Rebuilding Caribbean Environmental Health Post-Crisis Programs: A Preliminary Study for Virtual Mentorship
After the hurricanes in 2017 in the U.S. Caribbean, it was essential to rebuild, strengthen, and sustain essential environmental health (EH) services and systems. The National Environmental Health Association, in partnership with the Centers for Disease Control and Prevention, developed an online mentorship program for newly hired and existing EH staff and health department leadership in Caribbean health departments. Participants were provided with both practical and didactic learning and were allowed to evaluate the program. Both mentors and mentees were highly satisfied with the knowledge and skills acquired, and mentees expressed it was relevant to their daily work. Based on the findings, we recommend both an online and a hybrid mentorship program for leadership- and inspector-level workforces in EH and potentially in other fields.
Profiling Metal-Induced Genotoxic Endpoints
Many toxic metals are involved in the initiation and progression of DNA damage that can result in the activation of DNA damage response machinery at double- and single-stranded DNA; this response can result in global and gene-specific DNA alteration. The toxicological profiles from the Agency for Toxic Substances and Disease Registry (ATSDR) and several other studies have demonstrated the influence of metal exposure-induced genotoxic endpoints and epigenetic modifications. Our review systematically summarizes accumulating evidence from ATSDR toxicological profiles and the available literature that demonstrate a possible induction of various genotoxic endpoints and metal exposures. We include in this article studies on chromium, arsenic, nickel, lead, mercury, and zinc.
Promoting Health Literacy With Empathetic and Inclusive Communication
The National Environmental Health Association strives to provide up-to-date and relevant information on environmental health and to build partnerships in the profession. In pursuit of these goals, we feature this column on environmental health services from the Centers for Disease Control and Prevention (CDC) in every issue of the . In these columns, authors from CDC's Water, Food, and Environmental Health Services Branch, as well as guest authors, will share tools, resources, and guidance for environmental health practitioners. The conclusions in these columns are those of the author(s) and do not necessarily represent the official position of CDC. Traci Augustosky leads a team of writer-editors at the National Center for Environmental Health within CDC. Kathleen Walker is a senior content strategist who creates plain language health content that educates and inspires behavior change. Dr. Allison Chatham is a health communications specialist at the National Center for Environmental Health within CDC. Don Meadows is a technical writer-editor for the CDC Office of Communication. Yvanna Marlin-Guanga is a project manager who leads CommunicateHealth teams in creating inclusive products that educate, inform, and empower various audiences.
THE ASSESSMENT OF CHEMICAL EXPOSURES (ACE) PROGRAM: TOOLKIT ADVANCES AND RECENT INVESTIGATIONS
Educating Communities, Families, and High School Students About Lead Exposure as a Public Health Problem
The National Environmental Health Association strives to provide up-to-date and relevant information on environmental health and to build partnerships in the profession. In pursuit of these goals, we feature this column on environmental health services from the Centers for Disease Control and Prevention (CDC) in every issue of the . In these columns, authors from CDC's Water, Food, and Environmental Health Services Branch, as well as guest authors, will share tools, resources, and guidance for environmental health practitioners. The conclusions in these columns are those of the author(s) and do not necessarily represent the official position of CDC. Dr. Tanya Telfair LeBlanc is a senior health scientist/epidemiologist. Dr. Perri Ruckart is a health scientist and team lead. Shannon Omisore serves as a health communication specialist. All work in the Lead Poisoning Prevention and Environmental Health Tracking Branch at CDC.
Exposure Investigations Conducted by the Agency for Toxic Substances and Disease Registry
As part of our continued effort to highlight innovative approaches to improve the health and environment of communities, the is pleased to publish regular columns from the Agency for Toxic Substances and Disease Registry (ATSDR) at the Centers for Disease Control and Prevention (CDC). ATSDR serves the public by using the best science, taking responsive public health actions, and providing trusted health information to prevent harmful exposures and diseases related to toxic substances. The purpose of this column is to inform readers of ATSDR's activities and initiatives to better understand the relationship between exposure to hazardous substances in the environment, its impact on human health, and how to protect public health. This information is distributed solely for the purpose of predissemination peer review under applicable information quality guidelines. It has not been formally disseminated by ATSDR. The findings in this column are those of the author(s) and do not necessarily represent any agency determination, policy, or official position of CDC or ATSDR. Karen Scruton is the chief of the Exposure Investigations Section in the Office of Community Health Hazard Assessment at ATSDR.
Communicating Results of Drinking Water Tests From Private Wells: Designing Report-Back Materials to Facilitate Understanding
This evaluation assessed the effectiveness of graphic-based (i.e., pictorial) report-back materials in communicating the presence of toxic metals in private well water and soil samples. It also explored associations between recommendations in the report-back materials and appropriate actions to protect health taken by a subset of participants in an environmental monitoring pilot study. Overall, 39 residents of Stokes County, North Carolina, participated in the Well Empowered pilot study, which included water and soil testing and analysis. All participants received materials explaining the extent to which toxic metals were present in their well water and soil. A subset of participants ( = 14) responded to a follow-up evaluation, which showed that many found at least one component of their test results "very easy to understand." The existence of a federal standard for comparison appeared to influence participant recall of results, which was more accurate for contaminants with a federal maximum contaminant level. Our evaluation results suggest that a simple pictorial format, in combination with more detailed supporting text, can be useful in highlighting results that require action.
Assessment of Chemical Exposures Investigation After Fire at an Industrial Chemical Facility in Winnebago County, Illinois
After a chemical fire, an investigation assessed health effects by using syndromic surveillance to monitor emergency department (ED) visits, a general health survey to assess the general public, and a first responders health survey to assess first responders. A total of four separate multivariable logistic regression models were developed to examine associations between reported exposure to smoke, dust, debris, or odor with any reported symptom in the general public. Syndromic surveillance identified areas with increased ED visits. Among general health survey respondents, 45.1% (911 out of 2,020) reported at least one symptom. Respondents reporting exposure to smoke, dust, debris, or odor had 4.5 (95% confidence interval (CI) [3.7, 5.5]), 4.6 (95% CI [3.6, 5.8]), 2.0 (95% CI [1.7, 2.5]), or 5.8 (95% CI [4.7, 7.3]) times the odds of reporting any symptom compared with respondents not reporting exposure to smoke, dust, debris, or odor, respectively. First responders commonly reported contact with material and being within 1 mi of the fire ≥5 hr; 10 out of 31 of first responders reported at least one symptom. There was high symptom burden reported after the fire. Results from our investigation might assist the directing of public health resources to effectively address immediate community needs and prepare for future incidents.
Brownfields in Romania and the United States: A Visual Tour
This third article in a series of three on land reuse describes brownfield sites in Romania and the U.S. In 2018 and 2019, four of the authors toured brownfield areas in Romania (including Bucharest, southern Transylvania, and Oradea) and the U.S. (Southeast Missouri [called the Missouri Bootheel], Northern Arizona and Navajo Nation, and Northwest Indiana). We were interested in similarities and differences among brownfields in various urban and rural settings in both countries. This article describes these sites through a visual perspective as well as site characteristics and commonalities. Ultimately, potentially contaminated or land reuse sites such as brownfields are common in many parts of the world. We hope to advance the understanding of brownfields and site transformation options through our collaboration.
Bystander chemical exposures and injuries associated with nearby plastic sewer pipe manufacture: public health practice and lessons
Cured-in-place pipes (CIPPs) are plastic liners manufactured inside existing damaged sanitary sewer, storm sewer, and water pipes that extend the service life of host pipes. This process often is conducted in neighborhoods and near roadways. Before, during, and after plastic manufacture, waste materials that include volatile materials are released into the air. Emissions from this manufacturing process can affect outdoor air quality and indoor air quality for buildings connected to the sewer system. We identified key issues and solicited stakeholder feedback to estimate and manage public health risks of CIPP-generated chemical air pollution. A work group representing 13 U.S. agencies and public health associations provided feedback and prioritized public health issues for action. To mitigate potential public and occupational health risks, additional testing and public health educational efforts were recommended. An improved understanding of CIPP chemical exposure pathways, as well as stakeholder needs and interests, is essential.
Public Health Assessment Site Tool and Affiliated Applications: A Key Resource for Evaluating the Health Impact of Community Exposure to Hazardous Chemicals
As part of our continued effort to highlight innovative approaches to improve the health and environment of communities, the is pleased to publish regular columns from the Agency for Toxic Substances and Disease Registry (ATSDR) at the Centers for Disease Control and Prevention (CDC). ATSDR serves the public by using the best science, taking responsive public health actions, and providing trusted health information to prevent harmful exposures and diseases related to toxic substances. The purpose of this column is to inform readers of ATSDR's activities and initiatives to better understand the relationship between exposure to hazardous substances in the environment, its impact on human health, and how to protect public health.
Estimation of High Blood Lead Levels Among Children in Georgia: An Application of Bayesian Analysis
In Georgia, children in high-risk counties are at increased risk for lead exposure. Those children and others in high-risk groups, such as families receiving Medicaid and Peach Care for Kids (i.e., health coverage for children in low-income families), are screened for blood lead levels (BLLs). Such screening, however, might not include all children at high risk for having BLLs above the reference levels (≥5 μg/dL) in the state. In our study, Bayesian methods were used to estimate the predictive density of the number of children <6 years with BLLs of 5-9 μg/dL in a targeted county from each of five selected regions of Georgia. Furthermore, the estimated mean number of children with BLLs of 5-9 μg/dL in each targeted county, along with its 95% credible interval, were calculated. The model revealed likely underreporting of some children <6 years with BLLs of 5-9 μg/dL in counties of Georgia. Further investigation might help reduce underreporting and better protect children who are at risk for lead poisoning.
New Web-Based Public Health Assessment Guidance Manual -A Foundational Tool for Evaluating Exposure and Public Health Impacts in Communities
Operational Insights Into Mosquito Control Disaster Response in Coastal North Carolina: Experiences With the Federal Emergency Management Agency After Hurricane Florence
Preparation for post-hurricane mosquito control is essential for an effective emergency response to protect public health and promote recovery efforts. Effective pre-hurricane planning includes laying the groundwork for a successful reimbursement application to the Federal Emergency Management Agency. The critical and overlapping need to sustain funding for mosquito control programs is highlighted here in the context of both normal and emergency responses. Community support is an integral component of an effective integrated pest management program and is established over time with appropriate communication and engagement. Experienced mosquito control operators who are familiar with treatment areas are an essential component of successful operations. Here, practical advice is provided to plan, prepare, and implement a successful ground- and aerial-based mosquito control response.
Identifying Research to Evaluate Exposures to Microplastics
An Overview of Brownfields Redevelopment in the United States Through Regulatory, Public Health, and Sustainability Lenses
This second article in a series of three on land reuse highlights brownfields redevelopment in the U.S., focusing on regulatory frameworks, public health, policy, and sustainable development. The main regulatory agency in the U.S. involved in brownfields is the U.S. Environmental Protection Agency (U.S. EPA). Many other state and federal agencies have brownfield or brownfield-supporting programs. Apart from the Agency for Toxic Substances and Disease Registry, few agencies have programs fully dedicated to public health protection related to brownfields. Sustainable development, defined in this article as development that minimizes use of nonrenewable resources, is recognized as a component of redevelopment and is generally promoted by U.S. EPA and through other sustainable development initiatives. A broader focus on sustainable development and public health improvement could reduce the inequity and health disparities typically seen in areas with distressed environments. Such a focus could be implemented globally to improve population health and the environment over the long term.
Tools and Techniques to Promote Proper Food Cooling in Restaurants
Slow cooling of hot foods is a common pathogen proliferation factor contributing to restaurant-related outbreaks. The Food and Drug Administration (FDA) model provides guidelines on the time and temperatures needed for proper cooling and recommends several methods to facilitate rapid food cooling. Restaurants continue to struggle with proper cooling even given these guidelines (Hedeen & Smith, 2020). Research summarized in this guest commentary indicates that portioning foods into containers with a depth of <3 in. and ventilating the containers during the cooling process promote rapid cooling. Restaurant operators and health department inspectors could use these cooling methods to maximize cooling efforts. Additionally, a simple method (using a mathematical equation) could help restaurant operators and inspectors to estimate the cooling rates of foods. This simple method uses only two food temperatures taken at any two points in the cooling process (using the equation [Log(T - T) - Log(T - T)]/δt) to estimate whether the food is expected to meet FDA cooling guidelines. This method allows operators and inspectors to identify foods unlikely to meet FDA guidelines and take corrective actions on those foods without having to monitor food temperatures for the entire cooling process, which typically takes 6 hr. More research is underway to further refine aspects of this method.
Sustainable Brownfields Redevelopment in the European Union: An Overview of Policy and Funding Frameworks
This first article in a series of three on land reuse highlights sustainable brownfields redevelopment in Europe. Sustainability is a key European concept. Europe's densely populated urban areas are facing specific challenges that include urban sprawl and environmental pollution. Redeveloping brownfields, or reusing the abandoned built landscape, can positively impact the economic, social, and environmental health security of cities. Many European Union (EU) cities benefit from policy and financial assistance in renovating their urban areas. This article reviews the EU's policy and funding frameworks that support sustainable brownfields redevelopment. Brownfield site problems are common to many countries in Europe and around the world, and this article aims to share knowledge and resources that support the transformation of these abandoned or underused areas into public or private uses.
Educating the Future Environmental Health Workforce During COVID-19: Developing a Virtual Curriculum for Navajo Student Interns Using the Environmental Health and Land Reuse Certificate Program
Beginning in 2016, the Agency for Toxic Substances and Disease Registry (ATSDR) and the National Environmental Health Association (NEHA) launched a partnership to create a free online course with the goal of building capacity within communities to help remediate and redevelop brownfields sites. Brownfields are land reuse sites often contaminated by harmful chemicals or redeveloped without proper environmental oversight. Due to their potentially hazardous status, brownfields sites can lead to harmful exposures in humans while accentuating and often exacerbating socioeconomic disparities within their communities. As a result of this partnership, NEHA and ATSDR launched the Environmental Health and Land Reuse (EHLR) Certificate Program in 2020. The is pleased to feature this column to highlight an example of how the EHLR Certificate Program was used to build understanding and increase knowledge on this important topic within environmental health students. The findings and conclusions in this column are those of the authors and do not necessarily represent the views or official position of NEHA, ATSDR, or the Centers for Disease Control and Prevention. Furthermore, verbal permission was given by the students to use their work in this column.
Exploring the Benefits and Value of Public Health Department Internships for Environmental Health Students
Internships are an essential component of preparing prospective college graduates for entering the practice-based field of environmental health (EH). EH professionals continually encounter events or hazards of high complexity and impact, and many experienced EH professionals are expected to retire within the next several years. Efforts are needed to ensure a supply of highly qualified and prepared graduates is available to sustain and strengthen the EH workforce. The National Environmental Public Health Internship Program (NEPHIP) addresses this need by supporting health department internships for EH students of academic programs accredited by the National Environmental Health Science and Protection Accreditation Council. We conducted an assessment to examine former NEPHIP intern and mentor experiences and perspectives on 1) how well the internships prepared interns for careers in EH and 2) to what extent the internships provided value to the host health department. Overall, the internships appeared to provide EH students with a well-rounded professional and practice-based experience, while health departments benefited from hosting interns with a foundational knowledge and college education in EH. Promoting the value of public health department EH internships could encourage more students and graduates to seek internship or employment opportunities with health departments, ultimately strengthening the EH workforce.
Development, Evaluation, and Long-Term Outcomes of Environmental Health and Land Reuse Training-Part 1: Developing Environmental Health and Land Reuse Trainings for the Environmental Health Workforce and Their Community Partners
This article is the first in a series of three that describes the development and delivery of the Environmental Health and Land Reuse (EHLR) Basic Training and the first pilot of the EHLR Immersion Training. The EHLR Basic Training is based on the 5-step Land Reuse Model from the Agency for Toxic Substances and Disease Registry (ATSDR). Through a collaboration with the National Environmental Health Association (NEHA), we developed the EHLR Basic Training in two modalities: virtual/live (maintained by ATSDR) and online/asynchronous (maintained by NEHA). The modules include: 1) Engaging With Your Community, 2) Evaluating Environmental and Health Risks, 3) Communicating Environmental and Health Risks, 4) Redesigning With Health in Mind, and 5) Measuring Success: Evaluating Environmental and Health Change. From June 2019-August 2022, ATSDR and NEHA delivered 10 EHLR Classroom Basic Trainings, launched the EHLR Online Basic Training, and developed the EHLR Immersion Training. We piloted the EHLR Immersion Training in July 2022, March 2023, and July 2023. Our participants included science, technology, engineering, and mathematics (STEM) students from Diné College who were in a Summer Intern Program; tribal environmental professionals; NEHA members in environmental health careers; and environmental professionals, students, and community members who were engaged in environmental work or environmental justice. We have learned that individual training modules can be used for specific learning needs among our participants. Perhaps more importantly, we have learned that undergraduate students and community members can and should be engaged in EHLR Training. The results of the evaluation and long-term follow-up of the EHLR Training will be presented in the second and third articles in this series.