National Swimming Pool Codes – Junction of Health and Building Officials

In recent years there has been a steady increase of reported disease outbreaks where an aquatic venue was found to be the common source. In addition, every year there are tragic injuries and deaths in swimming pools. CDC is creating a Model Aquatic Health Code (MAHC) to improve the health conditions in these venues. The International Code Council (ICC) has created the International Swimming Pool & Spa Code (ISP&SC) governing pool and spa construction for enforcement by Building Code Officials. Meetings have taken place between CDC and ICC officials to explore how these codes can be complimentary.  In an early meeting, Jay Peters from ICC stated that he thought an arrangement could be reached where a “baton transfer” could occur between the building code officials after the design and construction phase to the environmental health officials for the on-going operation and maintenance phase of the aquatic venue.  The collaboration between the CDC and ICC needs to continue to create joint pool code strategies and explore the possibility of a joint code in the second version of the ISP&SC which will come out in 2015.  Environmental Health representatives are being considered for the ICC pool code committee for that second version. 

CDC, NEHA and other national organizations that represent EH professionals are likely to become more involved in the ICC’s code development processes.  The ICC creates codes dealing with areas including “green” buildings, sustainability, and property maintenance that need environmental health input. This move may also encourage more collaboration between the environmental health officials and building code officials at the local and state levels. Please consider joining CDC / ICC / NEHA for an informative session about how these efforts will integrate.

Nanomaterials for Environmental Remediation: The role of nanoinformatics in the state agencies' regulatory oversight of safety and health

The use of nanomaterials for environmental remediation is no longer a theoretical concept but a proven technology for many EPA superfund sites across the country. Although this new approach saves time and money in comparison to the traditional remediation (clean-up) technologies, there are many health and safety risks and uncertainties associated with the handling of nanomaterials throughout their life cycle.

State government agencies will play a more significant role in the future in ensuring that the employment of nanotechnology for environmental remediation does not significantly affect health and safety of workers or the general public. However, availability of relevant information relating to safety, health, environmental and toxicological properties of nanomaterials is often lacking. For state governments to effectively regulate and have a greater safety and health oversight of nanomaterials, it is necessary that as this information becomesavailable, it is collected, collated and made accessible to state agencies and programs in a timely manner in order to support regulatory efforts. This presentation will summarize results of a survey conducted in conjunction with state government agencies and programs throughout the fifty states documenting the current and future scientific and information needs related to safety and health of nanomaterials at the state level

Decrease Epidemiological Threats with Environmental Controls and Testing

Alabama Department of Public Health (ADPH) Central Office staff worked to customize the 6 Modules from the NEHA Epi-Ready training to incorporate Alabama policies, processes and protocols. The PowerPoint presentations include modules on Surveillance, Outbreak Determination, Environmental Assessment, Epidemiological Investigation, Laboratory Guidance, Concluding Actions, Report Writing and a Case Study Exercise. Each module included hands-on activities for the attendees to work on in identified groups.

Collaboration across the disciplines was essential to make the material informative, accurate and complete. Along with the development of the Modules, Central Office staff compiled resource, reference, and other materials needed when conducting a FBO. Examples of reference materials included the FBO Protocol, Acute Foodborne Gastroenteritis Reference Table, Foodborne Illness Investigation Sample Collection and Submission Criteria, laboratory slips for human and food specimens, Food Safety Temperature Poster, and Interviewing Techniques. All materials were incorporated into a manual for each training participant. Other resources included FBO investigation kits containing resources needed to collect clinical and food specimens such as sterile cups, mini-tongs, sample knife, scoop-an’ bag, and gloves allowing for more timely collection of specimens.ADPH trained over 250 disease intervention specialists, nurses, environmentalists, epidemiologists, social workers, health service administrators, and administrative support assistants across Alabama. Each PHA received 10 DETECT Kits for a total of 110 kits. Established protocols and procedures were implemented in multiple outbreaks after the completion of training. A statewide outbreak network drive was developed that contains templates for forms and procedures used and folders for all current outbreaks.

The training and materials developed have been modified and are useful for all types of events including waterborne and institutional outbreaks. Through the establishment of teams and processes, response, communication and outcomes are more efficient and organized.

The Role of Public Health in Promoting a Food System that is Safe, Secure, and Sustainable: S3.

Public health and safety considerations are an integral component to local food systems policy. A healthy food system should ensure the well being of consumers. To achieve that goal, local food systems policy should ensure that food is Safe, Secure, and Sustainable (S3) by supporting and encouraging healthy production of food for all.  Nothing in food systems policy should undermine the public’s health, especially the health of our vulnerable populations including our children, the elderly, or those who are immunecompromised.  Over time, our food system has become more centralized, decreasing reliance on local farmers and backyard gardens to feed the Country. Convenience foods became core to our diets and unfortunately have resulted in heart disease, diabetes, and childhood obesity among other things. In addition, taking better care of our environment is also on people’s minds.  There are many food systems lessons that have been learned over time. These lessons must not be overlooked when reformulating local policy. In fact, the lessons learned should be reflected upon and risk-based interventions integrated into new food systems policy that are protective of public health and the environment, making our local food system in San Diego County Safe, Secure, and Sustainable: (S3).

The Military/ Civilian Disaster Strategy: A National Emergency Food Protection Practicum

The Military/ Civilian Disaster Strategy: A National Emergency Food Protection Practicum Food and water protection is at the intersection of many of public health’s greatest challenges: pandemic disease preparedness, agriculture and bio-terrorism, emerging infectious disease, food security, and climate change. Moving between traditional environmental health, epidemiology, and all-hazards preparedness tracks, the Wright State University Master of Public Health Program, through the National Center for Medical Readiness, partnered with the US Air Force School of Aerospace Medicine located at Wright-Patterson Air Force Base to develop a novel, national training schedule for military and civilian food safety inspectors focused on realistic scenarios they could face during times of emergency.

This unique and intensive, two-day training program is based upon the Food and Drug Administration Model Food Code, a proven military food defense program, and (the soon-to-be-implemented) 2011 Food Safety Modernization Act. The course is a field practicum, taught by United States Air Force instructors and Wright State University academicians, and tested in a mobile food establishment designed for contingency situations. Training content tests the trainee’s ability to make sound judgment in the face of a real-time emergency. Knowledge of food microbiology/ toxicology, ionizing radiation, disease vectors, food storage and salvage, and detection equipment, is tested “hands on” in a mock food establishment that is an emergency simulator. Scenarios include: failed food holding units (stocked with perishable foods), vector infestations, flood waters, failed structural and mechanical systems, and many other tests of technical training competencies.

Trainees will be videotaped and graded according to performance. Successful candidates receive emergency training certification, issued jointly by Wright State University and the United States Air Force. Presenters will discuss expected training outcomes and proposals for future national training criteria augmentation and expansion.

NOTE: This Information is the property of the United States Air Force and Wright State University: confidential until selection for presentation.

EH Practioner and the 21st Century

Perception of the current state of environmental health practice is that of a specialist which is focused only on regulation and enforcement and not participating in development of a more holistic sustainable “green” approach to environmental issues for the twenty first century. Much of the this perception is due to the fact that a major focus of those who practice and that of the general public appears to be on the awareness of current environmental problems and not promoting sustainable solutions.  As examples, a brief review of basic environmental health practice in the areas of pollution control, water resources, and food protection clearly demonstrates that environmental health practice has always incorporated sustainability as the correct way to deal with modern environmental problems. Pollution control whether it is concerned with air, soil, water, or food has been viewed with a cradle to grave approach of pollutants emitted from obtaining source material, to the process of developing the product, the product use itself, and to the final disposal of that product.

Pollution control has emphasized protecting human health, allowed for “best available technology,” considers cost of controls, and not generating the pollutants whenever possible. Water resources utilization and availability for residence, industry, and agriculture have had major sustainable efforts applied by environmental health practitioners regarding water conservation techniques, waste water reclamation, and implementing social solutions to water scarcity. To address evolving threats and concerns with food sources and food-borne illness, emphasis on risk-based inspections to prevent problems before they start, to ensure preventive measures are effective, and provide a rapid response when contaminated food or feed are detected.

Environmental Public Health Online Courses (EPHOC): Training Evaluation and Outcomes

Beginning in 2006, the Jefferson County Department of Health’s Environmental Health Services (JCDH), the School of Public Health at the University of Alabama at Birmingham (UAB), the National Environmental Health Association and the CDC / NCEH’s Environmental Health Services Branch partnered to develop a comprehensive online package of courses for environmental public health practitioners.  The goal of the Environmental Public Health Online Courses (EPHOC) course package is to provide public health environmentalists (PHEs) with access to comprehensive, worthwhile and affordable workforce development resources that could not only serve as orientation materials for newly hired PHEs but that could also assist the more experienced PHEs as they study for the NEHA REHS/RS credentialing examination.  

EPHOC course package was launched in 2010.  It is made up of 15 online courses (over 45 contact hours) that mirror the chapters of the NEHA REHS/RS study guide.   These courses are available 24/7 and are accessible for free from www.southcentralpartnership.org/ephoc. EPHOC courses are evaluated according to Kirkpatrick’s four-level taxonomy for training evaluation.  The purpose of this presentation is to present results of the EPHOC course and program evaluation.  From the launch of EPHOC until October 2011 there have been 459 participants who have completed course evaluations. Evaluation results confirm that the course’s intent and objectives were met.Overall, learners rated the instructors (Mean= 4.14), course content (4.24), and course formats (4.15) as ‘Above Average’ (Scale: 1=Fail, 2=Below Average, 3=Average, 4=Above Average, 5=Excellent). Quantitative results of both Level 1 (Reactions) and Level 2 (Learning) evaluations for all EPHOC courses will be presented.  Also, in January 2012, a Level 3 (Behavior) follow-up electronic survey will be sent to those who have successfully completed one or more of the EPHOC courses.  The purpose of this survey will be two fold.  First, to determine to what extent are trainees applying training-related knowledge/skills/attitudes in the workplace.  Second, to determine if trainees have participated in the REHS/RS credentialing exam and to what extent do they believe the course content was relevant and helpful for preparation.   Follow-up survey results will be presented.

Food Handler Training under the Microscope

As food-borne illnesses continue to garner national attention, it is critical that health departments reevaluate their retail food handler food safety training protocols.  Although many of the serious outbreaks are linked to food production or processing, an analysis of 2006 CDC data indicated that in that year 52% of food-borne disease outbreaks were attributed to food service establishments.  Although it is unknown what percentage of these illnesses were due to inappropriate food safety procedures and behaviors at the food establishment, it is becoming increasingly important to the public to know that employees in the food service industry have the food safety knowledge to minimize their risk of contacting food-borne illness. 

This session will briefly summarize the research literature on food safety training for hourly workers in the retail food service work force, present an overview of health department practices around the country, and compare differing modalities of training. It is proposed that the author of this abstract bring together a panel of 4-5 individuals, representing environmental health personnel in departments that offer food handler training, as well as individuals involved in academic research of food handler training and behaviors.  This will allow the audience to hear information based on a range of experiences, participate in discussion, and receive input to their questions as they evaluate the direction of their department with regard to food handler/food safety training.

Data will also be presented on a study currently being conducted in collaboration with the Utah County Health Department evaluating operator perception of food handler training. Of critical interest will be an evaluation of the movement from classroom training to online food safety training.  Variables to be discussed include financial impact, relative value of the training vs. the testing component, issues related to fraud prevention and detection, learning styles, alternative guidelines for evaluating comprehension, and the evaluation of quality of training options.

Responding to Mercury Incidents

Mercury is the only elemental metal in its natural physical state to be liquid at standard temperature and pressure.  You can pour it out of a container; watch it separate into little globs; roll them back together with your hands; and pour it back into the container.  What we don’t realize is that mercury vapors are is extremely toxic.  Mercury vapors can be inhaled and absorbed through the skin and mucous membranes.  Acute exposure from inhalation of mercury vapors can cause short term health effects such as difficulty breathing, coughing, chest tightness, and upset stomach.  Chronic exposure to mercury has been known to cause headaches, weakness, tremors, emotional changes like mood swings, decreased cognitive functions and kidney problems.  

On March 21, 2011, Kern County Environmental Health and Bakersfield City Fire Department responded to an elementary school for a jar of mercury brought in by a couple of students.  This course will address the challenges First Responders faced from what seemed like a simple response call to a full scale hazardous materials response to mitigate, isolate, and decon 70+ students and faculty staff members while under the watchful eye of concerned and frightened parents.

The course will help the audience determine and evaluate what steps to take initially when responding to a mercury spill.   Lessons learned on the logistical challenges faced on how to decon children, disseminate public information, and multiple location responses will be discussed.  Cleanup techniques performed and acceptable cleanup action levels for mercury will be defined.  

Attendees will gain the knowledge and the ability to apply the necessary skills needed for proper response and mitigation procedures, the understanding of the effectiveness of utilizing a joint multi agency response team, identifying the risks associated with mercury releases, and the proper ways of handling a cleanup.

New Deli Slicer Standards in Food Safety

All newly manufactured and certified Deli Style Slicers comply with the sanitation requirements of the NSF standard.  However, over time, and with constant use and regular cleaning, seals can deteriorate, creating vulnerable points of bacterial harborage that have been associated with specific food borne illness outbreaks.  Regular inspection and routine maintenance has been shown as the most effective way to minimize this problem, especially for older equipment.

This presentation will focus on the key parts of the Deli Style Slicer that have shown deterioration with use over time.  This presentation will describe what  food safety professionals should monitor closely during routine sanitation inspections. We then will present recommendations on when to service equipment, or when to take  units out of service altogether.  The presentation will focus on the key findings of foodborne illness outbreak investigations specific to the Deli Style Slicers which led to the recommendation to revise  the NSF/ANSI standard pertaining to these products. We will then further look at the research and the science that formed the foundation for the revisions to the American National Standard.

The science behind the recommended changes to the revised NSF/ANSI standard has resulted in a necessary re-engineering of the design and construction of the Deli Style Slicer as we know it today. These changes  should result in the improvement of both the serviceability and food safety associated with this very common piece of food service equipment.  The presentation will focus on and describe several of the specific new requirements found in the revised standard.

Evaluating Laser Pointer Safety [POSTER]

The purpose of this study was to assess the safety of laser pointers. Additionally, a variety of consumer level laser devices were evaluated in order to test the validity of any existing manufacturer label classification.  Classification discrepancies are a problem for the environmental health professional due to the fact that the lasers are easily obtained, have widespread use and have the potential to cause permanent ocular and/or skin damage with very little contact time with the beam.  Ocular damage is of particular concern due to the eye’s ability to increase laser light intensity to many thousands of times by its focusing power.  Currently, there are no regulatory standards to keep class III and IV laser sources out of the hands of minors or careless consumers. This study will evaluate the power/energy emitted from a variety of 17 consumer lasers, all of which were unconditionally purchased online.  Data collected from the laser evaluations have been analyzed and tabulated in accordance with ANSI 2007 recommendations.

The Evolving World of Environmental Health: A strategy of how to best adapt and advance the profession from an entry-level professional, a mid-level manager and a senior director

The field of environmental health is constantly evolving, as new hazards threaten our communities. For example, Cryptosporidium is commonly associated with waterborne outbreaks, yet we knew little about this agent just twenty years ago. Less than ten years ago, sprouts were not considered a potentially hazardous food. Environmental health professionals are increasingly involved with disaster sanitation and emergency planning management, but are we prepared? Knowledge and skills must evolve in order to keep pace with current environmental health needs.

This panel presentation will offer a step-by-step strategy on how to adapt to the evolving world of environmental health by sharing perspectives of an entry level professional, a mid-level manager, and a senior director. The panel will assess the current environmental health employment opportunities and barriers for new graduates and experienced professionals.  The panel will identify common skills employers are seeking, how new graduates can best prepare to enter the work force, and discuss adaptation strategies to keep relevant in a changing field. Additionally, we will outline similarities and differences between the new entry level workers and the experienced managers as it relates to the progression of the profession.  The panel will conclude the presentation by providing solutions on how we can all effectively collaborate to advance the profession and meet the needs of the evolving world of environmental health.