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.

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.

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.

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.

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.

Environmental Health Perception Among College Students [POSTER]

An individual’s knowledge, perception, and attitude are fundamental in determining how a person behaves regarding environmental hazards.  While science has made great strides in promoting environmental health, threats still exist, largely due to individual actions in response to potential health hazards.  Undergraduate students (n=395) enrolled in an introductory Health Education course participated in an environmental health awareness survey examining knowledge, attitudes, and behaviors.  Results indicated that there was a general lack of knowledge among participants about environmental health-related issues.  In addition, it was determined that males were more likely to have positive attitudes towards issues relating to air quality and the green environment.  Further analyses revealed that there was a significant relationship between age and attitudes toward issues dealing with sustainability.  In addition, race/ethnicity predicted attitudes toward water quality and recycling behaviors.  While students typically possessed positive attitudes toward environmental health, they engaged in non-eco-friendly behaviors.  Because knowledge influences a person’s attitude, and ultimately behavior, continued efforts in environmental health education should be refined.

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.

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.

Army Field Sanitation Team: The Past, Present, and Future

US Army Field Sanitation Teams (FST) have served as public/environmental health extenders to company sized units (130 Soldiers) since World War II.  This is an additional duty assigned to two unit members who receive a 40 hour course in field sanitation covering subjects such as water quality, pest management, sanitation, and waste disposal.  If used properly, they are considered a valuable combat multiplier while reducing the unit's disease and non-battle injury rate.  FSTs are backed by an Army regulation but often fail because of competing interests, FST organization, and lack of command emphasis.  This presentation will look at levels of environmental health organization in the US Army, FST history, describe current problems reducing the effectiveness of FSTs, and present recommendations to improve these valuable teams. 

A Simplified Method for Objectively Evaluating Environmental Cleanliness

An evaluative system that objectively quantifies environmental cleanliness outcomes, using subjective and qualitative observational criteria, was developed and field tested.  It incorporates standard definitions and uniform inspection methodologies.  An observational matrix was developed to use a simplified statistical grid analysis to ensure consistency of observations. The system is particularly applicable where environmental cleanliness is of primary concern in infection control.

Infectious Diarrhoeal Pathogens in Developed and Developing Countries: A Meta-Analysis [POSTER]

It is estimated that diarrhoeal illness are responsible for about one in five of all child deaths worldwide. There is currently no precise or consistent estimate of the global burden of diarrhoeal illnesses caused by microbes including some classified as neglected tropical diseases, with risks varying between developed and developing countries. This meta-analysis used a rigorous approach in assessing and extrapolating data from 86 studies published mainly in the English language from six world regions to provide region specific prevalence of major pathogens associated with diarrhoeal diseases in different age groups worldwide. The DerSimonian-Laird random-effect methods were used for testing the heterogeneity of studies, on the basis of the Cochran’s Q-test, and was significant if p <0.05. Estimates for enteric pathogens showed regional and age-group differences with prevalence significantly higher in all developing regions when compared with developed (OECD) countries. Overall an organism was isolated in an average of 53% (95% CI= 48%-57%) of symptomatic cases, and the odds of isolating a pathogen was about five times more (OR=4.74%: 95% CI= 3.93-5.72) in cases than in asymptomatic controls. The isolation rate of enteric organisms was significantly higher in developing countries when compared with developed countries. The highest isolation rate was (62.4%) found in Sub-Saharan Africa (SSA) and (61.0%) in Latin America and Caribbean (LAC) regions. Bacterial pathogens were the most common isolated in all regions ranging from an average of 17.7% to 43.6% in all developing regions as opposed to the OECD countries, which had more viruses (20.3%; 95% CI, 15.9-25.6). Rotavirus was the most common pathogen isolated in children (23.80%; 95%CI=16.19%-33.55%); other E. coli sp., (6.57%; 95%CI= 1.09%-31.02%) and Campylobacter (16.61%; 10.10%-26.10%) in adults, compared with Shigella (6.16; 95%CI=3.20%-11.55%) and Salmonella (2.66%; 95%CI=1.50%-4.67%) in mixed age-groups.

Birth Anomalies Caused by Environmental Factors

Many environmental factors are linked with birth defects. These range from chemical teratogens and hormones to maternal infections, and nutritional factors. Environmental agents may affect the developmental process of the embryo and the fetus causing birth defects following maternal exposure to them. Many environmental agents may act as a teratogen.  A teratogen is any agent that causes congenital birth defects. Environmental factors like infection, drugs, sunbath, extremes of temperature, ionizing radiation may cause birth anomalies.

The embryo is most sensitive to teratogenic agents during this period of rapid differentiation and cell multiplication. Environmental factor causes 7 to 10% of congenital birth defects.  Early actions of environmental teratogen during first two week of development may cause death of the embryo. The exact mechanism by which drugs, chemicals, and other environmental factors disrupt embryonic development and induce birth defects is unknown. Many studies has shown that certain hereditary and environmental influences may adversely affect embryonic development by altering  such fundamental processes as the intracellular component, surface of the cell, extracellular matrix, and fetal environment.

Rapid progress in molecular biology is providing more information on the genetic control of differentiation of the embryo and the vulnerability of environmental teratogenic insults.  Teratogen acting during the first 2 weeks either kills all the embryo or their disruptive effects are compensated for powerful regulatory properties of the early embryo. Development of the embryo is most easily disrupted when the tissue or organs are forming. There are genetic differences in response to a teratogen.Animal research has shown that there is a dose response relationship for teratogens.

The purpose of this study is to Enumerate the environmental teratogenic agents, their possible mechanism of action.

Recommendations for possible ways to prevent the environmental teratogenic insults Method—Going through multiple text books and searching the literature.

Conclusion. There are many environmental teratogens.Although the list of suspected teratogenic factors is long, relatively few are unquestionably teratogenic in humans.  It is possible to prevent the congenital birth defects by avoiding the teratogens.

Human Mercury and Antibiotic Resistant Bacterial Sampling Along the Indian River Lagoon, FL; Dolphin and Human Health

Objectives: We previously described high levels of mercury in skin
and blood of Atlantic bottlenose dolphins from the Indian River Lagoon, FL and suggested that these animals may serve as sentinels for public health. Therefore, we assessed mercury exposure through fish consumption among individuals living near the Indian River Lagoon (IRL), FL who are potentially exposed to high levels of mercury in their diets. Results were compared to existing data on the Indian River Lagoon bottlenose dolphin population in order to fully understand the link between human and dolphin health in this unique environment.

Methods: We surveyed 59 adult residents at the Florida Oceanographic Society Center, Harbor Branch Oceanographic Institute, and around common fishing areas. Questionnaires provided information on species-specific fish consumption during the 3 months before the survey. Hair samples were collected from all participants to be analyzed for total mercury.

Results: Residents’ mean hair mercury concentration was 1.5 ppm (n=59; range, 0.04-16.18 ppm); 42% of participants had levels >1 ppm, which approximately corresponds to the US EPA’s reference dose. Hair mercury levels were positively associated with fish consumption and significantly higher in those who consumed seafood from the Indian River Lagoon. In particular, those who consumed tuna filets/steak, grouper, and salmon had higher mercury concentrations in their hair, which follows the nationally reported averages in tissue of these fish species. However, the mean concentration of mercury in human hair was lower than that in the skin of IRL dolphins (7 ppm).

Conclusions: Study participants had relatively elevated mercury concentrations in their hair. This group represents a highly exposed sub-population with an exposure profile that differs from fish consumers in other regions of the United States and the general population, suggesting a need for more regionally specific exposure estimates and public health advisories.

Rat Hoarder Case

This was one of the most challenging public nuisance complaint cases
I have ever been involved in during my 32 years in the environmental health field.
The Rat Hoarder involved a single woman that lived in a beautiful neighborhood located in Sedona, Arizona. The problem started with two pairs of pet rats (Rattus norvegicus) that she allowed to run free in her house, which were purchased to replace her beloved cat. After eleven months of the rats breeding freely in her house the number of rats grew exponentially and eventually destroyed her once beautiful home and eventually started to escape into the neighborhood. Even with this extensive infestation the Rat Hoarder was still very attached to her rats (she had names for each rat and would kiss each one she picked up). She fought us on ever step of the process even though she was told about the diseases that the rats may carry, or she had to turn off the power to her house because the rats had gnawed through the electrical wiring inside her house, or some of the rats were now starting to become aggressive and bite her.

The public nuisance process took seven (7) months to resolve. To resolve this nuisance we relied on the assistance of the County Attorney’s Office, Arizona Vector Control Department, Sedona Police Department, Sedona Community Development Department, and the National Humane Society. We carefully followed all appropriate enforcement steps available and made sure the Hoarder was given proper due process to prevent the case from being thrown out of court. Both non-judicial and judicial law processes were used in resolving this case, which included:
• Issuance of a notice of violation citing the public nuisance state statute;
• Issuance of a Search Warrant;
• An Administrative Law Hearing; and
• A Superior Court Hearing.

Sedona Animal Control and Coconino County Environmental Health worked together on this case and removed over 900 hundred pet rats from inside her home as well as some that were trapped outside her home. The house had to be completely gutted requiring the replacement of all wall and ceiling boards, insulation, wiring, and plumbing to remove the nesting materials, urine, and feces left from the rats.