in these beverages poses to various populations of American consumers, especially children. Children typically consume more fluid per body weight than adults and are particularly vulnerable to neurological damage from chronic arsenic exposure. While the EPA exposure limit for arsenic in drinking water is 10 parts per billion, no comparable exposure limit exists for juices, wines, sodas, or other beverages. In many cases, these beverages are consumed at levels approaching those of drinking water (especially by children). Families and communities lack a definitive guideline for how much of these contaminated beverages can be consumed before children run a substantial risk of chronic arsenic poisoning. Further, certain countries of origin, like China, have been implicated in contaminating the U.S. beverage supply. Is this a fair assessment, or does the problem extend well behind a particular country of origin? Given the types of beverages Americans drink on a daily basis, which groups of consumers, if any, are vulnerable to chronic arsenic poisoning?

This lecture session looks at the facts, side by side, for beverages ranging from drinking water to juices and to wines, and seeks to answer these questions, unpacking data from various studies to pull together a comprehensive conclusion and action plan to the problem of arsenic in consumer beverages.

Utilizing video editing software as a tool to educate and promote environmental health

Showing a video is a convenient way to communicate with people in a variety of settings. Videos can convey information in a clear and concise manor while at the same time display images that correspond with the dialogue. The process of making a video can be intimidating initially for those who have not taken advantage of video editing software. Fortunately, there are numerous free options on the internet that can guide an individual through the process of editing a video.

During the presentation, people will learn how to take the appropriate steps towards creating a usable video by utilizing video editing software and information found solely using the internet. Throughout the process participants will learn how identify the most viable footage, how to cut and manipulate footage during the editing process to create a proper sequence, add in audio and graphics, create titles and speed changes, as well as properly exporting the video so it can be displayed on various media sources. Participants will also learn how to upload a video to websites such as youtube and facebook and the benefits to having such material on social networking websites.

Preventing Illness and Mitigating Climate Change through Clean Construction Policies and other Simple Diesel Pollution Reduction Measures

Many of the issues we work on require complicated and time-consuming approaches, but a solution to one significant health and climate problem is fairly simple. Particulate diesel soot (PM) has been linked to diabetes, stroke, heart attack, cancer and over 21,000 premature deaths in the U.S. annually. As a warming pollutant, the black carbon component (BC) is about 2000 times more potent than CO2. However, we can virtually eliminate this threat with diesel particulate filters (DPFs) that remove over 90% of PM and BC from exhaust, immediately reducing a serious health threat and a potent source of global warming pollution. Filters are required on new vehicles but old dirty diesel engines are not being replaced quickly enough and must be cleaned-up.

• Unregulated prior to 1996, pollution from construction equipment is of special concern because the durability of diesel engines means much construction equipment in use today lack modern PM pollution controls. Adopting Clean Construction practices can protect patients, staff and community members from exposure on site, encourage financial support, and be leveraged for clean air benefits elsewhere. The Diesel Clean-Up Campaign, coordinated by Brooke Suter of the Clean Air Task Force, works on the local, state and national levels.

Endorsed by over 500 organizations across the country, the campaign has a presence in all 50 states and the District of Columbia providing a robust network to leverage any action into more clean air benefits. In addition to legislative initiatives such the introduction of the bi-partisan Clean Construction Act of 2011 in both houses of Congress, the campaign is also providing “Clean Construction” and “Climate” Tool Kits to those interested in taking action locally.

The role of The Federal Emergency Management Agency (FEMA) in post-disaster financial assistance for local governments facing budgetary constraints in Eastern North Carolina

Natural disasters such as hurricanes increase mosquito abundance as large amounts of rainfall, flooding, and standing water provide mosquito oviposition sites and facilitate population growth. Many mosquito species associated with flooding in North Carolina can potentially transmit pathogens such as West Nile virus and Eastern equine encephalitis virus. Hurricane Irene impacted Eastern North Carolina from August 26 until August 28, 2011 and resulted in drastic increases in mosquito abundance. In the past, many regions in NC received state financial support for arbovirus surveillance and mosquito control. Recent federal and state budget cuts have resulted in reductions in mosquito programs across North Carolina.

Consequently, many North Carolina counties now rely solely on funding from The Federal Emergency Management Agency (FEMA) for mosquito control following disasters such as Hurricane Irene that devastated Eastern North Carolina. This emergency funding is critical for short-term suppression of potential vector populations; however, funding is also needed to support continuous arbovirus surveillance for regional programs. In the current study, we examine the role of FEMA in mosquito control for local governments facing budgetary constraints. We discuss the extent to which federal funding has impacted mosquito control and arbovirus surveillance in eastern NC. Implications of reliance on reactive post-disaster assistance rather than preventive strategies will also be discussed.

FDA Rapid Response Team Pilot Project: Improving Food Emergency Response Capabilities

CDC estimates published in 2011better define the burden of foodborne disease in the United States. Roughly 1 in 6 Americans (or 48 million people) get sick each year, 128,000 are hospitalized, and 3,000 die of foodborne diseases. Ongoing multi-state outbreaks and food/feed recalls provide powerful evidence that local, state, and federal agencies will be judged by their ability to mount a credible response to foodborne outbreaks and other food emergencies.

Multiple initiatives have been launched to help agencies improve outbreak response team capabilities. Examples include the Guidelines for Foodborne Disease Outbreak Response by the Council to Improve Foodborne Outbreak Response (CIFOR), National Voluntary Retail Food Program Standards, National Environmental Health association’s Epi-Ready Training Program, and the U.S. Food and Drug administration’s (FDA) Rapid Response Team (RRT) Pilot Project.

This presentation highlights some of the resources developed by the RRT Pilot Project that environmental health professionals can use to improve the efficiency and effectiveness of their agency’s foodborne illness response team. The RRT Pilot Project is a series of multi-year cooperative agreements between FDA and nine states: California, Florida, Massachusetts, Michigan, Minnesota, North Carolina, Texas, Virginia, and Washington. The RRTs completed a nationally reviewed, seven-chapter manual of best practices in 2011. The manual shares concepts and tools that the RRTs found to be key to effective food/feed emergency responses. Chapter topics include multiagency coordination, training programs, multi-agency inspections, communication, food emergency response planning, traceback investigations, and the use of Incident Command System (ICS) concepts. Finally, this presentation will explore strategies that agencies can use for long-term sustainability of food emergency response capabilities during tight budget times.

Environmental Health Leadership and Leadership Deficits in the Crisis Economy

Leadership is the act of leading a group of people toward a common vision. It sounds simple enough, but is extremely challenging to manifest and implement. Are you waiting for things to return to normal in your organization? Sorry! Leadership in this new millennium will require new skills tailored to an environment of urgency, high stakes, and uncertainty. This presentation addresses characteristics of successful leaders, attributes and principles of effective leadership, and critical new skill sets that today’s leaders must develop and implement to achieve true success. The environmental health profession is both diverse and dynamic, and its leaders must vigorously excel in the management of innovation and change in a crisis economy. Our workplaces have an abundance of managers and administrators, but leadership deficits are endemic across the profession and the nation, and the successful leader must resolve to lead and not merely manage. Many organizations are well managed and poorly led as executives address routine, status quo issues while ignoring or not even recognizing rapidly emerging critical matters. They allow themselves to become buried with details, focus on trivia and “office politics,” and march firmly into the past. Today’s successful leader must encourage dissent, disagreement and truth from associates and search for self-truth by spending time in the field, analyzing their own operations, and speaking truthfully with both employees and customers. Today’s leaders must balance career and personal roles, and use vision, ambition, talent and learning ability to serve rather than enslave. They must embrace flexibility, self-awareness and self-direction. As constant as change has been for decades, and as vital as it is today, it’s still difficult to bring about. People in leadership positions must be agents of adjustment, who face things as they are and prepare for things as they will be. If competence, conscience and innovation are to be restored to government, business and society alike, that restoration must start with those who propose lead our organizations. It will require new and innovative skills to foster adaptation, embrace disequilibrium and generate leadership in all levels of the organization — and it must begin with you.

Phosphorous Loadings to Streams in Residential Watersheds Using On-site Wastewater Systems in Comparison to Centralized Sewer

It is well documented that excessive nutrients can degrade ground and surface water quality. Phosphorus is a limiting nutrient in algae growth under certain circumstances, which can lead to fish kills and environmental problems (Fear et al. 2004). Waste water is a major source of nutrients in residential ground and surface waters. This study attempts to compare the nutrient loads to groundwater from two similar watersheds, one which uses on-site waste water treatment systems (OWTS), or septic systems, and another which uses a municipal sewer system. Physical characteristics such as rainfall, flow volume, soil types; and chemical parameters such as pH and nutrient and ion concentrations will be monitored strategically to gain understanding of what effects each system has on the local water quality. Surface water will be compared among the different watersheds to distinguish what differences can be expected among two different land uses, and compared to the effluent of municipal wastewater treatment plant.  Soil borings will capture characteristics of soils such as phosphorus and mineral content at each site. The overall goal is to better understand mechanisms and variances in nutrient loads to surface waters among sites using OWTS and municipal sewer in the context of Pitt County, NC, with a focus on phosphorus. As bulk this paper should add to the aggregate of evidence showing human interaction with the natural environment can have discreet measurable and sometimes acutely negative effects.

The Health Impact as a Result of Abandoned Properties, illegal Dumping and Environmental Dilapidation in Urban Areas

The article pertains to a brief analysis on abandoned properties, illegal dumping and environmental dilapidation due in part to high rates of home foreclosures and decline in infrastructure. These factors have enormously contributed challenges to local Public Health Departments for many reasons.Dilapidated environments, in most cases are excellent habitats for vector borne disease animals like insects, raccoons etc.From an economic standpoint, dilapidated environments may drive away businesses from the area, creating higher unemployment rates and a sense of hopelessness and a lower quality of life for those living in the area.These areas also attract and provide shelter to people who may engage in illegal activities from drug dealing to violent crime.The absence of health care facilities, recreation centers, and grocery stores in these areas are associated with the state of environment, and those living in the area often suffer from higher rate of diseases such as diabetes, heart disease and other cardio vascular diseases related to high blood pressure and obesity.

Evaluation of a CBRN Response Program at a Tier I Medical Treatment Facility [POSTER]

Introduction: As the nation’s disaster management capabilities evolve, civilian and military emergency management and medical interoperability is critical for development of a successful response and consequence management plan. The U.S. military has a history of training for and managing healthcare needs in complex and unpredictable environments, such as Chemical, Biological, Radiological or Nuclear (CBRN) incident response, while civilian medical response capabilities during these scenarios vary drastically from community to community. Integration of military and civilian medical resources and response capabilities is important, and has been achieved in some regions, but capabilities, resources, and programs vary. Purpose: The purpose of this poster is to provide an example of a comprehensive guidance for medical contingency response to CBRN threat at a Tier 1 Medical Treatment Facility (MTF), based on the military model.

Methods: A model is provided for an effective response, providing thorough guidance on the employment of the Decontamination Incident Response Team (DIRT) to secure the MTF and protect the hospital staff members and patients from exposure to potentially life-threatening chemical, biological, or radiological contaminants. Described is the DIRT team’s responsibilities in developing, conducting, and managing warm-zone operations to prevent the spread of contamination by victims/patients in need of medical attention prior to entering the MTF. The seven categories of the warm-zone operations plan are dissected, and each category, including but not limited to agent detection, decontamination, and triage, is detailed with regard to how it affects the response actions and decision-making process. Roles and responsibilities of response team members are also discussed.

Conclusion: Providing a thorough glimpse of an effective military hospital-based program, this poster may be used as a reference to guide environmental health professionals involved in CBRN emergency response development, planning, or program improvement in similar military or civilian healthcare institutions.

Innovative solid waste permitting, organics diversion, and sustainability in the Napa Valley

Innovative solid waste permitting, organics diversion, and sustainability in the Napa Valley. Greg Pirie, REHS, Solid Waste Program Manager, Napa County Executive Office. 1195 Third Street, Room 310, CA 94559. Innovative trends in permitting composting and landfill facilities and incorporating multiple waste diversion programs have transformed the regulatory structure and solid waste facility operations for the Napa Valley in many positive ways to encourage waste diversion and increase organic sustainability.In the process of reviewing multiple compost facility plan applications, facility inspections, assisting operators in applying the regulatory planning process, and promoting organics diversion in solid waste and recycling franchise agreements, there are many areas of regulatory development that could be designed and changed to benefit the facility operator, regulator, garbage and recycling haulers, and agricultural farmer. You will learn about all of these factors and will be presented in a way to know how, as they all work together, to promote that all agencies and jurisdictions can have success from facility permitting to organics diversion in the Napa Valley wine region in California.


Problems have included updating historic solid waste franchise agreements with a focus on diversion, mandated diversion regulations, problem solve to identify appropriate facility permitting options, facility siting, and limiting the cost of to the public for garbage and recycling service.

The successful methodology and results is measured in approved and well applied facility permits, high diversion rates, low cost to the public for curbside garbage and recycling service, reuse of compost materials by large agriculture operations. Over 15,000 tons of used grape waste recycled and composted annually and then received back to the source as a soil amendment. The presentation will also include a high volume aerated static pile grape composting facility, aerated/in vessel food waste composting facility, landfill construction and demolition diversion, garbage and recycling franchise language to promote food composting.

We conclude that the “innovative” success that the Napa Valley has experienced, including all aspects of organic sustainability, can be duplicated in other jurisdiction. This presentation will assist you in how to also accomplish success.

Environmental Health, Sustainability, and Land Use Planning - A Perfect Trifecta

Come catch a vision of how Environmental Health, Land Use Planning and Sustainability are integrally related.  Learn how a local Environmental Health Division played a significant part in working with Planning Department staff to assure that the local comprehensive land use planning update (LPlan 2040) would have a stronger sustainability focus than in the past.  Environmental Public Health staff were actively involved in the process, including:

1. Presenting to the Planning Advisory Committee on the relationship between land use planning and public health, with emphasis on air quality, hazardous materials, sustainability, multi-modal transportation, and designing our community to increase physical activity.
2. Presenting at a Sustainability Town Hall, highlighting how the LPLAN 2040 land use plan would influence Energy & the Environment, Public Health & Safety, Air Quality and Greenhouse Gas Emissions, and Social Connectedness.  These are the key elements of a sustainable community. 

The process to create LPlan 2040 was guided by a citizen advisory committee consisting of members from the City-County Planning Commission and other community representatives. Health staff invited Planning staff to present to the Board of Health on several occasions to educate our Board on the interconnectedness between health and land use planning and sustainability.

Health Department Air Quality staff worked with the Metropolitan Planning Organization (MPO) Technical Committee on the transportation plan.  As planners determined what the future transportation network could look like, EPA's latest computer modeling software called MOVES (Motor Vehicle Emission Simulator) was used to determine potential air quality impacts.  This model estimated what the emissions of hydrocarbons (VOCs), nitrogen oxides (NOx), carbon monoxide (CO), and particulate matter (PM) as well as greenhouse gases based on the planned future transportation network.

The result was a comprehensive land use plan (LPlan 2040), which clearly described the impacts that land use has on environmental and public health, and how they impact the  sustainability of our community.

Collaborative Project serving as one voice to answer emerging issues in food safety

The intent of this project was to bring positive change and address the Centers for Disease Control’s 10 Essential Public Health Services. It is important for food safety regulators, businesses, farmers, academia and the public to have a better understanding of the regulatory requirements in growing and offering their fresh, locally grown foods. There are a variety of state constitutional exemptions, rules and regulations related to selling and serving food. The interpretation and dissemination of the exemptions varied widely throughout the State. This led to stakeholder confusion. To address this concern, a collaborative work group from regulatory agencies and academia developed food safety factsheets addressing common frequently asked questions and provided clarification. The factsheets serve as one voice to establish a more effective food protection model that achieves compliance through partnership, collaboration, training and enforcement by utilizing the strengths and resources of local farmers, vendors, market managers, restaurateurs, regulators, educators and community stakeholders.

The outreach addressed individual experiences with buying/selling as well as dispelling misconceptions regarding state and local rules and regulations. The result was teaming together in the development, writing, editing and dissemination of user-friendly topic specific factsheets. These factsheets address commonly asked questions regarding federal and state statutes, rules, regulations and policies. By proving one unified voice, we help support and improve the health of the public in eating or purchasing safe, fresh, locally grown foods.

Topics included:

1. Serving Locally Grown Foods in Food Facilities, June 2010
2. Existing Food Facilities Planning to Can Fresh Foods for Sale or Service, June 2010
3. Existing Food Facilities Planning to Freeze, Dry or Otherwise Preserve Fresh Foods for Sale or Service, June 2010
4. Harvesting and Selling Wild Mushrooms in Minnesota, June 2010
5. Hand Sanitizers: Not a Replacement for Hand Washing in Food Service Settings, June 2010.

These fact sheets can be found at:
http://www.mda.state.mn.us/en/food/safety/food-safety-resources.aspx

ECOLOGICAL WASTEWATER TREATMENT AND REUSE: THE DECENTRALIZED MODEL

Today's centralized model of wastewater treatment is expensive, energy intensive, complex, wasteful, and damaging to the nation’s freshwater, estuarine and marine ecosystems. Conversely, there are new innovative decentralized approaches to wastewater management that are energy efficient, cost effective and protective of the environment. The decentralized model also provides greater opportunities for water conservation and water reuse, thereby providing viable solutions to increasing water shortages. Critics of decentralized treatment and reuse argue that public health may not be adequately protected with distributed systems. Many decentralized treatment and reuse projects have relied on membrane bioreactors (MBRs), advanced treatment systems that provide excellent treatment performance but at very high energy and operations costs. Recently advanced wetland treatment systems have been used as energy efficient and cost effective treatment technology for water reuse in urban and rural locations. These systems provide performance equivalent to MBRs, with much lower capital and operating costs. Tidal-flow wetlands are modular energy-efficient advanced wetland treatment systems that utilize plants, microbial fixed-film ecosystems and innovative fill-and-drain "tidal cycling" to enhance aerobic and anoxic treatment processes. The ill-and-drain process allows the wetland footprint to be radically reduced, making these systems suitable for urban locations and larger flow rates. This presentation will provide in-depth information on the design, operation, and performance of recent advanced wetland treatment systems for reuse. Case studies will be presented from a Marine Corps base in San Diego, a school system in North Carolina, the headquarters facility of the Port of Portland at PDX, a pineapple plantation for Dole Foods in Hawaii, a CAFO pilot study in California, and the new headquarters for the San Francisco Public Utilities Commission in downtown San Francisco. Case studies cover a spectrum of wastewater concentrations and a number of water reuse applications, including irrigation, toilet flushing, and cooling tower make-up. Third-party performance data, including a recent CDC analysis of one of the case study sites, is used to address questions regarding public health of decentralized treatment and reuse. Regulatory challenges and solutions to achieving safe and cost effective reuse will be discussed.

Drug Residues in Milk and Milk Products Risk Assessment

Over the years, concern has been raised over the possibility of drug residues in dairy foods, such as fluid milk. The requirement to test milk and milk products for drug residues, is limited to only the Beta lactam drugs and has not changed over the past twenty years. For this reason, the National Conference on Interstate Milk Shipments (NCIMS) Drug Residue Committee has requested that FDA perform a risk assessment on potential drug residues in milk and milk products produced in the United States to re-evaluate the National Drug Residue Milk Monitoring Program. This symposium will describe the potential drug residue problem in milk and milk products and the approach utilized in analyzing this issue. The Drug Residues in Milk Risk Assessment Work Group consists of scientific and dairy experts from FDA, Center for Food Safety and Applied Nutrition (CFSAN) and Center for Veterinary Medicine (CVM) working together to develop a risk assessment on drug residues in raw milk and milk products.

EPH & Priority Based Budgeting - This Happened to Me!

As a kid growing up in Montana, one of my favorite things was reading my Dad’s Outdoor Life Magazine's "This Happened to Me!" feature. These amazing, graphic stories showed how preparation, ingenuity, and sometimes plain old luck, allowed people who were faced with life threatening situations in the wild survive. In today’s wild world of budget cuts and priority based budgeting, Environmental Health needs to be prepared to quickly respond not just to the threats, but the opportunities presented by these difficult times. It is my firm belief that EH can do more than survive, but can thrive. Come to this presentation and hear the real-life stories of those who have come up with some basic strategies, tools, and ways to present outcomes that make a difference to policy makers that make budget decisions. Leave this presentation with a new-found hope, that with some preparation, ingenuity, and maybe a little luck, you too can make the most of every dollar and not fear every budget cycle.

The Use of Smart Mobile Devices and Apps for Environmental and Occupational Health Surveys

Among the most important tools available to environmental professionals are those capable of on-site detection of physical, chemical, or biological agents, providing near real-time measurements when rapid results are needed. While there is no single portable “black box” that can be used to measure all hazards in all environments, industry is making significant strides in developing field-portable analytical equipment specifically for this purpose.

Nonetheless, there are tools that were not created for environmental health survey purposes that can potentially be beneficial. It was proposed that the advancement of smart phones, think pads, and their supporting software affords the potential move towards mobile analytical environmental health assessment devices. Available applications (apps) were assessed for their potential for inclusion into a mobile environmental and occupational health survey suite.

Numerous apps were identified to be tremendously useful for quick reference to regulations and standards, occupational exposure limit values, and EHS assessment forms. Additionally, mobile-device based sound level meters and light meters developed for photography, music studio work, and other purposes were evaluated for industrial hygiene (IH) use against commercially available IH instruments. Noise and light data were collected via both methods and analyzed for linearity, correlation, and agreement. In most cases, there was no significant difference observed between the mobile-based applications and the gold standard methods. In summary, currently available mobile device apps can be packaged into a mobile EHS suite and used, at the very least, for rapid on-site assessment prior to complete environmental or IH evaluation.

Implication of e-waste trafficking on human health

Global embryonic rise in e-waste and its disposal practices is becoming a severe cause of concern for human health, so is for the ecosystem health. With the rise of disquiet on e-waste management and disposals, there are also efforts to hold back this concern by various tools of regulatory instrument. A large part of the regulatory initiatives are focused on unlawful trafficking and improper handling of e-wastes. Center of attention in recent studies are primarily focused on linkages of improper handling and health effects on workers in different nations. Quite a few studies reported lead level in children’s blood, dechlorane in house dust and PBBs, PBDEs and PCBs in human hair in China. Before these issues can turn into global tragedy there is need to re-review the facts from recent research studies and design appropriate measures. An across-the-board review of available research study is necessary to offer course for a sustainable strategy to deal with global trafficking of e-wastes.

Scores and More: Can you be sued for giving a restaurant a good grade?

The City of Sunnyvale was rocked when news broke that patrons of the Greasy Spoon had become ill with E. coli infections. Despite its name, the restaurant had the reputation of having the cleanest kitchen in town and had received an A+ on its most recent inspection, which was posted on the City’s Website just days before the outbreak. In fact, Sunnyvale Environmental Health regularly held its annual End of the Year party at the Greasy Spoon because of its stellar reputation. The outbreak investigation took weeks to conduct, but the Sunnyvale Health Department and Sunnyvale Environmental Health final outbreak report pointed to cross-contamination between raw ground beef and fresh (irradiated) mango in the restaurant kitchen. Hours after the report was issued, Greasy Spoon owners, management, and staff appeared on local television to apologize for the outbreak and express their concern for victims. Meanwhile, Sunnyvale Environmental Health was served with a lawsuit filed by a plaintiff whose 3-year-old son had been hospitalized for 3 weeks with HUS. In an interview with a local TV station, the plaintiff explained that he was suing Sunnyvale Environmental Health rather than the meat producer or the Greasy Spoon because he had relied on the City’s posted restaurant inspection what he was led to believe was a safe place to take his son to dinner. He claimed he never ate anywhere that had received less than an A+ on an inspection and that the health department’s failure to prevent cross-contamination at the restaurant led to his son’s illness.

Sunnyvale Environmental Health’s restaurant inspectors were left scratching their heads. Did giving the Greasy Spoon a perfect score just days before the cross-contamination happened constitute a failure of some sort that left the City open to lawsuits? Food safety attorney Bill Marler will address this question and more.

Food Safety Allergen Training for Food Service Employees

Early in 2011 the Minnesota Food Code Rule Revision Committee voted overwhelmingly to adopt the Food and Drug Administration food allergen recommendations. The committee agreed to adopt language regarding training:

"Employees are properly trained in food safety, including food allergy awareness, as it relates to their assigned duties."

The Food Allergen Subcommittee encouraged Minnesota Department of Agriculture, Minnesota Department of Health, and the University of Minnesota, to develop training to address food allergen issues. Taking a proactive approach, our team decided to develop an online food allergen training course. We worked in consultation with an advisory group representing industry, regulatory, academia, and food service employees.

The course is approximately one hour in length and provides interactive activities, real life situations, decision making and application of concepts. By the end of the course, learners will be able to make informed decisions and provide safe food to the people they serve.

Healthy Homes Programs and Effective Public Health Governance

Local healthy housing programs, which are typically supported and approved by boards of health, have been the driving force in the rise of the healthy homes movement.

This presentation will provide information about local public health governance and the roles and responsibilities of boards of health, strategies for including healthy homes principles into board policies and nuisance law regulations, and information on how boards of health can advocate for healthy homes issues.

Confronting climate change health risks in the Pacific Northwest

Climate change has serious consequences for public health, with effects varying among communities. University of Washington researchers are investigating the impact of climate change on health in three Pacific Northwest counties. One research team is using quantitative risk analysis to forecast the health impacts of increasing heat events and worsening air pollution in those communities. A second research team is collecting information about community attitudes, needs and resources related to climate change. The findings of both study components are then used to work with the local health departments in developing communication strategies and credible messages that effectively engage their communities (policy makers and the public) in actions to address the health effects of climate change. Local health departments are active partners in shaping the research, and the specificity of the research findings enables public health officials to identify the most vulnerable populations and make evidence-based decisions about programs and policies. Using this research, local health departments may opt to focus on reducing the factors that contribute to climate change (mitigation), on reducing the severity of health impacts (adaptation), or a combination of the two.

Toolbox Approach of Source Tracking Human Sewage in Storm Drains

Public health departments are required by regulatory agencies to assess the concentrations of fecal indicator bacteria (FIB) such as Escherichia coli in the recreational waters as a means of determining relative risk for infection by sewage borne pathogens. However, the presence of E. coli in the environment does not discriminate between human and non human (birds and animal) feces, both of which may contain E. coli. County of Ottawa Health Department regularly monitors their watersheds for E. coli levels. Previous and recent monitoring at Dunton Park, Lake Macatawa exhibited high E. coli levels exceeding the state-allowed levels and often times beach closures. This high E. coli level remains a critical problem and puzzle in this watershed. Several storm drains and creeks open into the surroundings of Dunton Park area containing unknown discharges. Environmental Health Managers are in need of effective, easy, and low-cost methods to identify and pinpoint sources of human fecal contamination in storm drains and other sources that discharge into nearby water bodies. The microbiological quality of Dunton Park was evaluated and source tracked for human sewage using a toolbox approach, which combined 1) Canine scent tracking or human sewage-sniffing dogs, 2) Assessment of traditional FIB and 3) DNA based finger printing for human specific markers. The objective of this study was to deploy the sewage-sniffing dogs for source tracking human sewage in several storm drains, catch basin and creeks along the circumference of Dunton Park.

Water samples were collected and tested for traditional FIB and subjected to DNA fingerprinting based on positive signals obtained by sewage-sniffing dogs. The results of these three methods were correlated to provide weight of evidence data. This biological toolbox approach is helpful for providing significant information about the sewage sources in storm drains for implementing better management practices, thereby protecting environment and human health. This project is funded under Clean Michigan Initiative.

Determination of School Site Radon Potential in Los Angeles County, California

Select communities in Los Angeles County, California that are located on uranium-rich subunits of the Miocene Monterey Formation have been found to exhibit significant indoor radon levels. Since uranium is the source of radon gas, other areas underlain by related sediments may also contain high-risk neighborhoods that may be overlooked due to a lack of data or inaccurate extrapolations. Because radon is a serious health hazard that accounts for approximately 21,000 cancer deaths each year, identification of specific radon-prone neighborhoods and school sites can help to reduce student exposure to this known carcinogen. Current methods for identifying radon-prone areas include the use of indoor radon measurements, geological subunit composition, and aerial radiometric data collected for the National Uranium Resource Evaluation (NURE) Program during the early 1970s. Unfortunately, due to air space restrictions, many densely populated areas where radiometric measurements would be the most beneficial were not surveyed by the NURE effort. The present study suggests that site-specific gamma-ray spectrometry measurements that directly measure surface uranium concentrations can be an accurate and cost-efficient method for assessing the radon potential of specific school sites on the Monterey Formation. Furthermore, comparisons with reference school districts with both classroom radon data and school site uranium measurements can be used to generate more precise risk assessments for the targeted schools.

The Role of Rapid Cycle Improvement in addressing recurrent critical violations in restaurants

Through a grant from The Ohio Voluntary Accreditation Team (OVAT)The Food Protection Program staff assessed the strengths and weaknesses of the food inspection program. A weakness identified during the assessment was re-inspection time spent by the sanitarian in restaurants due to reoccurring critical violations. CCBH staff was spending just under 1,800 hours conducting re-inspections of food services with re-occurring CDC risk factor critical violations. Though re-inspections are a routine part of the food safety inspection program, this amount of time seemed excessive. A continuous quality improvement team was assembled and this issue was discussed with possible solutions to be measured. A Pareto chart was created to assess which facilities in the CCBH jurisdiction were taking the most time to inspect. The inspection reports showed that recurring critical risk factor violations were being documented during the re-inspections, but were not improving. This seemed to be a weakness in the program because there was no written protocol that would assist sanitarians in decreasing recurring violations. The rapid cycle improvement tool was chosen because we could conduct a pilot study to a limited amount of facilities and track results that can be analyzed within a short period of time. The rapid turnover of interventions and testing would give CCBH results to see what intervention would affect recurrent critical violations in restaurants.

The Fight Against Bed Bugs [POSTER]

A study was conducted to consider whether the knowledge base of East Carolina University students would be sufficient to provide identification and proper control of bud bugs, or if a more formal educational curriculum should be established to better protect the area, staff, and students from a potential infestation. The survey was completed voluntarily by 1837 students. Despite widespread media coverage of bed bugs in major department stores, homes and institutions in 2010, the study showed that students have a limited scope of bed bug knowledge. Approximately 40% of respondents believed that a bed bug would be the size of a dime, and over 60% considered that in the event of an infestation they would choose to use a bug “bomb” every night until the issue subsided. The study has shown that students lack knowledge in the identification, prevention, and mitigation techniques that would be used in defending the campus against future bed bug infestations. A formal educational approach for incoming students may provide a more adequately prepared East Carolina University population against the rise of bed bugs in the area.

Aquifer susceptibility and GIS: Illustrating the need for scrutiny and localized reconnaissance work.

The city of Cedar Falls, Iowa and the University of Northern Iowa rely heavily on a highly productive carbonate bedrock aquifer underlying this portion of the state as a municipal water supply and a source of once through cooling-water, respectively. This high quality groundwater resource is also tapped by local residents, businesses, and other entities for private drinking water and an ever-growing number of geothermal installations.

Detailed hydrogeological and historical work recently completed in this area used geographic information system (GIS) software to reveal, analyze, and illustrate some significant findings regarding aquifer susceptibility, source water protection, groundwater contaminant sources, and past hydrogeological misconceptions about the area. This presentation will highlight how GIS was combined with a simple mix of primary and secondary data to uncover and illustrate a much more representative picture of this aquifer’s characteristics and vulnerability to surface contamination. Findings show that more focused, detailed efforts are needed to accurately characterize local hydrogeological conditions and provide more reliable data needed for source water protection, planning and zoning decision making, municipal well siting, and watershed restoration efforts.

Vector Control for Public Health in North Carolina

In the 1970s the North Carolina Department of Environment and Natural Resources (NCDENR) formed the NC Public Health Pest Management (NCPHPM) division to assist community vector control programs. The NCPHPM in its leadership role has been actively involved in training and support for vector control programs across NC. However, NCPHPM was disbanded in July 2011 due to state budget cuts. Many local agencies that rely on state funds to carry out their vector control programs may also experience budget cutbacks. The impact of these budget shortfalls on services provided by vector control programs is still largely unknown. The objectives of this study are to: 1) assess the current status of vector control programs in NC, 2) evaluate the extent to which the status of local programs may be related to vector borne disease incidence and public health, 3) determine the impacts of losing the NCPHPM division to vector control programs in NC. The results of this study are expected to assess the current status of vector borne disease surveillance in NC that will inform the legislature about the implications of budget cuts to public health. The implications of our findings to public health risk assessment strategies will be discussed.

Bed Bugs, A Re-emerging Public Health Challenge

As with other major cities in North America, Toronto continues to experience an increase in bed bug infestations and the most vulnerable populations in Toronto continue to be the most seriously impacted by these infestations. Divisions within the City and community agencies in Toronto have responded to this re-emerging pest by developing partnerships, maximizing existing programs, and diverting resources from other funded programs. Bed bug control strategies can include both chemical and non-chemical approaches, but non-chemical techniques alone cannot effectively control or eliminate established infestations. The integrated pest management (IPM) approach is viewed as the best practice for most bed bug infestations today. This involves the application of both non-chemical and chemical techniques with an emphasis on those methods and products that will have the least impact on human health and the environment. Non-chemical controls include the use of vacuuming, steam cleaning, controlling indoor temperatures and exclusion strategies. Chemical approaches in Canada are restricted to synthetic pyrethroids which are available in liquid or powder forms.

Toronto Public Health continues to respond to request for service regarding bed bugs. The response includes amongst others, providing advice , bed bug identification services, providing inspection services in problematic cases, conducting education/ outreach sessions, liaising with landlords and coordinating extreme clean events and future case management for vulnerable clients.

Improving the Predictive Value of Air Sampling for Fungal Aerosols with Aggressive Sampling

The presence and activity of humans, in building spaces, that aerosolize deposited reservoirs of fungal particles seem to constitute the single most important cause of the significant variability observed for indoor air sampling for fungal aerosols. This study investigates whether the use of an aggressive sampling technique instead of the usual passive sampling technique, can reduce this variability. The measurements were made in rooms, with and without human activity. With passive sampling technique, the fungal aerosol concentration in rooms without human activity was on average only 9 % of that found with human activity. When aggressive sampling technique was used, this average was 103 %. Use of aggressive sampling, therefore, eliminates to a large extent the variability caused by differences in human activity and thereby improves the predictability of indoor air sampling for fungal aerosols. The level of fungal aerosols was determined by measurements of the activity of the fungal related enzyme β-N-acetylhexosaminidase(NAHA).

An Sanitarian's Overview of Green Certification

Green certifications are encountered daily in our practice. These certifications are for products, performance, people, processes and buildings. Knowing the scope and limitations of the various environmentally preferable certifications will aid us in our health and safety activities.

Geospatial Evaluation of Major Public Safety-related Infrastructure in the Event of an Accidental Radionuclide Release in South Carolina

Geospatial Evaluation of Major Public Safety-related Infrastructure in the event of an Accidental Radionuclide Release in South Carolina Isoken T Aighewi and Helen Tamboue Benedict College, Department of Biology, Chemistry and Environmental Health Sciences, 1600 Harden Street, Columbia, SC 29204 ABSTRACT Recent nuclear incidents in the U.S and elsewhere such as the 2010 Yankee nuclear reactor leakage in Vermont, the recent wild fire that threatened the Los Alamos National laboratory in New Mexico in 2011 and the Japan’s Fukushima Daiichi nuclear disaster in 2011 have brought about new concerns and discussion about how safe and prepared Americans living near nuclear installations are.

The United States have 65 operating nuclear plants with 104 commercial reactors, of which four operating plants are in South Carolina. Although site-specific emergency response plans for nuclear plant accident exist for communities in the immediate vicinity of nuclear plants, the ever-changing demography could render those plans ineffective overt time. This study was initiated to evaluate the present state of vulnerability of populations residing near one of the four nuclear installations in South Carolina-The Savanna River Site (SRS). Using Geospatial techniques, we evaluated populations at risk living within 25km and 50km radius of the installation, number of health facilities, major highways for evacuation during emergency-including their respective 2010 vehicle traffic loads (AADT).


The result shows that in the event of a nuclear emergency resulting in mass release of radionuclide, 12, 780 people in six towns in the immediate vicinity of the SRS will be at risk. However, 295,545 people will be affected if up to 50km radius is considered-based on the latest U.S 2010 census. Only one health facility is located within the immediate vicinity for emergency treatment and 15 within 50km radius of the site. For Emergency evacuation, Northeast bound U.S highway 278 to Georgia state line in Aiken county, SC has a higher traffic load compared to the Southwest bound alternative of the same limited access highway (AADT of 15,200 compared to 13, 800) leading to highway S-68. For the 50 km scenario however, several more evacuation routes are available. A comprehensive comparison of the different evacuation routes for the towns will be presented.

Reducing agricultural food contamination risk and increasing farm worker health and safety opportunities through implementation of an Agricultural Field Toilet Inspection Program

Unsanitary or improperly equipped field toilets are one of many sources that can contribute to Escherichia coli contamination of agricultural products. This public health risk can lead to unsafe field worker conditions, food borne illness, and substantial economic impacts to the agricultural industry. In 2005 and 2006, United States Food and Drug Administration investigations of food-borne illnesses linked outbreaks to fresh-cut lettuce and spinach grown in the Salinas Valley, California. Monterey County Health Department’s Environmental Health Bureau (MCEH) launched an array of potential source mitigations, one of which was an Agricultural Field Toilet Inspection Program (AFTIP) to register, monitor, and enforce sanitary practices. From project launch in late 2007 to the December 31 2009, MCEH inspectors permitted more than 7,500 field toilet units, estimated to likely be nearly all of the units that existed in Monterey County. From the first fully-operational program year (2008) to the second program year (2009), total violations decreased from 1,502 to 315 and of those, the number of violations requiring immediate correction decreased from 244 to 8. These results suggest a decreased probability of crop contamination, food-borne illness, and economic loss for Monterey County agricultural products due to field toilet sources. The study describes MCEH’s rigorously-maintained process to adhere to public health egulations and standards with relatively minor impact on resources, and provides a local health policy, procedures, and materials (forms, tools) to assist other counties in enacting similar policies and cost effective programs. Adoptions of similar practices by other local health departments throughout the U.S. are expected to provide similar results and benefits within those counties. However, because agricultural workers and farming equipment (machinery, trucks, tools, toilet units, etc.) are seasonally transported across county and state boundaries, possibilities of contamination will exist due to differentials in inspections and regulations between counties. Yet implementing AFTIP in California counties would give researchers the opportunity to compare findings, thereby providing further recommendations for greater protections.

Assessing Wastewater Infrastructure Needs – Using Trends to Establish Priorities in Environmental Programs

The most common approach in the United States for dealing with wastewater is the centralized sewer. Environmental laws and public funding largely promote and support the construction, operation and maintenance of large wastewater treatment facilities. Contrast that with historic population declines in many small communities in rural areas of the Upper Midwest and other rural areas of the United States of America, a trend that continues. For example, according to figures provided by the U.S. Census Bureau the median population of communities in Nebraska was 342 in 2000 which declined to 318 by 2010.

Regulatory requirements and demands on wastewater treatment systems continue to increase. The blanket application of environmental regulations and resources to all communities, especially small communities with declining populations on limited incomes, can result in costly upgrades or new construction, and onerous sampling, record keeping and reporting requirements. There may be better ways of assessing needs and maintaining or obtaining regulatory compliance.

Some basic questions are worth asking:

• What is and what will be the overall or comparative watershed impact from
• these small sources (or how can resources best be applied to meet environmental goals and achieve compliance with regulatory requirements)?
• Are all wastewater treatment options or combinations considered equally, or do funding source limitations restrict these choices?
• Can a risk-based approach to wastewater treatment be developed that would
• optimize available resources and still result in adequate and acceptable levels of environmental protection?
• How can wastewater treatment systems, centralized and decentralized, best be
• selected, funded and used consistently and appropriately in each situation?

No single method of wastewater treatment is the answer for all situations and this presentation is not intended to determine the most appropriate wastewater treatment method for any particular situation. However, the intent of the AWIN (Assessing Wastewater Infrastructure Needs) effort is to help develop, enhance and continue the discussion, look at a possible approach to provide a qualified assessment of infrastructure needs, and work towards solving the problem of how best to use available resources to meet wastewater infrastructure needs while providing adequate and appropriate environmental protection.

CSI: Twin Falls, Idaho

On September 15, 2009, elemental mercury was discovered splashed around a small area within a parking lot of an apartment complex in Twin Falls, Idaho. Local and state fire and hazmat teams responded immediately, as did the Idaho Department of Environmental Quality (DEQ), the South Central Public Health District (SCPHD), and the U.S. Environmental Protection Agency (EPA). These agencies joined together in Unified Command and combined resources to assess, stabilize, and mitigate the incident while calmly dealing with the close attention from the local media. A public health concern quickly surfaced due to several factors: the source and quantity of the mercury were unknown, the timing of the incident was vague, school-aged children were involved. The concern was heightened due to the potential dangers of mercury exposure, the possible spread of contamination in homes and school, and the intense media coverage.  That concern was confirmed by data gathered by EPA and hazmat entry teams showing high levels of mercury vapors on the parking lot and inside one family’s apartment unit. Ultimately, the agencies were able to determine the mercury contamination was limited to the apartment and parking lot, and did not affect other homes, the school bus, or school. The apartment has since been remediated and family returned (after being evacuated from their residence).  Some of the “lessons learned” of the response were the importance of incident command leadership, each partner doing their jobs well and staying in their lanes, and open communication between the partners. While EPA provided equipment and technical assistance to the incident response and DEQ handled media inquiries, SCPHD worked smoothly with the school district and children to ascertain the exact number of children involved, to locate the source and amount of mercury spilled, and to provide valuable outreach to the affected families and larger community. This emergency response was a huge success as a result of close cooperation between local, state, and federal agencies. Awards were given to all partners involved by EPA in recognition of their exemplary performance and interagency cooperation during the mercury emergency response.

Lead guidelines for children’s play areas: The need for clean soil policies to protect children

Children’s empirical response to lead (Pb) in soil and revised policy needs are discussed. The median US background soil Pb is 16.5 mg/kg (range 10.3 to 30.1 ppm), and soils of urbanized areas (UAs) are often 500-1000 ppm or more. Two Pb products, Pb-based paint and additives in gasoline contaminated UAs, and 1950 through 1982 fuel sales by state accounts for ~1.4 million metric tons (MT) Pb of the US total of 4.6 million MT in the same years. Aerosol inputs into the 90 UAs from gasoline Pb additives range from 100’s to more than 100,000 MT of Pb depending on traffic flows. Soils are a sink and a source of urban Pb dust.

The response of children to urban soil Pb contamination in New Orleans serves as a case example. The maximum of ~1811 MT lead (Pb) in exterior paint on 86,000 New Orleans houses, compares with ~12,000 MT from vehicle exhaust yielding ~ 9100 MT Pb; ~4850 MT were particles >10 µm and ~4200 MT were <0.25 µm. Brick public properties in the inner city had significantly more Pb contamination and higher prevalence of elevated children’s blood Pb than same-aged brick public properties in the outlying urban areas. The median Pb dust in the inner-city soil was 438 mg/kg or 3.7 times larger than median soil Pb of 117 mg/kg (p-value <0.0001). The prevalence of children’s blood Pb ≥ 10µg/dL was 22.9% within the inner-city and 9.1% in the outlying areas of New Orleans (p-value <0.0001). Lead dust from gasoline additives explains the discrepancy of soil Pb and children’s blood Pb in the traffic congested inner-city core compared with the lower traffic outer areas of New Orleans. Similar patterns of environmental Pb dust contamination and childhood Pb exposure are expected in all US cities. To meet the goal of primary childhood Pb prevention, the findings underscore the need for revised soil policies that act to eliminate the impact on children of Pb dust that has accumulated in urban soils.

Sanitation in Classroom and Food Preparation Areas in Child Care Facilities in North Carolina and South Carolina [POSTER]

Introduction:  Approximately 60% of U.S. children age 5 and younger spend time in child care settings.  Such environments increase risk of enteric disease, including foodborne illness.

 

Purpose: To describe adherence to sanitation standards in classrooms and food preparation areas in child care facilities in the southeastern United States.  

Methods:  Site visits were conducted at 35 licensed child care facilities: 27 centers (77%) and 8 homes (23%). Data were collected in two classrooms at 16 facilities; thus, the sample size for classroom-level data was 51 (43 rooms for centers and 8 homes). Data collection methods included questionnaires, audits, observations, and environmental samples. Audits in up to two classrooms (an infant, toddler, and/or combined infant/toddler classroom) at each facility and the food preparation area were performed using a form similar to a regulatory inspection form. Audit data were used to calculate indices to describe adherence to sanitation standards based on the 2009 FDA Food Code and guidance from food safety experts.

Results:  The mean classroom sanitation index (0-8) was 7.7 (SD=0.7) and the mean food preparation area sanitation index (0-10) was 7.2 (SD=1.4). Items with low compliance included availability of a sanitizer test kit and use of hair restraints by food handlers. For classrooms with a refrigerator used to store food and beverages for children, 40% of centers and 75% of homes had refrigerators with ambient temperatures > 39°F. For facilities with a separate food preparation area, 48% of centers and 63% of homes had refrigerators with ambient temperatures > 39°F. 

Significance: Most facilities participating in this study adhered to sanitation standards within the classroom; however, improvements with regard to sanitation in food preparation areas and refrigerator operating temperature are needed.  These results, in conjunction with observational data and microbiological analysis of environmental samples, provide insight into risk factors for enteric disease transmission in child care facilities. 

Cross Community Collaborations for Environmental Health

Environmental health problems typically cross boundaries of race, gender, class, and geography, especially problems that impact those who are disproportionately at risk from harmful chemical exposures. Developing successful collaborations among the diverse stakeholders seeking to resolve such problems is a major challenge for environmental health professionals. The Oakland-based Center for Environmental Health (CEH) has successfully facilitated collaborations among environmental justice community-based groups, government agencies, non-profits, labor unions, and business leaders to eliminate health threats and create more sustainable communities. In this session CEH Executive Director Michael Green will discuss with participants the strategies for facilitating successful collaborations across diverse communities, the methods for developing successful relationships, and practices that professionals can use in their work with diverse constituencies.