JOURNAL of Twelve Dollars Environmentaldedicated to the Advancement of the Environmental Health Professional Healthvolume 76, No

JOURNAL OF twelve dollars EnvironmentalDedicated to the advancement of the environmental health professional HealthVolume 76, No. 10 June 2014

Published by the National Environmental Health Association www.neha.org

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EnvironmentalDedicated to the advancement of the environmental health professional HealthVolume 76, No. 10 June 2014

ABOUT THE COVER ADVANCEMENT OF THE SCIENCE Incorporating Community-Based Participatory Research Principles Our cover this Into Environmental Health Research: Challenges and Lessons Learned month emphasizes From a Housing Pilot Study ...... 8 an important point that the authors A Strategic Cleaning Assessment Program: Menu Cleanliness at Restaurants ...... 18 of our feature, “Incorporating Voluntary Approaches to Solid Waste Management in Small Towns: A Case Study Community-Based of Community Involvement in Household Hazardous Waste Recycling ...... 26 Participatory Research Principles [CBPR] Into Envi- ADVANCEMENT OF THE PRACTICE ronmental Health Research: Challenges and Lessons Learned From Direct From ATSDR: Agency for Toxic Substances and Disease Registry’s a Housing Pilot Study,” make about CBPR: it Don’t Mess With Mercury Initiative ...... 34 is rooted in the communities that are active participants as well as subjects of environmental Direct From CDC/EHSB: Impact of Budget Cuts to Environmental Health Services health research. The authors’ goal was to col- at Local Health Departments: Key Findings...... 38 laborate with residents of both green-built and conventional low-income housing to determine differences in chemical exposure and biological agents. The authors also aimed to explain ADVANCEMENT OF THE PRACTITIONER to residents how to reduce their exposure and Guest Commentary: I Am an Environmental Health Pracademic (And So Can You!) ...... 42 UL PUTS SAFETY therefore improve health outcomes. See page 8. Demystifying the Future: Passing the Fortune Cookie Test ...... 44 Cover illustration © iStockphoto/John Woodcock AT THE TOP OF Career Opportunities ...... 46 EH Calendar ...... 48 ADVERTISERS INDEX Resource Corner ...... 50 THE FOOD CHAIN American Chemistry Council/ Chlorine Institute ...... Insert American Public University ...... 7 YOUR ASSOCIATION Anua ...... 57 Comark Instruments ...... 25 President’s Message: Where Everybody Knows Your Name…...... 6 Custom Data Processing...... 47 Decade Software ...... 79 Special NEHA Members ...... 53 Full Service Solution Provider for the Food Service Industry Digital Health Department, Inc...... 41 HealthSpace USA Inc...... 80 Special Listing ...... 54 For more than a century UL has employed exacting scientic processes and the Industrial Test Systems, Inc...... 24 Inspect2GO ...... 5 NEHA News ...... 56 highest ethical principles to deliver trusted results. Today, we continue to focus on InspekPro ...... 37 LaMotte ...... 43 In Memoriam ...... 56 the next generation of food safety challenges and more, helping the food service Mitchell Humphrey ...... 51 Mycometer ...... 33 industry and stakeholders achieve safer living and work environments. NEHA 2014 AEC ...... 59 NSF International ...... 77 Ozark River/Integrity Distribution ...... 46 Presby Environmental, Inc...... 51 NELSON FABIAN’S Managing Editor’s Desk: The Time Has Come … Learn about our many food service and food safety resources below: Shat-R-Shield ...... 49 Sweeps Software, Inc...... 17 FAREWELL COLUMN! Thank You, NEHA! ...... 78 Underwriters Laboratories ...... 2 FOOD SERVICE EQUIPMENT FOOD SAFETY & BRAND PROTECTION RETAIL FOOD SAFETY TRAINING University of Illinois Springﬁeld ...... 25 UL.COM/APPLIANCES UL.COM/FOOD ULEDUNEERING.COM/FOODSAFETY

JEH6.14_PRINT.indd 3 5/1/14 4:08 PM Showcase Environmental Health and All It Encompasses 24x36˝ For many years NEHA’s Journal of Environmental • Three different frame-able sizes* Health has been adorned by visually-stunning and 3 • Glossy, high-quality prints creative covers portraying a wide variety of • Select covers from 2005 to the present environmental health topics. You can now own these 18x24˝ *Framing available on request for an extra fee. amazing cover images in poster size. Use the walls of your department and of ce to display to visitors, your boss and staff, and the public what environmental 2 health encompasses and your pride in your profession. Special Offer: Get a free 8.5x11˝ 8.5x11˝ For more information and to place your order: print of any cover with the order ª Go to neha.org/JEH 1 of at least one poster. ª Contact Kristen Ruby at [email protected] or 303.756.9090, ext. 341

Published monthly (except bimonthly in January/February and July/ Official Publication August) by the National Environmental Health Association, 720 S. Colorado Blvd., Suite 1000-N, Denver, CO 80246-1926. Phone: (303) 756-9090; Fax: (303) 691-9490; Internet: www.neha.org. E-mail: [email protected]. Volume 76, Number 10. Subscription rates in U.S.: $135 per year and $250 for two years. International subscription rates: $160 per year and $300 for two years (airmail postage included). Single copies: $12, don’t if available. Reprint and advertising rates available at www.neha.org/JEH. CPM Sales Agreement Number 40045946. Journal of Environmental Health Claims must be fi led within 30 days domestic, 90 days foreign, © Copyright 2014, National Environmental Health Association (ISSN 0022-0892) (no refunds). All rights reserved. Contents may be reproduced only missin the next Journal with permission of the content editor. of Environmental Health Nelson Fabian, MS, Managing Editor Opinions and conclusions expressed in articles, reviews, and other Kristen Ruby, Content Editor contributions are those of the authors only and do not refl ect the policies or views of NEHA. NEHA and the Journal of Environmental Health are not Elizabeth Donoghue-Armstrong, PhD, Copy Editor liable or responsible for the accuracy of, or actions taken on the basis of, any information stated herein.  Environmental Health Literacy in Hughes design|communications, Design/Production Cognition Studio, Cover Artwork NEHA and the Journal of Environmental Health reserve the right to reject Support of Social Action any advertising copy. Advertisers and their agencies will assume liability for Soni Fink, Advertising the content of all advertisements printed and also assume responsibility for For advertising call 303.756.9090, ext. 314 any claims arising therefrom against the publisher.  Norovirus Outbreak at a Full text of this journal is available through Bigchalk.com at www. Wildland Fire Base Camp Ignites Technical Editors bigchalk.com and from ProQuest Information and Learning, (800) William A. Adler, MPH, RS 521-0600, ext. 3781; (734) 973-7007; or www.proquest.com. The Investigation of Restaurant Journal of Environmental Health is indexed by Current Awareness in Retired (Minnesota Department of Health), Rochester, MN Biological Sciences, EBSCO, and Applied Science & Technology Index. Inspection Policies Nancy Culotta, MPH It is abstracted by Wilson Applied Science & Technology Abstracts and Retired (NSF International), Ann Arbor, MI EMBASE/Excerpta Medica.  Incorporating Occupational Risk in Elizabeth Donoghue-Armstrong, PhD All technical manuscripts submitted for publication are subject to peer NEHA, Denver, CO review. Contact the content editor for Instructions for Authors, or visit Heat Stress Vulnerability Mapping www.neha.org/JEH. Gary Erbeck, MPH  Online prepublished article: Retired (County of San Diego Department To submit a manuscript, visit http://jeh.msubmit.net. Direct all questions to of Environmental Health), San Diego, CA Kristen Ruby, content editor, [email protected]. Isolation of Legionella Carolyn Hester Harvey, PhD, CIH, RS, DAAS, CHMM Periodicals postage paid at Denver, Colorado, and additional Eastern Kentucky University, Richmond, KY mailing offi ces. POSTMASTER: Send address changes to Journal of pneumophila From Cooling Environmental Health, 720 S. Colorado Blvd., Suite 1000-N, Denver, Thomas H. Hatfi eld, DrPH, REHS, DAAS CO 80246-1926. Towers, Public Baths, Hospitals, California State University, Northridge, CA and Fountains in Seoul, Korea Dhitinut Ratnapradipa, PhD, MCHES Printed on recycled paper. Southern Illinois University, Carbondale, IL

4 Volume 76 • Number 10

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June 2014 • Journal of Environmental Health 5

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YOUR ASSOCIATION

 PRESIDENT’S MESSAGE

Where Everybody Knows Your Name

Alicia Enriquez Collins, REHS

Making your way in the world today takes didate pools, simplify their recruiting efforts, everything you’ve got. and keep salary expenses down, this combi- Taking a break from all your worries sure NEHA is the nation can translate to the whittling away at would help a lot. the demand for our credential. As this occurs, Wouldn’t you like to get away? home base, either our members or environmental health Be glad, there’s one place in the world. agencies will approach NEHA to lend support the go-to place, in the fi ght to uphold the REHS/RS creden- Where everybody knows your name and tial. At our annual spring board of directors’ they’re always glad you came. and the welcoming meeting, I appointed an ad hoc committee You want to go where people know, people are to draft a position paper that will offi cially all the same. venue for proclaim support for the REHS/RS credential. You want to go where everybody knows environmental This affi rmation document can then be used your name. by the membership and jurisdictions when Excerpt from the theme song of “Cheers,” a health professionals. working to preserve our premier credential popular sitcom that aired during 1982–1993 for environmental health practitioners. Written by Gary Portnoy and Judy Hart For additional information regarding NEHA’s REHS/RS credentialing program, offi cial posi- Registered Environmental Health tions, and strategic directions, visit our Web site s my term as your president comes Specialist/Registered Sanitarian at www.neha.org. to a close, it has provided an oppor- (REHS/RS) Credential tunity for refl ection on the friend- A NEHA’s REHS/RS credential is our premier Sustainability in ships, partnerships, and bonds that have credential and it represents technical compe- Environmental Health been developed or strengthened because of tency for environmental health practitioners. In 2010, the board approved a white paper our organization. Thinking about the lyrics It includes an array of program disciplines, entitled, “The Role of Sustainability in Envi- to this song brings to mind the gathering of such as food protection, air quality, drinking ronmental Health.” This team effort was friends in a familiar and welcoming venue. water quality, recreational health, disaster led by Technical Advisor Tom Gonzales of The setting was a neighborhood pub in Bos- preparedness/emergency response, and land Colorado. The team worked for two years to ton called “Cheers.” In my view, NEHA is a use, to name a few. This July, NEHA will begin develop our annual Sustainability Award and lot like Cheers: a gathering of friends in a fa- offering a newly revised REHS/RS exam. And our white paper. Education and advocacy in miliar and welcoming venue where our com- it will be offered at our upcoming Annual the area of food protection are in line with mon ground provides the basis for improving Educational Conference & Exhibition in Las NEHA’s strategic directions; therefore, I have ourselves and collectively seeking ways to Vegas! Congratulations and many thanks to asked the team to reconvene to closely exam- enhance and protect the communities where the NEHA staff and a team of subject-matter ine the food section of the document. As we live, work, and recreate. experts for updating the exam. we have witnessed a movement to promote Before I say “cheers” to you, I would like Approximately 23 states require an REHS locally grown and manufactured foods, it is to share a few thoughts and updates to let credential and approximately 18 states have important for NEHA to consider food pro- you know what we are doing to better serve reciprocity with NEHA’s REHS/RS credential. tection and security within these initiatives our members. As agencies seek ways to increase their can- (e.g., farmers’ markets, urban farming/urban

6 Volume 76 • Number 10

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farm stands, food co-ops, cottage foods, food 78th Annual Educational (see pages 54 and 55), I thank you for your composting, and organic foods). Conference & Exhibition creativity, commitment, and perseverance. On July 7–10, 2014, NEHA will join with the When members attend a conference, par- Best Practices Review International Federation of Environmental ticipate in a workshop, take an e-Learning In 2013, the board of directors decided to Health (IFEH) to cohost our premier educa- course, receive the JEH or E-News, or visit search for a consultant to complete a best tional event in Las Vegas, Nevada. We are hon- NEHA’s social media sites, they are experi- practices review for our association. NEHA ored to have the opportunity to partner with encing the result of your magical hands and is encountering many of the same challenges IFEH colleagues from around the world. The bright and creative minds. I truly appreciate public and private-sector organizations are program agenda and the ceremonies are ready that your motivation is focused on giving facing—generational change, fewer grant to launch in just a few short weeks. We have back to NEHA to represent our members and funding opportunities, and decreased travel an educational program that will feature guest support the advancement of the environmen- budgets for our members. The board thought presenters from around the world, poster ses- tal health professional. it was a good time to reexamine the way NEHA sions, award and scholarship presentations, Cheers and bravo to this magniﬁcent cast does business to ensure that it continues to be a student mentorship program, and a virtual for championing our great cause! NEHA is the the leadership organization for our members conference option. I look forward to seeing and for the environmental health profession. you there as we welcome IFEH members. home base, the go-to place, and the welcoming We continually seek innovative methods venue for environmental health professionals. for delivering our services. Our e-Learning Cheers! It has truly been an honor and a pleasure opportunities, virtual conference options, and Cheers to the many volunteers and staff who to serve you as president this year. Thank traveling educational workshops are perfect work countless hours to make our organiza- you for your friendship and for your support examples of NEHA’s efforts to deliver qual- tion run successfully. I offer my sincere grati- throughout the year. ity education to environmental health prac- tude to my husband Rick for his support and titioners. A best practices review is intended for being by my side throughout the year. to identify additional innovative methods for To the board of directors, technical advisors, delivering our products and services. each one of our volunteers, and all of the staff [email protected]

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June 2014 • Journal of Environmental Health 7

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ADVANCEMENT OF THE SCIENCE

Paris Ponder-Brookins, MPH Incorporating Community- Joyce Witt, MPH, RN Centers for Disease Control Based Participatory and Prevention John Steward, REHS, MPH Research Principles Into School of Public Health Georgia State University Environmental Health Douglas Greenwell, PhD Atlanta Regional Health Forum Research: Challenges and Ginger L. Chew, ScD Centers for Disease Control Lessons Learned From a and Prevention Yvette Samuel Housing Pilot Study ZAP Asthma Chinaro Kennedy, MPH, DrPH Mary Jean Brown, ScD, RN Centers for Disease Control and Prevention

which a specifi c collaboration includes each Abstract In environmental health research, a community-based principle can vary (Cornwall, 1996; Green et al., 1995; Israel et al., 2008). CBPR is the participatory research (CBPR) approach can effectively involve community overarching concept that incorporates “par- members, researchers, and representatives from nonprofi t, academic, and ticipatory research” and “action research.” governmental agencies as equal partners throughout the research process. These terms describe how research partici- The authors sought to use CBPR principles in a pilot study; its purpose was pants “actively” participate in the research to investigate how green construction practices might affect indoor expo- process (Bailey, 1992; Cornwall, 1996; Heron & Reason, 2001; Lewin, 1946). Green and co- sures to chemicals and biological agents. Information from this pilot authors (1995) defi ne participatory research as informed the development of a methodology for a nationwide study of low- a “systematic inquiry with those affected by the income urban multifamily housing. The authors describe here 1) the issue being studied, for purposes of educating incorporation of CBPR principles into a pilot study comparing green vs. and taking action or effecting social change” and they provide a framework for appraising conventionally built urban housing, 2) the resulting implementation and various levels of participatory research. reporting challenges, and 3) lessons learned and implications for increased Not all research conducted in a community community participation in environmental health research. uses a participatory action research method (Hatch, Moss, Saran, Presley-Cantrell, & Mallory, 1993; Schulz, Israel, Selig, & Bayer, 1998). Hatch and co-authors (1993) describe Introduction of community-based participatory research four models of “community-based” research. Community participation and its empha- (CBPR). CBPR involves community members, In two of these, research is conducted in a sis on the partnership between researchers organizational representatives, and research- community setting, but the community’s and affected communities is an important ers equally in all aspects of the research pro- role is passive and not involved with setting part of urban and environmental health cess—all partners contribute their expertise in the research agenda. The other two models research (Israel et al., 2005; Minkler, 2005). an environment of shared responsibility and are more “participatory” in that researchers The scientifi c literature uses various terms decision making (Israel et al., 1998; Israel et partner with community members 1) as key to describe “community-based/involved/cen- al., 2005; Israel et al., 2008). Unlike traditional recruiters to identify others to participate and tered/engaged research” that features a col- investigator-driven research, CBPR is rooted in 2) as active members of the research team in laborative partnership approach to working the community (Flicker, 2008; Sclove, 1997). establishing the direction of the research. with communities (Ahmed & Palermo, 2010; According to Israel and co-authors (1998, “Community engagement” has been defi ned Israel et al., 2005; Israel, Schulz, Parker, & 2008) CBPR has nine key principles or char- as supporting mutual respect of values, strat- Becker, 1998). However it is described, the acteristics (Table 1). While researchers should egies, and actions for authentic partnership partnership approach is an essential aspect strive to meet these principles, the extent to of people affi liated with or self-identifi ed

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by geography or specific interests affecting academia, and community-based organiza- locations. The pilot study was designed to the community (Ahmed & Palermo, 2010; tions. Staff from the Centers for Disease Con- compare the concentration of allergens and Clinical and Translational Science Awards trol and Prevention (CDC) collaborated with chemicals in green versus conventional hous- Consortium & Community Engagement Key staff of the Atlanta Regional Health Forum ing. Team members met with management of Function Committee Task Force, 2011). In (ARHF), a nonprofit coalition dedicated to each complex to explain the study’s objectives. this article, “community participation” signi- creating healthy communities by educating The green housing consisted of an 84-unit fies how community members are included and empowering individuals to achieve their complex completed in 2003. The green com- in the research process. fullest health potential. Other team members ponents included low VOC-emitting carpets This article describes 1) the incorporation included academic partners from Georgia State and paints, Energy Star appliances, insula- of CBPR principles into a pilot study com- University School of Public Health (GSU) and tion, energy efficient windows, and recycled paring green vs. conventionally built urban community health workers (CHWs) from Zap building materials. Other features included housing for low-income senior citizens, 2) the Asthma. Zap Asthma is a public-private partner- fresh air intakes, integrated pest management, resulting implementation and reporting chal- ship dedicated to reducing asthma in children and moisture protection measures. The con- lenges, and 3) lessons learned and implica- and the CHWs administered questionnaires trol complex was a conventionally built 195- tions for increased community participation in and collected environmental samples inside unit, 14-story apartment tower completed in housing-based environmental health research. the home and in nearby outdoor locations. 1978. Each conventional apartment had inside Although—unlike model CBPR practice—the Studies on asthma and other chronic diseases access from a hallway. community was not involved in establishing have consistently shown positive outcomes The populations of interest were residents the research questions, throughout the research associated with CHW-delivered interventions living in senior citizen housing complexes. The process community members (i.e., residents) (Condon, Hynes, Brooks, Rivard, & McCarthy, Department of Housing and Urban Develop- were planned-in for participation. Intended 2007; Krieger, Takaro, Song, & Weaver, 2005; ment (HUD) categorized the study properties community benefits included 1) measurement Postma, Karr, & Kieckhefer, 2009). The CHWs as multi-unit residences for low-income senior of the level of environmental hazards in resi- were essential partners who had experience citizens. In the green complex, the majority of dents’ homes and 2) explanation of actions par- working with similar low-income populations, participants were African-American aged 64 to ticipants could take to reduce exposures. several of which were older (>50 years of age) 90 years; in the control complex, both African- and of the same racial/ethnic population as the Americans and whites participated with ages Background pilot study participants. ranging from 55 to 97 years. In 2008, a pilot study investigated how green The research team met regularly over two Resident recruitment was conducted through construction practices affected indoor air in years from 2006 to 2008 before data collec- town hall meetings at the respective housing low-income housing. Green-built environ- tion began in 2008. The team discussed the complexes. The meetings were advertised with ments are believed to promote occupant health project, defined roles and responsibilities, flyers designed to be culturally sensitive by because they can minimize pest infestations, and established an implementation process. reflecting the participants’ age and ethnicity. exposures to many chemical compounds, and The pilot study was approved by the GSU Incentives to encourage attendance included moisture (given appropriate ventilation in the institutional review board (IRB). GSU also light refreshments, game prizes, and a raffle home). The objectives of the pilot study were assisted with CHW training, sampling, data- drawing and were provided solely to make to quantify levels of allergens, fungi, pesticides, base construction, analysis, results verifica- the information dissemination sessions fun and volatile organic compounds (VOCs) to tion, and reporting. The CHWs participated and informal. The principal investigator intro- test for a possible difference between the levels in many aspects of the project, including duced the CHWs and research team, provided in green-built housing versus conventionally feasibility issues, implementation, and trans- an overview of the pilot study, described its built housing and to translate or communicate lation of results back to the community to benefits, and answered questions. Residents the results in plain language to study partici- ensure cultural relevance and sensitivity. were told they would receive an IRB-approved pants. The pilot study also laid the foundation CDC technical advisors provided oversight $10 gift card at the completion of environmen- for a nationwide prospective cohort study to on collaboration with community leaders, tal sampling. A total of 74 participants were ascertain health outcomes in low-income, protocol, survey design, CHW training, and recruited: 34 (46%) from the study complex inner-city populations before and after moving analysis. The research team agreed to share and 40 (54%) from the control. The town hall into green housing. While the results of the publication authorship. meetings began recruitment in March 2008 pilot study are not presented here, they can be and sampling began in April. Environmental found elsewhere (Chew et al., 2009). Site Selection and Study Population sampling was conducted over three months The pilot study sampling frame was a non- from April to July 2008. Methods probability convenience sample drawn from two urban senior citizen independent liv- Environmental Sampling by CHWs Partner Selection ing housing complexes in Atlanta, Georgia. Two training workshops were held for the The pilot study used a CBPR approach by The complexes were selected because of the CHWs before sampling began. The first train- establishing a collaborative research team willingness of the property managers to paring included sessions on the study objectives, made up of partners representing government, ticipate and because of the complexes’ central participant and property manager question-

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naires, participant interview techniques, con- nationally accepted thresholds for safety (i.e., Results on pesticide measurement were sent process, protocol for collecting and logging VOCs and pesticides). Assessing health risks recorded as either detected or not detected. temperature and humidity, air sampling devices was beyond the scope of the pilot and blood Input on the reporting form from the CHWs for formaldehyde and other VOCs, and wet- or other clinical samples were not collected, resulted in modifications, including remov- wipe sampling for pesticides. The CHWs prac- nor was information on a resident’s inges- ing illustrations of mice and cockroaches and ticed opening, resealing, and labeling the air tion or contact with chemicals in the hous- revising text to a lower literacy level. The sampling devices. The second training was held ing unit. Therefore, special consideration CHWs thought that the elderly population in in a team member’s home to allow hands-on was given to communicate results without our study would be offended by the pictures practice with equipment and dust sampling in a raising fear. Quantifying risk was further of cockroaches and mice because they take home environment. CHWs reviewed protocols complicated because the sampling methods pride in the cleanliness of their home; the pic- on laboratory supplies, shipping, and storage of provided only indirect estimates of exposure tures of cats and dust mites were deemed not collected samples. For further details, see Chew levels and because the ability to assess expo- offensive. Although the John Hopkins forms and co-authors (2009). sures varied by contaminant. were used in a childhood asthma study with- Data collection from each housing unit Another reporting concern was allaying out any problem with the illustrations, we took place over two consecutive CHW visits. residents’ concerns that detection of some incorporated the CHWs’ suggested revisions On the first day, the CHWs met with the par- agents in the home reflected poorly on their (Principle 7). The final result-reporting forms ticipants in a public meeting room, explained housekeeping practices. For example, mouse had a reading grade level of 5.4, 7.4, and 7.6 the study, and obtained signatures on consent allergen was detected in some units (23% for the allergen, pesticide, and VOCs reports, forms according to GSU’s IRB-approved pro- green vs. 6% conventional) and one unit in respectively, based on the Microsoft Word tocol. Residents were considered eligible to the green housing had detectable rat allergen. Flesch-Kincaid grade level index. Although participate if they were able to answer ques- Pest management by the residents and build- it was challenging to translate results without tions on the study’s purpose, activities, and ing maintenance influence rodent allergens; national standards, the development of the voluntary nature. After obtaining consent, but we did not investigate past and current results-reporting form allowed the research the CHWs performed a visual assessment of practices. While we could not say that these team to communicate individual environmen- the participants’ apartments to document fire exposures were health hazards to the resi- tal exposure findings in plain language. damage; visible mold; musty odors; open dents in either complex, we were able to sug- windows; working heating, ventilation, and gest several methods of decreasing exposures Results Dissemination via Town Halls air conditioning and air cleaners; and paint in their homes. The result-reporting forms were distributed stored in the home. Temperature and humid- The final aim of the results reporting was at closing town hall meetings held in Decem- ity were recorded indoors and out, and passive to inform residents of differences in allergen, ber 2008 (green housing) and January 2009 air sampling badges were placed in the home fungi, pesticide, and VOC levels between (conventional housing). Approximately half overnight. On the second data collection day, the green and conventionally built housing. of the pilot study participants attended the CHWs retrieved the air sampling badges and To this end, we selected the John Hopkins final town hall meetings. For those not in conducted dust sampling from the bed, bed- Center for Childhood Asthma in the Urban attendance, a copy of the slides and individual room floor, and kitchen floor. The CHWs also Environment form to serve as a model to adapt results were mailed. The closing town hall recorded household cleaning products found for our needs (Figures 1 and 2). Not only agenda included an overall pilot study result’s in each unit. Separately, the property managers did this format give individual results, but it presentation, VOC demonstration, a question completed maintenance records on each unit described the environmental agents and listed and answer session, individual results distri- describing painting history, water damage and actions to take to decrease exposures. For bution, refreshments, and raffle drawings. The repair, carpet replacement, and overall pest those whose homes had results above the “lev- presentation began with a reminder that this management practices of the complex. els of concern,” information was presented on was not a health effects study and an expla- At the completion of all sample collection, how to reduce levels of allergens, VOCs, and nation about individual susceptibility factors a debriefing meeting was held with the CHWs pesticides. The exposure levels that were used (e.g., allergies). To minimize residents’ fears to discuss the sampling process and obtain for determining “levels of concern/caution lev- of eviction because of detection of high lev- feedback on how it could be improved for the els” were based upon the California Chronic els of rodent or cockroach allergens, care was nationwide study. Certificates of appreciation Reference Exposure Levels (chRELs) (2007). taken to explain that pests and pest allergens were presented to the CHWs for their data The chRELs are designed to address continu- in a unit can originate from several sources, collection efforts. ous exposures for up to a lifetime and the and that cross-sectional measurements of exposure metric used was the annual average environmental agents are not always reliable Results and Discussion exposure. Results of VOC sampling included risk indicators. The VOC levels were reported the numeric value for the level detected and in parts per million—a sometimes challenging Results Reporting to Participants a comment on units of measurement. In addi- concept; therefore, we demonstrated measure- A primary goal of the pilot study was to tion, a thermometer giving a visual graphic of ment of VOCs with a colorimetric detector develop and test mechanisms for present- caution levels for each VOC was printed adja- tube and a commonly used window-cleaning ing results of environmental agents without cent to the list of individual results. agent containing isopropanol. This allowed

10 Volume 76 • Number 10

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FIGURE 1 Results Report Form—Pesticides and Allergens

Dust Sample: What You Need to Know: Pesticides in To Improve Your Home, Your Home: You Should:

Pesticides . Possible sources of indoor pesticides Cypermethrin was . Contact the property manager if you feel include contaminated soil or dust that  Detected you have a problem with pests. floats or is tracked in from outside.  Not detected . Use nonchemical methods of pest control . Risk cannot be determined with when possible, such as roach traps. the information we collected for Chlorpyrifos was . Increase ventilation when using chemical this study.  Detected pesticides indoors. . 75% of U.S. households used at  Not detected . Do not store unneeded pesticides inside least one pesticide product indoors your home. during the past year. . To decrease use of pesticides: . Pesticides can last on surfaces for a - keep food in sealed containers; long time and you should be careful around eating areas. - don’t leave pet food out overnight; and - seal cracks and crevices to keep the . In 2001, the federal government pests out. phased out use of chlorpyrifos in homes. . If possible, take plants and pets outside when applying pesticides/flea and tick treatments. . Always store pesticide products out of the reach of children.

House Dust Mite . House dust mites are tiny bugs. Dust mite allergen was . Put allergen-proof mattress and pillow Allergen They live in fabric and can be found  Detected (____ µg/g) covers on your bed. in mattresses, pillows, cloth-covered  Not detected . Wash all bedding in hot water. furniture, and carpeting. . Dust mites live off dead skin flakes Note: If you are allergic to and need humidity to grow. dust mites and your value . The allergen is very small. When is above 10 µg/g, you breathed in, it can trigger allergy and should try to reduce your asthma problems in some people. contact with this allergen. . The allergen in the mattress and pillow is very close to the face while sleeping. . Some people are allergic to dust mites and may have a reaction (sneezing, watery eyes, etc.) and some are not allergic.

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residents to see that an ordinary substance Results of CBPR Principles rational goal to achieve (Cornwall, 1996; sprayed into the air could be several orders of Incorporated Green et al., 1995; Israel et al., 2008). Our magnitude higher than the VOC levels found The implementation of the CBPR principles pilot study used CBPR principles, but due in their homes. Time was provided to answer in the pilot study is described in Table 1. to the context of the pilot study (i.e., aim to all questions. Lastly, individual result forms CBPR principles occur on a continuum, and quantify levels of common environmental were handed out to each participant. incorporation of all nine principles is an aspi- contaminants and pilot a methodology) and

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FIGURE 1 continued from page 11 Results Report Form—Pesticides and Allergens

Dust Sample: What You Need to Know: Dust Levels in To Improve Your Home, Your Home: You Should:

Cockroach . Roaches live in small cracks and Cockroach allergen was . Use baits and traps. Never use roach Allergen near sources of food and water.  Detected (____ µg/g) sprays because they can contain . Allergens are found in both dead  Not detected harmful chemicals. and living roaches. . Take trash out every day. . It is hard to get rid of roaches Note: If you are allergic . Keep floor, countertops, and appliances because each female roach can to cockroaches and your clean by sweeping and mopping often. have another 300 babies. value is above 0.32 µg/g, you should try to reduce . Put exposed food, such as sugar, snacks, . Some people are allergic to roaches your contact with this pasta boxes, breads, and cereals in and may have a reaction (sneezing, allergen. tightly sealed containers. watery eyes, etc.) and some are . Clean grease from the stove and walls not allergic. after cooking.

Mouse . Mice enter homes through holes in Mouse allergen was . Exterminate mice by using a mousetrap. Allergen walls and doors and live in nests in  Detected (____ µg/g) . Clean up floors, countertops, and stoves dark places. They come inside when  Not detected after meals. it gets cold outside. . Put exposed food, such as sugar, snacks, . Mice travel inside the home through Note: If you are allergic pasta boxes, breads, and cereals in holes in the walls or up and down to mice and your value tightly sealed containers. gas and water pipes. is above 0.5 µg/g, you . Take trash out every day. . Mice live near food and water should try to reduce your sources. They can live inside the contact with this allergen. . Fill holes and around pipes with copper oven, behind walls, and in the ceiling. mesh to keep mice out. . Some people are allergic to mice . Remove clutter and keep clothes and and may have a reaction (sneezing, papers picked up. watery eyes, etc.) and some are not allergic.

the influence of various partners (see chal- participants and the research team and gatekeepers in controlling access to residents. lenges below), we could not employ all prin- facilitate recruitment. In addition, the con- Because Georgia’s “Right to Rent” law allows ciples. The purpose of the pilot study was tinuous communication among the CHWs, property managers to refuse admission to not to address health disparities or commu- participants, and their families or caregivers housing complexes, obtaining the property nity concerns, which are the most common further helped explain the project’s goals and managers’ support and cooperation was essen- reasons for a CBPR approach. Rather, the increase receptivity of specific findings and tial. Property managers were concerned about study was to gather pilot data for the future recommendations. Nevertheless, more cole- the time commitment, disrupting the commu- nationwide study. Nonetheless, many CBPR arning could have been done (Principle 4). nity, and repercussions from results that might principles were applied and the value of the The principles not fully incorporated into the reflect negatively on the property. To build CBPR approach was realized. For example, pilot study are described below (i.e., chal- trust and support, the property managers were the CHWs were instrumental in the recruit- lenges and lessons learned). involved in approving communication mate- ment, consent process, data collection, and rials (post-CHW input) before any materials in sharing promising practices to communi- Challenges were shared with residents (Principle 4). cate results to the participants. The strategic The research team encountered challenges to Furthermore, identifying the convention- use of the town hall meetings as a vehicle for fully incorporating a CBPR approach during ally built complex proved to be a challenge. transparent communication and informa- study implementation. We underestimated Potential properties were first identified from tion sharing helped to build trust between the importance of the property managers as lists of low-income housing that received

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FIGURE 2 Results Report Form—Volatile Organic Compounds

Air Sample: What You Need to Know: To Improve Your Home, You Should:

Volatile Organic VOCs come from many sources: . Do not smoke inside. Compounds (VOCs) . Formaldehyde—particle board, cigarette smoke, . Increase ventilation (opening windows or using insulation, and carpet exhaust fans) when using chemical indoors or . Acetaldehyde—fireplaces, vehicle exhaust, cigarette getting new furniture or carpet. smoke . Try to reduce use of chemicals in your home. . Isopropyl alcohol (rubbing alcohol)—cleaning agents and perfumes . Toluene—solvents, glue . para-Dichlorobenzene—toilet bowl deodorants and air fresheners . It’s hard to know if some levels of VOCs are safe because people can react differently to exposures (for example, if you have asthma)

Air Levels in Your Home: Range of Caution Levels:

Formaldehyde was 3000 Isopropyl alcohol (2850 ppm)  Detected (______ppm) 2500  Not detected 2000 Acetaldehyde was 1500 Series1  Detected (______ppm)  Not detected 1000 500 Isopropyl alcohol was Note: If your value 0  Detected (______ppm) is above the caution  Not detected level, you should try 1 to reduce your contact with these chemicals. Toluene was 0.8  Detected (______ppm)  Not detected 0.6 Series1 para-Dichlorobenzene was 0.4  Detected (______ppm) para-Dichlorobenzene (0.2 ppm)  Not detected 0.2 Toluene (0.08 ppm) Formaldehyde (0.03 ppm) 0 Acetaldehyde (0.005 ppm)

ppm = parts per million.

HUD subsidies. We visited at least 10 prop- conditions. Ultimately, the decision to par- participation of resident leaders as key infor- erties to request participation and inform ticipate was predicated upon a manager’s per- mants in the planning and decision-making the property managers about the pilot study. ception of the pilot study’s beneﬁt. process. One manager later vetoed this idea, Concerns arose regarding possible punitive Once the green and conventionally built however, because she feared identifying cer- consequences from the government if resi- control complexes were identiﬁed (Principle tain residents as “leaders” might encourage dents were found to be living in substandard 1), both managers originally agreed to the complaints against management. Property

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TABLE 1 Community-Based Participatory Research (CBPR) Principles Incorporated in the Pilot Study

CBPR Principles* Applied to Pilot Explanation Study (Yes/No) 1. Recognizes community as a unit of identity Yes Two community partners were identified. • Residents based on geographical location and housing type. • Community health workers (CHWs) represented interests of senior citizens. 2. Builds on strengths and resources within the community Yes • Community-based organizations (ARHFa and Zap Asthma) had experience with similar communities. 3. Facilitates collaborative, equitable partnership in all No Inequitable decision-making opportunities because research phases and involves an empowering and • Partners were engaged at different stages. power-sharing process that attends to social inequalities • Residents and CHWs were not involved in study design. • CHWs did contribute, however, to communication materials and results dissemination. 4. Promotes colearning and capacity building among Yes Many colearning opportunities were provided, per below, yet more were all partners possible (see lessons learned). • Frequent knowledge exchange among researchers, CHWs, and property managers. • Town hall meetings and Q&A sessions for residents. • Received input from CHWs on sampling and results-reporting forms. • CHWs interacted with participants and their families/caregivers, which increased receptivity of pilot study recommendations. 5. Integrates and achieves a balance between research and No • Power sharing was not balanced among all partners. action for the mutual benefit of all partners • No “action” was identified as a study outcome. • Input from other partners (in planning stages) may have influenced study outcomes. 6. Emphasizes public health problems of local relevance No • The pilot study did not attempt to address determinants of health given and also ecological perspectives that recognize and assessing health risks were beyond the pilot study’s scope. attend to the multiple determinants of health and disease 7. Involves systems development through a cyclical and Yes • The pilot study process allowed for cyclical feedback through phases of iterative process data collection, data analysis, and results reporting. • Participants had access to CHWs and research team from initial consent to final results reporting as needed. 8. Disseminates findings and knowledge gained to Yes Many information sharing opportunities were provided, per below, yet more all partners and involves all partners in the were possible (see lessons learned). dissemination process • Strategic information dissemination to residents via the informed consent process and town hall meetings. • CHWs ensured information was presented in an easily understood, nonalarming format. • Town hall meetings were discrete episodes of information sharing, while CBPR encourages a long-term commitment to support sustainability in the community. 9. Requires a long-term process and commitment No • Communications dwindled after the closing town hall meetings. to sustainability • Our team could have made more effort to foster long-term relationships (see lessons learned).

*Source: Israel et al., 2008. aARHF = Atlanta Regional Health Forum.

management also labeled residents who been socially oppressed to ensure equity Several CHWs reverted to a previous study’s were overly exuberant about participating as and shared inﬂuence and control, thereby protocol for dust sampling and altered the “troublemakers,” and dissuaded them from changing the paradigm by which research is length of time and locations for sampling. participating. This notion of silencing “trou- conceived and conducted (Chavez, Duran, Placement of air sampling devices also varied blemakers” in the research process is con- Baker, Avila, & Wallerstein, 2008). among CHWs. The CHWs also modiﬁed the trary to CBPR. Principles 3, 4, and 5 encour- Ensuring consistent sampling methods labeling system, which hampered the process age inclusion of those who traditionally have among the CHWs was also challenging. of sample tracking with laboratories.

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Lessons Learned for Increased the study participants—became more criti- guage, results-reporting form to communicate Community Participation cal. Once the partnerships are established, it is multiple environmental housing exposures The need to identify the pilot study sites important the group develops a set of bylaws without raising unnecessary concern for those before engaging the residents limited the (i.e., operating norms) to guide the partner- environmental agents that have no national community’s involvement. Defining the com- ship’s work (Israel et al., 1998; Metzler et al., thresholds for safety. Because studies increas- munity is one of the first steps in initiating 2003). Our research team had informal under- ingly generate difficult-to-interpret data, the CBPR (Green et al., 1995; Israel et al., 2008) standings of operations but did not establish scientific literature has begun to focus more particularly with susceptible, vulnerable sub- explicit working guidelines and could have on the ethical considerations related to report- populations like older adults (Shendell et al., benefited from having a consensual decision- ing these results (Altman et al., 2008; Morello- 2011). We recognize the pilot study could making process. For example, more commu- Frosch et al., 2009; Resnik & Zeldin, 2008). have been more participatory by having the nication between the CHWs and researchers As we undertake the nationwide study, we will residents involved in decision making, which including joint field visits and additional train- continue to reach out to community members would have increased colearning opportuni- ings might have improved adherence to the from each site to consider how best to relay the ties and power sharing (Principles 3 and 4). sampling protocol (Principles 3 and 4). results not only to the study participants but If residents had been allowed to participate The influence of funding allocation rules also to the community in general. In summary, from the pilot’s inception, their knowledge limited community involvement in the plan- our pilot study could have been more “partici- of the social environment and property man- ning process due to the pilot study’s fund- patory.” Lessons learned to increase commu- agement’s temperament would have been ing mechanism (i.e., government contract). nity participation include the following: extremely helpful and might have improved Research suggests the relationships that most • adequately defining the community by relations with the property managers. Fur- favor the community are those that place including at the planning table the gate- thermore, the residents could have been funding and decision-making power with keepers, community representatives, and instrumental in identifying policy changes the community’s lead agency (Principle 2); others who are affected by the study; and other benefits to improve their commu- that agency can then subcontract with public • determining methods and explicit guide- nity’s health and social welfare, thereby fos- health practitioners (Duran & Duran, 1999). lines to ensure equitable decision making tering “action research” that identifies social A conscious effort was made to increase com- and power sharing among all partners; change efforts (Principle 5). Active participa- munity participation and decision-making • acknowledging the effect of funding dynam- tion of residents could have increased recip- authority by providing primary funding to ics on a CBPR approach; rocal transfer of knowledge, skills, and capac- the community-based organization, who then • collaboratively disseminating results among ity building (Principle 4). The residents could subcontracted with the university and CHWs all partners; and have learned scientific practices, enhanced for data collection. Because the idea for the • building long-lasting relationships that leadership skills, and gained a sense of own- pilot study was initiated by CDC who con- mutually benefit everyone involved. ership while the researchers learned the com- tracted with ARHF to identify study sites and If all CBPR principles are applied con- munity’s social norms and more effective partners, however, the community members sciously, a CBPR approach can be a powerful ways to communicate and translate results. only became involved once the sites were tool to improve outcomes of environmental Also having the residents and property chosen (i.e., the property manager agreed to and urban health research, address commu- managers provide their perspectives dur- participate), but henceforward were an inte- nity concerns, and promote social change. ing the post-study presentations would have gral part of the pilot study. increased their role in the information shar- Acknowledgements: We are grateful to the indi- ing and dissemination process and help foster Conclusion and viduals who participated in the study. We appre- a longer relationship (Principles 8 and 9). Recommendations ciate the contributions of the community health The pilot study identified two types of com- This article discussed challenges to imple- workers, Dr. Joyce Essien, Marcia Griffith, and munity partners: the residents and the CHWs menting CBPR and provided lessons learned Dr. Antonio Neri for their assistance with pro- working with the community organization to improve community participation in envi- tocol development and study implementation. ARHF to build upon community strengths ronmental health research. The experience We also thank Marilyn Metzler, Dr. Jacquelyn (Principles 1 and 2). Partnering with a com- demonstrates that incorporating CBPR princi- Mason, and Monica Lindsey Ponder for their munity-based organization comprising mem- ples in environmental health research involves assistance in publication review. bers more reflective of the community would trial/error, adjustment, and compromise and have added another opportunity to enhance can take several years to develop effective Corresponding Author: Paris Ponder-Brookins, community participation and incorporate partnerships. Our study piloted the environ- Public Health Advisor, Centers for Disease concerns of the residents into the pilot study mental methodology and laid the foundation Control and Prevention, 1600 Clifton Road (Principle 5). Although ARHF’s leadership did for a current nationwide study of the health NE, Mailstop D-29, Atlanta, GA 30333. Phone: not include residents of the pilot study com- and economic benefits of green renovations 404-639-5962. Email: [email protected]. munity or low-income seniors, the role of Zap in low-income urban housing. The impor- Asthma’s CHWs—who serve the community tance of the pilot study is that it allowed us References on page 16 and are of similar age and demographic of to work with CHWs to develop a plain-lan-

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References continued from page 15 Ahmed, S.M., & Palermo, A.G. (2010). Community engagement in patory research in health promotion in Canada. Vancouver, British research: Frameworks for education and peer review. American Columbia, Canada: Royal Society of Canada. Journal of Public Health, 100(8), 1380–1387. Hatch, J., Moss, N., Saran, A., Presley-Cantrell, L., & Mallory, C. Altman, R.G., Morello-Frosch, R., Brody, J.G., Rudel, R., Brown, P. , (1993). Community research: Partnership in black communities. & Averick, M. (2008). Pollution comes home and gets personal: American Journal of Preventive Medicine, 9(6 Suppl.), 27–34. Women’s experience of household chemical exposure. Journal of Heron, J., & Reason, P. (2001). The practice of cooperative inquiry: Health and Social Behavior, 49(4), 417–435. Research “with” rather than “on” people. In P. Reason & H. Brad- Bailey, D. (1992). Using participatory research in community con- bury (Eds.), Handbook of action research: Participative inquiry and sortia development and evaluation: Lessons from the beginning practice (pp. 179–188). Thousand Oaks, CA: Sage. of a story. The American Sociologist, 23(4), 71–82. Israel, B.A., Parker, E.A., Rowe, Z., Salvatore, A., Minkler, M., López, California Chronic Reference Exposure Levels. (2007). Air toxicol- J., Butz, A., Mosley, A., Coates, L., Lambert, G., Potito, P.A., ogy and epidemiology. Retrieved from http://www.oehha.ca.gov/ Brenner, B., Rivera, M., Romero, H., Thompson, B., Coronado, G., air/allrels.html & Halstead, S. (2005). Community-based participatory research: Chavez, V. , Duran, B., Baker, Q.E., Avila, M.M., & Wallerstein, N. Lessons learned from the Centers for Children’s Environmental (2008). The dance of race and privilege in CBPR. In M. Minkler Health and Disease Prevention Research. Environmental Health & N. Wallerstein (Eds.), Community-based participatory research Perspectives, 113(10), 1463–1471. for health. From process to outcomes (2nd ed., pp. 91–105). San Israel, B.A., Schulz, A.J., Parker, E.A., & Becker, A.B. (1998). Review Francisco: Jossey-Bass. of community-based research: Assessing partnership approaches Chew, G., Witt, J., Mason, J., Steward, J., Greenwell, D., Samuel, Y., to improve public health. Annual Review of Public Health, 19, Ponder, P. , Curtis, G., Neri, A., Kennedy, C., & Brown, M.J. (2009, 173–202. September). Green housing: How can we better assess exposure Israel, B.A., Schulz, A.J., Parker, E.A., Becker, A.B., Allen, A.J., & and health outcomes? Paper presented at Healthy Buildings 2009: Guzman, R. (2008). Critical issues in developing and following Proceedings of the 9th International Healthy Buildings Conference CBPR principles. In M. Minkler & N. Wallerstein (Eds.), Com- and Exhibition, Syracuse, NY. munity-based participatory research for health. From process to out- Clinical and Translational Science Awards Consortium, & Commu- comes (2nd ed., pp. 47–66). San Francisco: Jossey-Bass. nity Engagement Key Function Committee Task Force. (2011). Krieger, J.W., Takaro, T.K., Song, L., & Weaver, M. (2005). The Seat- Principles of community engagement (2nd ed.). Retrieved from tle-King County healthy homes project: A randomized, controlled http://www.atsdr.cdc.gov/communityengagement/pdf/PCE_ trial of a community health worker intervention to decrease expo- Report_508_FINAL.pdf sure to indoor asthma triggers. American Journal of Public Health, Condon, C., Hynes, P. , Brooks, D.R., Rivard, D., & McCarthy, J. 95(4), 652–659. (2007). The integrated pest management educator pilot project Lewin, K. (1946). Action research and minority problems. Journal of in Boston public housing: Results and recommendations. Local Social Issues, 2(4), 34–46. Environment, 12(3), 223–238. Metzler, M.M., Higgins, D.L., Beeker, C.G., Freudenberg, N., Lantz, Cornwall, A. (1996). Towards participatory practice: Participatory P.M., Senturia, K.D., Eisinger, A.A., Viruell-Fuentes, E.A., Ghei- rural appraisal (PRA) and the participatory process. In K.D. Kon- sar, B., Palermo, A.G., & Softley, D. (2003). Addressing urban ing & M. Martin (Eds.), Participatory research in health: Issues and health in Detroit, New York City, and Seattle through commu- experiences (pp. 94–107). London: Zed Books. nity-based participatory research partnerships. American Journal Duran, B., & Duran, E. (1999). Assessment, program planning, and of Public Health, 93(5), 803–811. evaluation in Indian Country: Towards a postcolonial practice. In Minkler, M. (2005). Community-based research partnerships: Chal- R.M. Huff & M.V. Kline (Eds.), Promoting health in multicultural lenges and opportunities. Journal of Urban Health, 82(2 Suppl. 2), populations: A handbook for practitioners (pp. 291–311). Thou- ii3–12. sand Oaks, CA: Sage. Morello-Frosch, R., Brody, J.G., Brown, P. , Altman, R.G., Rudel, R., Flicker, S. (2008). Who beneﬁts from community-based participa- & Pérez, C. (2009). Toxic ignorance and right-to-know in bio- tory research? A case study of the Positive Youth Project. Health monitoring results communication: A survey of scientists and Education and Behavior, 35(1), 70–86. study participants. Environmental Health, 8, 6. Green, L.W., George, M.A., Daniel, M., Frankish, C.J., Herbert, C.P., Postma, J., Karr, C., & Kieckhefer, G. (2009). Community health & Bowie, W.R. (1995). Study of participatory research in health pro- workers and environmental interventions for children with motion: Review and recommendations for the development of partici- asthma: A systematic review. Journal of Asthma, 46(6), 564–576.

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References Resnik, D.B., & Zeldin, D.C. (2008). Environmental health research Shendell, D.G., Foster, C., Sexton, J., Roden, J., Yamamoto, N., Kelly, on hazards in the home and the duty to warn. Bioethics, 22(4), S.W., Chandler, L., Venables, M., Williams, S., Burr, S., Wagen- 209–217. leitner, V. , & Anderson, N. (2011). Knowledge and awareness Schulz, A.J., Israel, B.A., Selig, S.S., & Bayer, I.S. (1998). Development of symptoms and treatment among low- to middle-income older and implementation of principles for community-based research in adults with asthma and/or COPD: Community-based participa- public health. In R.H. MacNair (Ed.), Research strategies for commu- tory research in a central California county. Journal of Asthma and nity practice (pp. 83–110). New York: The Haworth Press. Allergy Educators, 2(2), 81–90. Sclove, R. (1997). Research by the people, for the people. Futures, 29(6), 541–549.

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Jinkyung Choi, PhD A Strategic Cleaning Assessment Department of Foodservice Management Woosong University, South Korea Program: Menu Cleanliness Barbara Almanza, PhD Douglas Nelson, PhD at Restaurants School of Hospitality and Tourism Management Purdue University Jay Neal, PhD Sujata Sirsat, PhD Conrad N. Hilton College of Hotel and Restaurant Management University of Houston

As bacterial and viral contaminations are not detectable by visual assessment, the lack The importance of clean food contact surfaces Abstract of microbiological analysis can be problem- has been recognized; however, the importance of cleanliness on nonfood atic. The results of studies using hygiene contact surfaces such as menus may be underestimated. The aim of the swabs and agar contact plates have shown study described in this article was to determine the cleanliness of restaurant that visual inspection is a poor indicator of menus, evaluate typical cleaning methods used in a restaurant, and provide cleaning (Griffith, Cooper, Gilmore, Davis, & Lewis, 2000; Moore & Griffith, 2002). recommendations for improving menu cleanliness. The authors’ study used Microbiological assessment of restaurants an adenosine triphosphate meter to assess the cleanliness of the menus. is generally not conducted, however, as A pretest identified the most commonly touched areas of the menu by part of the inspection process since tra- consumers. Based on the results of the pretest, menus were collected from ditional microbiological analyses require casual-family dining restaurants and analyzed for cleanliness. Results 48–72 hours after the sample is collected to obtain results. Equipment such as an ade- suggested that menus should be cleaned after each shift and that menus nosine triphosphate (ATP) meter provides a distributed by the staff when guests are seated are cleaner than those kept faster assessment of cleaning, but ATP meters on the table. assess organic soils (which include food soil and other organic residues in addition to microorganisms) and are expensive for routine inspections. Introduction Consumers are likely to judge the cleanli- Furthermore, consistent cleaning of cer- Cleanliness of the environment in which food ness of a restaurant on visual perceptions. tain surfaces outside the kitchen may not is being prepared, served, and consumed is Similarly, although health inspectors use an be done in all restaurants. This may be par- critical in reducing the potential for food- inspection manual and the food code to inspect ticularly true for furniture, equipment, and borne illness. Foodborne illness outbreaks restaurants, their judgments also rely heavily other frequently used items such as menus. can certainly damage a restaurant’s reputa- on visual assessment. Where visual observa- Contaminants on menus can be transferred tion and lead to a loss of revenue. Previous tions are used, subjective assessments may also to guests’ hands and subsequently to food research found that 70% of consumers would be needed to quantify cleanliness. Moore and being consumed. Cleaning of menus is no longer buy food from a food service estab- Griffith (2002) state, “‘Cleanliness’ is a relative commonly done in many restaurants; how- lishment where they had concerns about concept—what is acceptable as being ‘clean’ in ever, the need for cleaning is based more on hygiene (Food Safety Agency, 2008). Knight one situation may be unacceptable in another esthetic considerations and may simply be and co-authors (2007) found that people (p. 318).” This perceptual difference was found done by visual inspection or by touching the who perceived that a restaurant was “not at in a previous study in which health inspectors menu. Standards or protocols to clean menus all” committed to food safety were less likely showed variations in their opinions of cleanli- or even to determine when the menu needs to choose that restaurant when eating out. In ness (Lee, Almanza, Nelson, & Ghiselli, 2009). to be cleaned have not yet been established. fact, at least one study found that cleanliness The typical assessment of what is clean, there- This is potentially a concern as it has been was the most important determinant for con- fore, relies heavily on visual assessment, which demonstrated that microorganisms could be sumers’ perceptions of restaurant food safety may be subjective and is likely to differ from transferred from damp menus to fingertips (Henson et al., 2006). one individual to another. for up to 24 hours for certain types of menus

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(Sirsat, Choi, Almanza, & Neal, 2013). The mination of surface cleanliness at a hospital uated all four menus following the protocol purpose of our study was therefore to assess kitchen showed both techniques were highly described above. To ensure participants used the cleanliness of menus in a restaurant and correlated (Aycicek, Oguz, & Karci, 2006). the menu as they would in a restaurant, they the impact of different factors (such as type of Hence, because of the advantages of ATP test- were handed the menu after being seated and cleaning method and how menus are stored ing and its correlation to traditional swabbing asked to select their choice of entrée, bever- or distributed) on menu contamination. methods, our study used ATP meters to assess age, and dessert as if they were eating in that the cleanliness of food contact surfaces. restaurant. After collecting the first menu Determination of the Cleanliness from the participants, the second menu was of a Surface Using ATP Meters Materials and Methods presented to the participants. Similarly, after The cleaning of food service equipment or completing the second menu, the third menu furniture in a restaurant depends on the Pretest and finally the fourth menu were presented. protocols of that facility. Capable restaurant In order to validate the most appropriate areas A coupon for a gourmet cookie was then managers institute their own cleaning and of the menu to test for the impact of cleanli- given to the participants in appreciation for sanitizing schedules for the restaurant to ness, a pretest was conducted to identify the their participation. Menus were stacked on facilitate cleaning and sanitizing procedures. high-touch areas of the menu by consumers. clean sheets of paper so that the liquid could Factors influencing the choice of hygiene Because restaurants use a variety of different dry thoroughly without smearing or contact- practice methods include cost, time, staff, menu styles, this pretest included four styles ing other menus. ease of use, management needs, and nature of of menus. Two sizes were tested (letter size Menus were then analyzed visually using the food contact surfaces (Griffith, Blucher, and legal size) for two different menu formats a 5-watt ultraviolet disclosing lamp black Fleri, & Fielding, 1994). (single page and multipage). The menus were light. To quantify the areas of highest touch More recently, ATP meters have been sug- made with a high-quality color copy glossy and identify the areas for testing in the later gested as a less time-intensive and acceptable 32 lb. weight paper similar to that used by study, the menu was divided into smaller method for determining the cleanliness of a many restaurants. To standardize consum- units. A transparent grid marked with 2.8” surface (Griffith et al., 2000). They measure ers’ visual and tactile use of the menus, both squares was laid over the menu to ascertain if the bioluminescence from ATP (an energy- single-page menus had a restaurant’s name any touch contact occurred in these smaller containing substance present in living cells) on one side and the menu printed on the units. This grid was then used to create a map from microorganisms, food residues (or other other. The two single-page menus listed the of consumer contact on the menus. Contact organic materials), and humans (Worsfold same menu items using the same font and patterns were determined by recording a & Griffith, 1996). Because of the potential type size (Times New Roman, 12 point); the positive result each time an area had been for contamination on menus and the pos- only difference was the spacing between the touched as indicated by the ultraviolet visible sible transfer of contamination onto custom- menu items for the letter vs. legal sizes. To fingerprints left on the menu. ers’ hands, it is important to consider menu standardize consumers’ visual and tactile use Results of the pretest were then used to cleaning practices and their effectiveness. of the menus for the multipage formats, the determine which areas of the menus to evalu- More specifically, the purpose of our study same food items using the same font and type ate for the main study. Results showed that was to assess the contamination on restau- size were again used for the letter vs. legal the lower and outer sides of the menus were rant menus to determine if typical cleaning sizes. The multipage menus were created by most likely to be touched for both sizes of methods are effective and the impact of differ- folding the paper on the long side resulting the two page menus (Figure 1). One different factors (such as type of cleaning method in a four-page menu that measured either 8 ence for the 8.5” x 11” menu was that the and how menus are stored or distributed) on 1/2” x 5 1/2” for the letter size paper or 8 lower half of the menu was most likely to be menu contamination. 1/2” x 7” for the legal size paper. For both touched, whereas for the 8.5” x 14” menu, ATP values of 500 relative light units multipage menus, the name of the restaurant it was not the bottom half but an area rep- (RLU) for a clean surface are considered a was printed on the front and the menu was resenting a similar distance from the top as realistic upper critical limit (Griffith et al., printed on the two inside pages. the shorter menu that was most likely to be 2000). The use of ATP meters in research The research investigator and three field touched. The lowest section of the 8.5” x 14” studies is thought to be advantageous in that workers visited with a group of 36 students menu was in fact less likely to be touched, it is a rapid test that provides results within enrolled in a hospitality and tourism man- particularly for the one page menus. Multiple minutes and is a more cost-effective means to agement program to explain the purpose of page menus were unique in that the cover of monitor surface cleanliness than traditional the study and ask if students were willing the menu was less likely to be touched on the microbiology (Griffith et al., 1994). The use to participate in the pretest. Seventeen stu- left side of the menu. The one-page letter-size of the ATP technique has also been suggested dents agreed. Participants were asked to rub menu did not show distinct patterns and was for the restaurant and food service industry their hands with a fluorescing liquid that therefore excluded from the analyses. to indicate the level of potential cross con- would leave traces on menus when they were tamination of food (Leon & Albrecht, 2007). touched and then be visible under ultraviolet Main Study A comparison of ATP bioluminescence and light. Menus were presented one at a time to The owner of a casual-family dining restau- traditional swabbing methods for the deter- each study participant. Each participant eval- rant chain agreed to allow our study to be

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conducted in one of his restaurants using his menus. The restaurant represented a FIGURE 1 small chain that offered sandwiches, salads, pizza, and desserts. Information was col- Mapping of the Most Accessed Areas by Participants lected regarding menu storage, menu distribution and collection procedures, and menu 8.5” 8.5” cleaning procedures. After discussing possible research questions in this real-world 2.75” 2.75” setting, permission was received from the owner to evaluate the impact of three factors on menu cleanliness. The ﬁrst question 11” 11” was to ﬁnd out the impact of typical cleaning methods on menu cleanliness (before

being cleaned vs. after being cleaned by the staff). The second question was to ﬁnd out Page A. Version Page how the type of cleaning method (spray vs. 1.7” 1 of 2 One Page 1.7” 2 of 2 wet cloth) impacted cleanliness. Finally, the third question was to determine the impact of menu storage and distribution method (servers handing them out vs. leaving menus in a 8.5” 8.5” holder on the table). 2.8” 2.8” Prior to the start of data collection all

menus were collected and thoroughly cleaned using 91% isopropyl alcohol. This standard-

ized the beginning level cleanliness among 14” 14” the restaurant menus. The menus were circulated in the restaurant for two weeks and the staff cleaned menus according to their routine cleaning policies. Routine cleaning practices included the use of a commercial grade chlorine-based solution as a sanitizer. Page B. Version Page The standard cleaning practice in the restau- 1 of 2 One Page 2 of 2 1.7” 1.7” rant was to spray the menus with this sanitizer and then wipe it from the menus using a washable cotton cloth. All menus were nor- Darker color indicates a more accessed area as compared to a lighter color. mally cleaned at the end of each shift. A fresh cleaning cloth was used for each shift. Tw o rooms were used in the restaurant to determine the impact of handing out menus The first part of our study determined the menus on the first day, 15 menus the sec- vs. leaving them on the table in a storage effectiveness of current cleaning procedures ond day, and 20 menus the third day) and 55 rack. This was already a standard practice in the restaurant. Menus were collected for menus were sampled the second week (20 in the restaurant (one room normally had sampling at two time periods (1:30 p.m. and menus for the first day, 15 menus the second servers hand out menus that were stored at 4:30 p.m.). Those times were specifically day, and 20 menus the third day) for a total the host station, the other room had wire chosen to determine how dirty the menus of 105 menus. racks on each table that stored the menus became after the lunch rush (the 1:30 col- To determine the impact of the spray vs. wet and were readily available for customers to lection time) and how well the menus were cloth cleaning method, a total of 120 menus use without the need to have one handed cleaned by the staff during their routine were selected for sampling (30 menus in each to them by a server). Identical menus were cleaning (prior to the 4:30 collection time) of the two weeks for each of the two clean- used in each of these two rooms. The staff and before the evening meal service period. ing methods). The second variable tested the were asked not to exchange menus between Menus were collected without the staff being effect of cleaning method (wiping vs. spray- these two rooms during this time period. All alerted as to the reason why they were being ing) and sought 60 menus for sampling (15 menus were cleaned with isopropyl alcohol collected. A sample of menus was collected menus for each of the two weeks for each prior to start of our study to standardize for three days in each of two weeks (six data cleaning method). For the third variable, the cleanliness levels between the two distribu- collections) for this portion of our study. For effect of handing out vs. storing menus on tion treatments. the first week, 50 menus were sampled (15 the table, a total of 40 menus were selected

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The other cleaning method involved wiping the menus with a damp towel. The towels FIGURE 1 continued were impregnated with 200 parts per mil- Mapping of the Most Accessed Areas by Participants lion U.S. Environmental Protection Agency– approved sanitizing solution of quaternary 8.5” 8.5” ammonium. To release the sanitizer from the towel (as given in the manufacturer’s direc- 2.75” 2.75” tions) they were immersed in one gallon of water at approximately 75°F (24°C) then

squeezed 10 times. One towel was used to clean all 10 menus in that week. To minimize 11” 11” the effect of carryover of contamination from

one menu to another, the towel was placed back into the bucket after four menus were Page C. Version Page wiped down and then squeezed to remove

1.7” 1 of 8 Multiple Pages 1.7” 8 of 8 excess liquid. After the cleaning process, menus were air dried for 20–30 minutes and then swabbed with the ATP meter. All menus 8.5” 8.5” were cleaned with 91% isopropyl alcohol before they were given back to the restaurant 2.8” 2.8” for use by customers. Lastly, the effect of menu storage and han-

dling was assessed. This part of our study hypothesized that menus handed out by the 14” 14” staff would be cleaner than menus displayed

on tables since customers could easily touch the menus on the tables while they were eating and food debris could contaminate the menus. One room in the restaurant had serv- Page D. Version Page ers hand out menus that were stored at the 1 of 6 Multiple Pages 6 of 6 host station. The second room left the menus 1.7” 1.7” in a holder at the table. This portion of our study differed slightly in its collection method in that the menus were sampled prior to staff Darker color indicates a more accessed area as compared to a lighter color. cleaning to assess the differences in contamination associated with these two storage and handling methods. Of the 45 menus typically used in each room, 10 menus were randomly for sampling. These included 10 menus from The second part of our study examined collected for sampling from each room at each of the two rooms (one room had servers the effect of two cleaning methods. The approximately 4:00 p.m. (prior to cleaning) hand out the menus and the other room kept first cleaning method involved spraying for each of the two weeks. The menus were menus on the table) in each of the two weeks. the menus with a Lysol brand product then swabbed with ATP meters using the method ATP sampling on menus was conducted wiping with a clean towel. Each menu was described above and cleaned with 91% iso- in the following manner. Menus were par- sprayed once per cleaning. To evaluate the propyl alcohol before they were given back to titioned into squares measuring 10 cm x amount of spray used, the volume of Lysol the restaurant. 10 cm (100 cm2) as recommend by Moore was measured. Volumes used for the two and Griffith (2002). The areas used for sam- weeks were fairly similar with a total of 25 Results and Discussion pling were those determined in the pretest mL of Lysol used to clean the 15 menus in the Because of changes in menu availability and for multipage menus. Based on the results first week and a total of 22 mL used for the handling in the restaurant and one dropped of the pretest, a 100-cm2 area in the lower menus in the second week. After spraying, sample during testing, the actual number of right hand side of the front of the menu was the menus were wiped with a towel with anti- menus sampled changed slightly for the first swabbed for testing. After swabbing, menus microbial protection. Each towel was used to test, but were still considered adequate for were cleaned with 91% isopropyl alcohol clean a maximum of four menus before it was analysis. For the first test (before and after before they were handed back to the restau- then discarded to minimize the effect of any restaurant cleaning), 53 menus were sampled rant for customer use. carryover from one menu to another. prior to cleaning and 58 menus after clean-

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TABLE 1 TABLE 2 The Effect on Adenosine Triphosphate Values (Relative Light Units) The Effect on Adenosine for Test 1 (Menu Cleanliness)* Triphosphate Values (Relative Light Units) for Test 2 (Type Before Cleaning After Cleaning Before Cleaning After Cleaning of Cleaning Method)* 163 546 9 66 174 151 103 14 Type of Cleaning Method Dropped 283 82 48 Spray Cleaning Damp Towel 217 431 83 41 26 60 367 403 58 39 117 69 218 440 255 36 69 50 295 329 59 27 125 82 208 220 87 16 83 24 121 306 118 39 77 72 208 85 76 21 70 91 157 203 282 32 120 67 752 109 700 24 115 26 1152 147 75 26 151 74 508 342 95 30 63 113 188 246 59 60 32 249 267 142 107 69 117 66 310 120 4838 50 77 106 84 148 152 82 119 69 108 115 169 24 7 16 249 163 121 72 26 12 346 43 222 91 41 61 39 48 66 67 36 64 249 35 57 26 76 16 16 95 150 74 82 21 657 29 81 113 207 23 67 39 28 32 93 0 *Relative light unit values greater than 500 indicate an unacceptable cleanliness level. 77 10 69 4 12 32 ing (Table 1). The number of samples used results were at values greater than 500 RLU 116 32 for the second test (60 menus) and third (657; 700; 4,838; 752; 1,152; and 508). Inter- 47 32 test (40 menus) were the intended numbers estingly, one cleaned menu even showed a 159 16 described in the methodology. critical ATP value > 500 RLU (546). A t-test was used to compare the ATP val- The assessment of cleaning methods using *Relative light unit values greater than 500 indicate an unacceptable cleanliness level. ues of the menus after lunch (and before they a t-test showed a statistically significant differ- were cleaned) at 1:30 p.m. to those after they ence in cleanliness between the two methods: were cleaned (and before the supper period) t(58) = 2.303, p = .025. Menus cleaned with at 4:30 p.m. by the staff. As expected, menus the spray cleaning method (M = 81.23, SD = dry cloth was also able to adequately clean the had higher ATP values prior to being cleaned 46.97) gave significantly higher ATP values menus according the ATP test. (M = 306.20, SD = 687.42) as compared to than menus cleaned by the wiping method Results of the third study showed that menus that had been cleaned (M = 125.36, (M = 52.97, SD = 48.12) and were therefore menus stored on the table (M = 370.35, SD = 125.90). This difference was statistically considered less clean. None of the menus had SD = 243.70) gave statistically significant significant: t(103) = 1.92, p < .05. The aver- values higher than 500 RLU and all of the higher RLU values than menus that had been age of RLU values (306.20) for the uncleaned menus were in an acceptable range of 0 to 249 handed out (M = 96.80, SD = 47.07; t[38] = menus did not reach the critical upper limit RLU (Table 2). These results suggest that the 4.93, p < .001), indicating that menus stored of 500 RLU; however, approximately 11% use of a wet wipe to clean menus may be more on the table were dirtier than menus handed or 6 out of the 53 usable individual menu effective, but that the spray method using a out. None of the individual menus that were

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Conclusion al., 2006) have been found to be important Our study showed that menus should be cues to the cleanliness of the restaurant. TABLE 3 cleaned after each shift or approximately every Our study measured contamination on The Effect on Adenosine four hours. Skipping even one cleaning might the surfaces of a multipage restaurant menu. Triphosphate Values (Relative result in a high level of contamination increas- One limitation of our study is that only one Light Units) for Test 3 (Menu ing the potential risk of cross contamination. type of menu was assessed. Future studies Distribution)* If the menus are not clean, contamination may wish to evaluate the differences with could easily be transferred from the menus other types of menus and other variables. Menu Distribution to the customers’ hands or to the staff’s hands For example, laminated menus, disposable Hand Out Left on Table when they serve food to the customers. There- menus (including children’s menus), and 47 130 fore, restaurant staff need to pay close atten- menus that fit in leather-type holders may 27 47 tion to cleaning the menus with the appropri- offer different results. In addition, the length 121 176 ate cleaning methods after each shift. of time that menus are used prior to disposal 16 576 Better cleaning was associated with the may make a difference. Finally, the types of 82 102 wet wiping cloths, although both methods foods offered on the menu may make a dif- 67 1035 achieved adequate cleaning scores accord- ference. Foods that are eaten with fingers or 58 298 ing to the ATP results. In addition, our study hands (particularly when menus are kept at 118 434 found that menus stored on the table had the tables) may offer different results when 89 533 greater levels of contamination than menus menus are handled by customers. 134 252 that had been handed out. Restaurant man- It would appear that cleaning can reduce 74 185 agers should consider handing out menus contamination if it is done correctly. Better rather than leaving menus on the table. cleaning and lower levels of contamination 155 746 Menus stored on the table appear to have may be possible with certain cleaning methods 133 326 more chances for contamination from food such as the sanitizer towel tested in our study. 185 471 or the hands of customers. If a restaurant’s Differences in the level of contamination were 102 529 policy is to put menus on the table, the staff also found with different service methods 173 359 may need to clean the menus more frequently. (leaving the menu on the table vs. the server 62 224 Previous studies have assessed consum- handing it to the customers). One of the most 56 209 ers’ perceptions of risk when purchasing food significant findings of our study is that critical 103 212 (Mitchell, 1998; Mitchell & Harris, 2005) levels of contamination (as assessed by ATP 134 563 and when selecting a restaurant (Henson et values) may occur if regular cleaning is not *Relative light unit values greater than 500 indicate al., 2006; Knight et al., 2007). Future stud- done. High levels were found after one service an unacceptable cleanliness level. ies may wish to consider the perception of period. Cleaning may not have been a prior- consumers about clean or unclean menus ity in the past for restaurants, but should be and whether an unclean menu affects their considered in the future based on the results handed out exceeded 500 RLU; however, revisit intention. Although our study did of our study. Regular menu cleaning can make 30% or 6 out of the 20 menus left on the not measure consumers’ perception of the a difference in the cleanliness of menus. table had levels greater than 500 RLU (576; importance of clean menus, it is possible that 1,035; 533; 746; 529; and 563; Table 3). As clean menus may be an indicator of restau- Corresponding Author: Jinkyung Choi, As- predicted, menus stored on the tables may rant cleanliness to consumers in the same sistant Professor, Department of Foodservice have had more chances for contamination by way that odors (Fatimah, Boo, Sambasivan, Management, Woosong University, Daejeon, customers as food was being eaten. & Salleh, 2011) and workers’ behavior and South Korea 300-718. appearance (Fatimah et al., 2011; Henson et E-mail: [email protected].

References Aycicek, H., Oguz, U., & Karci, K. (2006). Comparison of results of Fatimah, U.Z.A.U., Boo, H.C., Sambasivan, M., & Salleh, R. (2011). ATP bioluminescence and traditional hygiene swabbing methods Foodservice hygiene factors—the consumer perspective. Interna- for the determination of surface cleanliness at a hospital kitchen. tional Journal of Hospitality Management, 30(1), 38–45. International Journal of Hygiene and Environmental Health, 209(2), Food Safety Agency. (2008). Scores on the doors. Retrieved from 203–206. http://www.food.gov.uk/multimedia/pdfs/board/fsa080306.pdf continued on page 24

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References continued from page 23 Griffith, C.J., Blucher, A., Fleri, J., & Fielding, L.M. (1994). An eval- (APC) on plastic cutting boards. Journal of Foodservice, 18(4), uation of luminometry as a technique in food microbiology and 145–152. a comparison of six commercially available luminometers. Food Mitchell, V. W. (1998). A role for consumer risk perceptions in gro- Science and Technology Today, 8(4), 209–216. cery retailing. British Food Journal, 100(4), 171–183. Griffith, C.J., Cooper, R.A., Gilmore, J., Davis, C., & Lewis, M. Mitchell, V.W., & Harris, G. (2005). The importance of consum- (2000). An evaluation of hospital cleaning regimes and standards. ers’ perceived risk in retail strategy. European Journal of Marketing, Journal of Hospital Infection, 45(1), 19–28. 39(7–8), 821–837. Henson, S., Majowicz, S., Masakure, O., Sockett, P. , Jones, A., Hart, Moore, G., & Griffith, C. (2002). A comparison of traditional and R., Carr, D., & Knowles, L. (2006). Consumer assessment of the recently developed methods for monitoring surface hygiene safety of restaurants: The role of inspection notices and other within the food industry: An industry trial. International Journal information cues. Journal of Food Safety, 26(4), 275–301. of Environmental Health Research, 12(4), 317–329. Knight, A.J., Worosz, M.R., & Todd, E.C.D. (2007). Serving food Sirsat, S., Choi, J.K., Almanza, B.A., & Neal, J.A. (2013). Persistence safely: Consumer perception of food safety at restaurants. Inter- of Salmonella and E. coli on the surface of restaurant menus. Jour- national Journal of Contemporary Hospitality Management, 19(6), nal of Environmental Health, 75(7), 8–14. 476–484. Worsfold, D., & Griffith, C.J. (1996). An assessment of cleanliness Lee, J., Almanza, B.A., Nelson, D.C., & Ghiselli, R.F. (2009). Using in domestic kitchens. Hygiene and Nutrition in Foodservice and health inspection scores to assess risk in food service. Journal of Catering, 1, 163–173. Environmental Health, 71(7), 28–33. Leon, M.B., & Albrecht, J.A. (2007). Comparison of adenosine triphosphate (ATP) bioluminescence and aerobic plate counts

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Voluntary Approaches to Solid Waste Management in Small Towns: A Case Study Ephraim Massawe, PhD Tye Legleu of Community Involvement Laura Vasut Kelly Brandon in Household Hazardous Southeastern Louisiana University Greg Shelden Waste Recycling City of Hammond

HHW is distinguished by four character- Abstract An enormous amount of household hazardous waste istics: ignitability, corrosivity, reactivity, and toxicity (Hall, Davis, Schwartz, Bryson, & (HHW) is generated as part of municipal solid waste. This scenario presents McCrum, 1996). Since these features con- problems during disposal, including endangering human health and the tribute to the extent to which HHW can dam- environment if improperly disposed. This article examines current HHW age property and cause physical illness and recycling efforts in Hammond, Louisiana, with the following objectives: (a) fatalities, concerns for the growing fraction analyze factors and attitudes that motivate residents to participate in the of MSW being HHW will continue to present real waste management challenges to munici- program; (b) quantify various types of HHW; and (c) analyze the e-waste palities of all sizes for the foreseeable future. stream in the HHW. The main objectives of our study were to Residents and city officials who were surveyed and interviewed cited assess factors that motivate residents to par- that commitment shown by local authorities and passion to protect the ticipate in the city of Hammond, Louisiana’s, environment and human health were part of their active participation in HHW recycling program; to quantify various fractions of HHW generated in a semiurban the program. An awareness program has played a key role in the success environment; and to address the issue of of the program. A legislation specific to e-waste is encouraged. While e-waste in the city of Hammond and its sur- knowledge and information on laws and permit application processes and rounding communities. the promotion of greener products are encouraged, provision of storage or collection facilities and communal transportation will further motivate Background Household waste management practices pres- more residents to participate in the recycling program. ent major environmental and public health concerns. High disposal costs and lack of disposal facilities along with the increasing strin- Introduction oped countries (Pendle & Poll, 1993; Stasis- gency of laws and regulations and declining Household waste management is a growing kiene, Gaiziuniene, & Zidoniene, 2011; U.S. or limited natural resources have been cited problem in the U.S. and many other parts EPA, 2011). as some of the problems associated with the of the world. The U.S. generates at least 4.5 In 2006, U.S. residents, businesses, and management of HHW (Forfás, 2006; Reinhart, pounds of household solid wastes per day per commercial institutions generated more than 1993; U.S. EPA, 1993). An ever-increasing cost person (Government Accountability Office 251 million tons of MSW per year and about of waste disposal is clearly an incentive to pro- [GAO], 2007; U.S. Environmental Protection 8 billion tons of industrial solid wastes (U.S. mote good HHW management practices such Agency [U.S. EPA], 2008a). In a small town EPA, 2009a, 2009b). This enormous amount as pollution prevention strategies that embrace with a population of slightly higher than of waste is both hazardous and nonhazard- on-site recycling and reduction, reuse, or 20,000, household wastes can easily trans- ous. While hazardous waste is regulated by remanufacture, commonly known as the 3 Rs late into about 100,000 lb. per day. About subpart C of the Resource Conservation and of the pollution prevention hierarchy of HHW 1% of municipal solid waste (MSW) gener- Recovery Act (RCRA) or 42 U.S.C. § 6901, management practices (Figure 1). Pollution ated in the U.S. is household hazardous waste nonhazardous waste falls under the manage- prevention approaches can sustain MSW man- (HHW), a fraction that corresponds closely ment guidelines of RCRA, subpart D (U.S. agement practices, particularly in small cities with what is being produced in other devel- EPA, 2009a). and towns where resources are limited.

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FIGURE 1 FIGURE 2 Pollution Prevention Hierarchy Study Location and the 3 Rs for Reducing, Recycling, and Reusing

Prevention and Reduction

Recycling and Reuse

Treatment

Disposal

Lack of landfi ll sites for waste disposal is an obvious challenge in the management of HHW. Key infrastructures to support safe and sustainable waste disposal management operations are also lacking in many semiurban areas (Forfás, 2006). Since most cities and towns continue to face population growth, this continually puts pressure on local government, including communities’ resistance to locate landfi ll facilities in their neighborhoods. Popu- lation growth and awareness on the impacts of HHW include what is now commonly known as the “not in my backyard” syndrome among people. This condition makes it extremely dif- fi cult for cities and towns to implement safe and sustainable management of HHW (Forfás, Since the early 1980s, the U.S. Environmen- Materials and Methods 2006; U.S. EPA, 1993). tal Protection Agency (U.S. EPA) has encour- A semistructured study questionnaire was Another significant problem of HHW aged voluntary community approaches to designed during March and April 2011 with an management is myriad regulations regard- managing HHW (Illinois Environmental objective of assessing perceptions of residents ing waste collection, storage, transportation, Protection Agency [EPA], 2003; U.S. EPA, and fi nding out key factors for their voluntary disposal, and long-term monitoring require- 2008a). Municipalities across the country participation. Recycling of HHW in Hammond ments for landfi lls and human health impacts have successfully used these approaches as is a half-day, twice-per-year event. It brings of HHW. Although regulations have evolved tools to minimize impacts of HHW, mainly by together citizens from the city and the neigh- over the years at different levels of the gov- voluntary recycling efforts and encouraging boring towns to recycle and dispose HHW. ernment to solve solid waste management proper disposal of wastes through training The questionnaire was circulated for issues, recycling efforts that are being encour- and awareness raising (Illinois EPA, 2003). review among members of three separate aged by nonregulatory voluntary programs As a result of these initiatives, which include entities. These included faculty members are receiving positive responses from com- sharing of successful case studies, volun- from Southeastern Louisiana University’s munities across the country. As an example tary community programs have increased by kinesiology and health studies department, (Figure 1), the Pollution Prevention Act of a factor of 400 within a period of 10 years, Hammond city officials, and committee 1990 encourages nonregulatory voluntary from two programs in 1980 to more than 800 members representing the household solid waste management initiatives through the programs countrywide (Illinois EPA, 2003; waste advisory committee. The latter over- 3 Rs of recycling, reducing, and remanufac- U.S. EPA, 1993). The city of Hammond, in sees Hammond’s recycling activities and turing or reusing resources embedded in the Tangipahoa Parish, Louisiana (Figure 2), has played a key role in the city since the HHW that would otherwise be discarded is one of the cities in the country that have recycling program began almost a decade (National Pollution Prevention Center for embraced pollution prevention and voluntary ago (City of Hammond Storm Water Advi- Higher Education, 1995; World Class Com- participatory approaches to address HHW sory Committee [SWAC], 2012; Subsurface munications Technologies, 2011). management practices at the local level. Drainage, 2012). A review by that commit-

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tee was sought out in order to ensure the validity of the questionnaire and to clarify TABLE 1 and identify relevant issues related to HHW management at the local level. Exposures to Heavy Metals and Potential Human Health Impacts Three undergraduate students were asked to answer the questions as if they were Heavy Metals Potential Sources of Minimum Risk Chronic Toxicity responding to the questionnaire. This pro- Emission or Exposures Levels Effects cess helped to determine the approximate Lead Paints (in U.S. before 1978), Blood lead levels Neurological impacts amount of time required to fill out the ques- (Levy & Bro, 1994) burning of plastics and <10 µg/L and lowering of IQ tionnaire and also provided an opportunity papers, plumbing, electronic products, circuit boards for editorial feedback and accuracy. In addi- Mercury Electronic products, Blood levels <10 Gastrointestinal (GI) tion, exemption for review was submitted to (European Council, plastic wastes, pesticides, µg/L disorders, respiratory Southeastern Louisiana University’s institu- 1991) pharmaceuticals, fluorescent tract irritation, renal tional review board (IRB) together with the tubes, dental wastes failure, neurotoxicity questionnaire. An exempt research includes Cadmium Electronic products, Blood lead levels Irritation of the lungs activities where human subjects are not sub- (Friberg, Elinder, plastic wastes <1 µg/L and GI infections, Kjelistrom, & damage to kidneys jected to any form of discomfort such as labo- Nordberg, 1986) ratory tests or clinical trial and experiments to determine drug efficacies. Following the Other sources: Schübeler et al., 1996; United Nations Environment Program, 2006. approval of the exemption form, an IRB consent form was prepared to communicate important information to participants of their Results and Discussion 2006). About 5% of residents were in the age rights and privacy in the study. This consent group of 60–70 and 7% were in the 20–39 form accompanied the questionnaire. Participants age group. Married couples represented On the day of the HHW recycling event, At least 360 residents participated in the 75.9% as compared to those who were sin- questionnaire and consent forms were HHW recycling program in spring 2011. gle (21.7%) or divorced (2.3%). Middle age administered to each resident who drove Out of the total participants at the event, 187 has been reported, however, as a significant through the park where the recycling event (51.9%) residents agreed to fill out the sur- factor in residents who are willing to partici- took place. Respondents received a brief- vey. One respondent submitted responses via pate in community and curb recycling efforts ing on the objective of the survey and were regular mail. On-the-spot survey methods (Gamba & Oskamp, 1994). informed that the survey was voluntary and it are usually rare, but often the response rates More whites (85%) than African-Americans would take at most 15 minutes to complete. are very similar to what is expected (Health (3%), Asians (1%), Native Americans (11%), In addition, participants were informed that Communication Unit, 2006). and Hispanics (0%) attended the HHW recy- the number of questions to be answered was About 32% of the participants attended this cling event. This can be attributed to many completely under their own discretion and event for the first time. A similar number of factors including lack of transportation to and that they could remain anonymous if they so participants (31%) attended past events more from the recycling event or the lack of passion desired. Identifying information such as par- than three times, and 16% attended either and perhaps knowledge about protecting the ticipant’s social security numbers or dates of once or twice. About 1% of the residents environment among some residents. birth was not needed for this survey. attended more than five program events, While residents with a $25,000–$40,000 Participants who were willing to fill out the and 3% do not remember the exact number annual income accounted for 62% of the questionnaire could choose to complete the of events they have attended. Based on the participants, a small fraction (4%) reported survey at the site or to take it home and mail zip code, 48% of residents were from the city an income in excess of $150,000 per year. it back once completed. Each participant was of Hammond, and 16% lived in the nearby While 42% of residents were employed full given the questionnaire at the entrance to the city of Ponchatoula. At least 6% and 4% of time, 6.8% and 41% showed part time and park. The questionnaires were collected at the residents were from the cities of Tickfaw retirement status, respectively. Previous stud- the park’s exit. and Springfield, respectively. Only 1% of the ies demonstrate that income and employ- Participants willing to participate in a respondents came from as far as 100 miles ment status, both of which are dependent on short interview were asked four questions: away from Hammond. education level, are good predictors of the (a) What motivates you to participate in the Analysis based on ethnicity, age, sex, and willingness to participate in community recy- recycling events? (b) Describe difficult types marital and income status indicated that more cling efforts (Saphores et al., 2006). of HHW not accepted at the recycling event. males (58%) than females (42%) attended the (c) What do you consider to be the most recycling event. Previous studies, however, How Residents Receive Information significant strengths and weaknesses of the have reported women to be more willing to on HHW Events HHW recycling events? and (d) What would participate in recycling activities than men About 59% of residents participating at the you like to be done five years from now? (Saphores, Nixon, Ogunseitan, & Shapiro, HHW event received information from local

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show that most local government authorities in developing countries spend between TABLE 2 20% and 50% of their total budgets for solid Household Hazardous Waste in Municipal Solid Waste in the U.S. waste management (Schübeler et al., 1996). Local authorities in developed countries are Category of Household Hazardous Waste Percentage by recognizing that environmental laws and Weight (% w/w) regulations, including HHW management Household maintenance items (paint, thinners, glues) 36.6 guidelines, are more stringent now than in the Household batteries (plus electronics) 18.6 past and will continue to be so in the future. Personal care products (nail polish and remover, hair spray) 12.1 Therefore, given the nature of contemporary Janitorial cleaning products 11.5 financial constraints, these authorities are Automotive maintenance products (grease, oil, windshield washer fluids, tires) 10.5 becoming more innovative in designing safer Pesticides, pet supplies, and fertilizers 4.1 and sustainable HHW management practices, Hobbies/other (pool chemicals, lighter fluid) 3.4 including recycling program. Pharmaceuticals 3.2 Of the 68% of residents who left one type of HHW or another at home, some raised Sources: Pendle & Poll, 1993; U.S. Environmental Protection Agency, 2011. concerns that either that HHW was not being accepted at the recycling event or they lacked the ability to transport that fraction of HHW newspapers. The Daily Star is a local newspa- also cause significant environmental, public to the recycling event. While 32% of residents per circulated throughout Tangipahoa Parish. health, and safety concerns. Some HHW con- left no unacceptable HHW in their house- This media outlet in a rural community with tains acids and alkalis, which are corrosive. holds, 68% could not recycle some HHW, fewer Internet services can be an effective Examples of corrosive HHW include automo- such as pesticides. The recycling event did way of communicating information. Other tive battery acid, which can have a pH of 2 not accept pesticides because a permit that ways by which residents became aware of the or less, and domestic detergents with a pH of is needed from the Louisiana Department of program were through word of mouth (14%), 12.5 or greater because of their high sodium Environmental Quality (LDEQ) for this frac- fliers (7%), radio (4%), Internet (3%), and hydroxide content (Levy & Bro, 1994). tion of HHW was not secured. local television (4%). About 49% and 20% of residents surveyed An issue of unaccepted HHW can be produce 10–50 lb. or 50–100 lb. of HHW per addressed by implementing a fee-to-recycle Characteristics of Recycled HHW year, respectively. Data in the city of Ham- system. A nominal fee paid upfront during Residents recycling HHW contributed by mond and interviews indicate that a con- purchase of household products can sup- only one person accounted for 17%; but 55% siderable and consistent increase of HHW port end-of-life product management, such and 28% of residents recycled HHW that was generation has occurred since the inception as incineration or other proper methods of contributed by two and three other people of the program (City of Hammond SWAC, recycling of pesticides and other HHW not in the household, respectively. At least 64% 2012). Although current levels of about 100 accepted at the recycling event. For exam- of the HHW originated from one household; tons per year of HHW recycled at the events ple, the state of California has successfully and slightly over 19%, 9%, and 6% of HHW are high, it is far less than the national aver- reduced in a significant way the waste gen- originated from two, three, and four other age of about 4–5 pounds per person per day. erated by electronic products by implement- households, respectively. This is not surpris- At the national level, composition of HHW ing such systems (California State Board of ing in a community with close-knit families. in most MSW is broken down as shown in Equalization, 2010). Most HHW products contain toxic chemi- Table 2. cals such as heavy metals, e.g., lead, mercury, The effort taken by local governments to Interviews and Comments From and cadmium (Schübeler, Wehrle, & Chris- promote good HHW practices is beneficial for Residents and City Officials ten, 1996). Table 1 shows the relationship the environmental and public health because Residents and city officials who were inter- between exposure to heavy metals and poten- poor management of MSW can be a leading viewed showed that turnout at the HHW tial human health impacts. HHW also con- cause of ground water contamination and events continues to increase each year, resulting tains solvents such as propylene glycol ether, environmental degradation (Kumar, 2012). in over 100 tons of waste being recycled to date which can be found in ordinary inks, resins, There are constraints, however, such as bud- (City of Hammond SWAC, 2012). Residents adhesives, paints, and household cleaning getary constraints which make it difficult for cited the passion to protect the environment products (Bolognesi et al., 2001; European small cities and towns across America to pro- and human health, top management commit- Council, 1991; Friberg, Elinder, Kjelistrom, & duce reference manuals that can help small- ment, and the ability of the city officials to con- Nordberg, 1986; Levy & Bro, 1994; Nestmann, quantity generators of hazardous wastes to nect with residents. These factors correlate well Otson, Williams, & Kowbel, 1981; Staples & comply with existing regulations pertaining to with the concerns of other communities who Davis, 2002; United Nations Environment proper HHW management (Missouri Depart- have practiced recycling (Domina & Koch, Program, 2012). Exposure to solvents can ment of Natural Resources, 2008). Literature 2002; Meneses & Palacio, 2005).

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Another motivating factor cited was commitment of city officials to recycling efforts TABLE 3 through the resources they provided. The city pays fees to truck owners for recycling Amount of E-Waste Discarded or Recycled in 2007 HHW and provides fliers, safety briefings to residents, student volunteers, and emergency Product Type Total Disposed or Trashed Recycled Recycling Rate trucks and personnel. The fliers outline the (Million Units) (Million Units) (% w/w) types of waste that are and are not accepted Television sets 47.5 6.3 9% at the recycling events. Computer products 362.8 48.2 9% Residents and city officials cited the short Cell phones 266.6 14 5% duration (about four hours on Saturday for this recycling event), the number of events Source: U.S. Environmental Protection Agency, 2008b. (only twice per year), lack of storage, and lack of collection and communal transportation facilities for HHW as being the main weak- tronic products and their recycling rate that million cell phones is equivalent to disposing nesses of the recycling program. Design of has remained relatively low. of 35,000 lb. of copper, 800 lb. of silver, 75 lb. permanent and temporary collection facilities Appropriate e-waste handling practices of gold, and 33 lb. of palladium. have proved to provide convenience in other serve two major purposes: first, to prevent or Appropriate legislation includes regulatory communities to residents who wish to recycle minimize significant health, safety, and ecolog- and nonregulatory frameworks at local, state, HHW but are unable to do so because of lack ical impacts from the toxic materials embed- and federal levels. Existing federal regulatory of transport, time, or other resources (Califor- ded in the products; and second, to support requirements such as the Pollution Preven- nia State Board of Equalization, 2010; Domina recovery of valuable materials for reuse. tion Act of 1990 can provide a sustainable & Koch, 2002; Hornik, Cherian, Madansky, & framework since most state governments Narayana, 1995; Saphores et al., 2006). Legislative Frameworks to Manage E-Waste can use these legislative and regulatory at the Local Level resources as their benchmarks (Kubasek & E-Waste Currently, 50% of states have enacted legis- Silverman, 2008). For example, LDEQ has At the event, cell phones, stereos, computers, lation to address sustainable management of guidelines covering hazardous materials han- television sets, and other e-waste were recy- e-waste (Figure 3). Some initiatives are in the dlers, including conditionally exempt small- cled. In comparison to other types of HHW, form of take-back plans, and others focus on quantity generators (Louisiana Department the amount of e-waste was significantly the producer responsibility laws (Electronic of Environmental Quality, 2012). higher (45%) than paint, tires, and “other” Take Back Coalition, 2011). E-waste consti- Nonprofit organizations and communities HHW that constituted 15.6%, 5.2%, and 1.6% tutes a significant amount of recycled HHW. can also support these initiatives by provid- of the total HHW, respectively. In comparison The use of electronic devices will continue to ing resources for sustainable management of to the nation, e-waste is a growing concern in increase and this situation may present chal- e-wastes. For example, the federal government the city of Hammond. Generation of e-waste lenges to e-waste end-of-life management to passed the Resource Conservation and Recov- occurs in homes, government agencies, and state and local authorities. ery Act (RCRA) in 1976, which offers a good at commercial facilities in the form of tele- framework to manage both hazardous and vision sets, laptops, desktops, cell phones, Resources to Support E-Waste Recycling nonhazardous wastes, including the e-waste and stereos. E-waste accounts for about 2% Management fraction of HHW. Another federal government of all the waste transported to landfills and is Many useful resources are available for com- initiative is the Hazardous Waste Electronic nearly 70% of all hazardous waste generated munity use to design and implement success- Manifest Establishment Act of June 2011, in the U.S. (Ahmed & Tanveer, 2008; Inte- ful management strategies for e-wastes. The which requires generators of hazardous wastes grated Waste Management Board, 2012). Basel Action Network (BAN) in Seattle and to use electronic version of e-waste manifests In 2003, at least three million tons of the Silicon Valley Coalition in California and to track hazardous wastes through a “cradle- e-waste were generated, but in 2008, more numerous nonprofit organizations have accu- to-grave” approach (Government Printing than 36 million units of television sets, 24 mulated a lot of information about e-waste Office, 2011). The waste electrical and elec- million personal computers, and 140 mil- problems (BAN, 2002; Canadian Broadcasting tronic equipment directive number 2002/96/ lion pieces of portable cell phones, pagers, or Corporation, 2008). Large amounts of useful EC of the European Union can influence the phones were being sold, leading to the gener- resources are discarded with e-waste across e-waste recycling at the community level ation of more than 13 million tons of e-waste the globe. A personal computer may contain (European Parliament and Council, 2002). (Consumer Electronic Association, 2008; 26% silica or glass; 20% ferrous and nonfer- U.S. EPA, 2008a). In 2007, data showed a rous metals; 23% plastic materials; 14% alu- Conclusion and Recommendations significant increase in e-waste (Table 3). This minum; and 17% precious heavy metals such There is every reason to believe that—like in apparent increase in e-waste is attributed to as lead, copper, zinc, mercury, and cadmium other parts of the country—HHW is a grow- the fast expiration of the useful life of elec- (E-Waste Collections, 2011). Discarding one ing problem in the city of Hammond and

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newspapers, can contribute to this awareness raising. A plan for community transportation FIGURE 3 for residents who cannot afford to transport Number of States With E-Waste Legislation wastes to the events is recommended. Equally important is raising awareness on applicable regulations and ordinances 30 about HHW through training and to pro- 25 vide residents with fundamental knowledge 25 of procedures and permit application pro- 21 cesses for HHW currently not permitted at 20 20 the recycling events. These needs will promote proper management of HHW waste 15 such as pesticides and polychlorinated biphe- nyl–containing products. 10 9 Some legislation to encourage take back of e-waste would minimize the generation 5 4 of e-wastes in Tangipahoa Parish and in the 3 2 state of Louisiana. Finally, green products are 1 0 0 0 less toxic, and for common household prod- 0 ucts, promotion of these products can make a Number of States With E-Waste Legislation E-Waste Number of States With 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 big difference in efforts to minimize the gen- Year eration of HHW.

Sources: Electronic Take Back Coalition, 2011; E-Waste Collection, 2011. Acknowledgements: The authors wish to express acknowledgement to the mayor of the city of Hammond, Louisiana, and the city surrounding areas. Although the amount of ment authorities, and community members of Hammond Storm Water Advisory Com- HHW generated is not comparable to the through a participatory approach. This case mittee members for their dedication to the national average data, the current recycling study can be replicated elsewhere to support Hammond HHW management program and programs should be improved in frequency initiatives that are designed to reduce HHW. support of this project. and time allocated in order to tackle any E-waste is a growing problem in the city of potential future growth of HHW as a result of Hammond and surrounding communities. An Corresponding Author: Ephraim Massawe, potential population growth. urgent need exists to establish e-waste man- Assistant Professor, Industrial Hygiene and The city of Hammond’s HHW program is agement programs to address this waste. Con- Environmental Health, Southeastern Louisi- successful as it incorporates a component tinuous involvement and engagement of resi- ana University, SLU 10847, Hammond, LA of raising awareness and education through dents is also as important as raising awareness 70402. E-mail: [email protected]. the use of fliers. This approach brings including that of the 3 Rs of pollution preven- together residents, local institutions, govern- tion in managing HHW. Media, especially local

References Ahmed, S., & Tanveer, S. (2008). Electronic waste: Addressing the future California State Board of Equalization. (2010). Electronic waste recy- today. Retrieved from http://are.berkeley.edu/~sberto/ewaste.pdf cling fee. Retrieved from http://www.boe.ca.gov/pdf/pub95.pdf Basel Action Network. (2002). Exporting harm: The high-tech trash- Canadian Broadcasting Corporation. (2008). Electronic waste and ing of Asia—the Canadian story. Retrieved from http://ban.org/E- China. CBC Environmental News in Review. Retrieved from http:// waste/Exporting%20Harm_canada.PDF newsinreview.cbclearning.ca/wp-content/uploads/2008/12/dec- Bolognesi, C., Baur, X., Marczynski, B., Norppa, H., Sepai, O., & 08-electronicwaste.pdf Sabbioni, G. (2001). Carcinogenic risk of toluene diisocyanate City of Hammond, Hammond Storm Water Advisory Committee. and 4,4’-methylenediphenyl diisocyanate: Epidemiological and (2012). City of Hammond departments. Retrieved from http://www. experimental evidence. Critical Reviews in Toxicology, 31(6), hammond.org 737–772. continued on page 32

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References continued from page 31 Consumer Electronics Association. (2008). U.S. consumer electronics 012). Retrieved from http://www.calrecycle.ca.gov/Publications/ sales and forecast, 2003–2008. Washington, DC: Author. Detail.aspx?PublicationID=1039 Domina, T., & Koch, K. (2002). Convenience and frequency of Kubasek, N., & Silverman, G.S. (2008). The American legal system: recycling: Implications for including textiles in curbside recycling The source of environmental law. In Environmental law (6th ed., programs. Journal of Environment and Behavior, 34(2), 216–238. pp. 3–12). Upper Saddle River, NJ: Prentice Hall. Electronics Take Back Coalition. (2011). State legislation. Retrieved Kumar, H. (2012). Quality of life in relation to environmental pol- from http://www.electronicstakeback.com/promote-good-laws/ lution. Journal of Advances in Asian Social Science, 1(1), 72–76. state-legislation/ Levy, S.C., & Bro, P. (1994). Battery hazards and accident prevention. European Council. (1991). Council directive 91/157/EEC on bat- New York: Plenum Press. teries and accumulators containing certain dangerous substances. Louisiana Department of Environmental Quality. (2012). Conditionally Retrieved from http://eur-lex.europa.eu/LexUriServ/LexUriServ. exempt small-quantity generators: Materials handling suggestions. do?uri=CELEX:31991L0157:EN:HTML Retrieved from http://www.deq.louisiana.gov/portal/Portals/0/ European Parliament and Council. (2002). Council direc- assistance/sbap/CESQG.pdf tive 2002/96/EC on waste electrical and electronic equipment. Meneses, G.D., & Palacio, A.B. (2005). Recycling behavior: A multi- Retrieved from http://eur-lex.europa.eu/LexUriServ/LexUriServ. dimensional approach. Journal of Environment and Behavior, 37(6), do?uri=CELEX:32002L0096:en:HTML 837–860. E-Waste Collections. (2011). E-waste collections: Put your electron- Missouri Department of Natural Resources. (2008). Hazardous waste ics in the right place. Retrieved from http://e-wastecollections.com/ management handbook for small-quantity generators. Retrieved Forfás. (2006). Waste management benchmarking study: A baseline from http://www.dnr.mo.gov/pubs/pub2174.pdf assessment. Retrieved from http://www.forfas.ie/media/forfas National Pollution Prevention Center for Higher Education. (1995). 060613_waste_benchmarking_report.pdf Introductory pollution prevention: Materials, pollution preven- Friberg, L., Elinder, C.G., Kjelistrom, T., & Nordberg, G.F. (1986). tion concepts, and principles. Retrieved from http://www.umich. Cadmium and health: A toxicological and epidemiological appraisal, edu/~nppcpub/resources/GENp2.pdf vol. 2: Effects and response. Boca Raton, FL: CRC Press. Nestmann, E.R., Otson, R., Williams, D.T., & Kowbel, D.J. (1981). Gamba, R.J., & Oskamp, S. (1994). Factors influencing community Mutagenicity of paint removers containing dichloromethane. residents’ participation in commingled curbside recycling pro- Cancer Letters, 11(4), 295–302. grams. Journal of Environment and Behavior, 26(5), 587–612. Pendle, W. , & Poll, A.J. (1993). Common household products: A Government Accountability Office. (2007). Recycling: Additional review of their potential environmental impacts and waste manage- efforts could increase municipal recycling (GAO Report No. GAO- ment options. London: Warren Spring Laboratory. 07-37). Retrieved from http://www.gao.gov/htext/d0737.html Reinhart, D.R. (1993). A review of recent studies on the sources of Government Printing Office. (2011). Hazardous waste electronic hazardous compounds emitted from solid waste landfills: A U.S. manifest establishment act (Senate Report No. 112-20, 112th experience. Waste Management & Research, 11(3), 257–268. Congress). Retrieved from http://www.gpo.gov/fdsys/pkg/CRPT- Saphores, J.M., Nixon, H., Ogunseitan, O.A., & Shapiro, A.A. 112srpt20/html/CRPT-112srpt20.htm (2006). Household willingness to recycle electronic waste: An Hall, R.M., Davis, R.C., Schwartz, R.E., Bryson, N.C.S., & McCrum, application to California. Journal of Environment and Behavior, R.T. (1996). RCRA hazardous waste handbook. Rockville, MD: 38(2), 183–208. Government Institute. Schübeler, P. , Wehrle, K., & Christen, J. (1996). Conceptual frame- Health Communication Unit. (2006). Advantages and disadvantages work for municipal solid waste management in low-income coun- of survey methods. Retrieved from http://www.thcu.ca/infoand tries. Retrieved from http://www.worldbank.org/urban/solid_wm/ resources/publications/surveytable.pdf erm/CWG%20folder/conceptualframework.pdf Hornik, J., Cherian, J., Madansky, M., & Narayana, C. (1995). Deter- Staples, C.A., & Davis, J.W. (2002). An examination of the physical minants of recycling behavior: A synthesis of research results. properties, fate, genotoxicity, and potential environmental risks Journal of Socio-Economics, 24(1), 105–127. for a series of propylene glycol ethers. Chemosphere, 49(1), 61–73. Illinois Environmental Protection Agency. (2003). Household haz- Stasiskiene, Z., Gaiziuniene, J., & Zidoniene, S. (2011). Assessing ardous waste collection results: State fiscal years 1999, 2000, 2001, the sustainability of the Lithuanian hazardous waste management 2002 (Report No. IEPA/BOL/98-023). Retrieved from http://www. system. Journal of Industrial Ecology, 15(2), 268–283. epa.state.il.us/land/hazardous-waste/household-haz-waste/hhwc- U.S. Environmental Protection Agency. (1993). Household hazardous collection-results.pdf waste management: A manual for one-day community collection pro- Integrated Waste Management Board. (2012). Proper automotive grams (Report No. 530-R-92-026). Retrieved from http://epa.gov/ waste management: Resource manual (Publication No. 610-2003- osw/conserve/materials/pubs/manual/index.htm

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References United Nations Environment Program. (2006). Environmental www.epa.sa.gov.au/xstd_files/Waste/Guideline/guide_waste_ pollution and impacts on public health: Implications of the Dandora defi nitions.pdf municipal dumping sites in Nairobi. Retrieved from http://www. U.S. Environmental Protection Agency. (2009b). Proposed revision to unep.org/urban_environment/pdfs/dandorawastedump-report defi nition of solid waste—frequent questions. Retrieved from http:// summary.pdf www.epa.gov/osw/hazard/dsw/dsw-faq.htm U.S. Environmental Protection Agency. (2008a). Municipal solid U.S. Environmental Protection Agency. (2011). Household hazardous waste generation, recycling, and disposal in the United States: Facts waste reduction, pollution prevention (P2) education toolbox (Report and fi gures for 2008. Retrieved from http://www.epa.gov/osw/non No. EPA-905-F-97-011). Retrieved from http://www.epa.gov/ haz/municipal/pubs/msw2008rpt.pdf region5/waste/solidwaste/p2pages/pdfs/tb-hhw.pdf U.S. Environmental Protection Agency. (2008b). Electronic waste World Class Communications Technologies. (2011). 3 Rs of sustain- management in the United States, approach 1, table 3.1 (Report ability: Reduce, reuse, recycle. Retrieved from http://www.learn- 530-R-08-009). Retrieved from http://www.epa.gov/osw/conserve/ com.com/pdf/VL6811_ILN.pdf materials/ecycling/docs/app-1.pdf U.S. Environmental Protection Agency. (2009a). Waste guidelines: Waste defi nitions (Report No. EPA 842/09). Retrieved from http://

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 DIRECT FROM ATSDR

Agency for Toxic Substances and Disease Registry’s Don’t Mess With Mercury Initiative Michelle Jamie Rayman, Watters, MPH, MPH MD, PhD

ercury has long been recognized Editor’s Note: As part of our continuing effort to highlight innovative by the public health community as approaches to improving the health and environment of communities, the M an environmental and occupational health hazard. In October 2013, the U.S. Journal is pleased to publish a bimonthly column from the U.S. Agency signed and ratified the international Minamata for Toxic Substances and Disease Registry (ATSDR). The ATSDR, based in Convention on Mercury. Once fully ratified, Atlanta, Georgia, is a federal public health agency of the U.S. Department of this global treaty will require countries to re- Health and Human Services and shares a common office of the Director with duce emissions and releases of mercury from products, processes, and industries to protect the National Center for Environmental Health at the Centers for Disease human health and the environment (United Control and Prevention (CDC). ATSDR serves the public by using the best Nations Environment Programme, 2014). science, taking responsive public health actions, and providing trusted While many public health policy efforts focus on methylmercury exposure from fish or health information to prevent harmful exposures and diseases related to airborne elemental mercury emissions from toxic substances. coal-powered plants, a recent Agency for Toxic The purpose of this column is to inform readers of ATSDR’s activities Substances and Disease Registry (ATSDR) initiative, Don’t Mess With Mercury (DMWM) and initiatives to better understand the relationship between exposure (Figures 1 and 2), is aimed at preventing ex- to hazardous substances in the environment and their impact on human posure from elemental mercury spills. health and how to protect public health. We believe that the column will Elemental mercury is a dense, silvery metal provide a valuable resource to our readership by helping to make known that is liquid at room temperature. When spilled, its high surface tension causes tiny the considerable resources and expertise that ATSDR has available to droplets to form. These unique physical char- assist communities, states, and others to assure good environmental health acteristics appeal to children and adolescents practice for all is served. who have been observed playing with mercury, sharing it with friends, decorating their The findings and conclusions in this article are those of the author(s) and hair with it, taking it on school buses and do not necessarily represent the views of CDC/ATSDR. into school buildings, and smoking mercury- Michelle Watters is a medical officer for ATSDR’s Division of Community dipped cigarettes. Mercury can be found in Health Investigations. Dr. Watters provides medical expertise in public health a variety of household items including ther- mometers, fluorescent light bulbs, and elec- issues related to exposure to biological, chemical, and radiological agents tronic switches. People have kept jars and for the regional offices, state and local public health and environmental containers of mercury for refining metals, agencies, and community members. Jamie Rayman is a health educator for folk medicine, and some ritualistic practices (Agency for Toxic Substances and Disease ATSDR’s Division of Community Health Investigations in the Region 9 office Registry [ATSDR], 1999). (San Francisco). Ms. Rayman develops health education and communication Elemental mercury volatilizes at room materials for community members affected by hazardous waste. temperature; the vapors are colorless, odor- less, and heavier than air and accumulate in lower areas of a room. Heating mercury or

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dispersing mercury droplets by vacuuming or sweeping will increase concentrations of FIGURE 1 airborne mercury. The droplets can settle Agency for Toxic Substances and Disease Registry’s Don’t Mess deep into cracks and crevices making the With Mercury Initiative spill difﬁ cult to remediate and providing an ongoing exposure. Inhalation of mercury vapor is the major route of exposure and toxicity; minimal dermal or gastrointesti- DON’T MESS WITH MERCURY nal absorption occurs. Once inhaled, mer- IS A MERCURY SPILL PREVENTION cury enters the bloodstream and distributes INITIATIVE FOR STUDENTS AND SCHOOLS to all tissues but accumulates primarily in the kidneys and brain. Elemental mercury If you see mercury don’t mess with it. Don’t touch it. Find an adult. Mercury looks cool, but it’s not! It is poisonous It can make you sick. crosses the blood-brain and placental barri- ers (ATSDR, 1999). The human body has no known physi- To learn more, visit: www.atsdr.cdc.gov/dontmesswithmercury/ ologic requirement for mercury. The nervous system and renal system are sensitive targets for both acute and chronic exposures to mercury vapors. Exposures may result in tremor, personality changes, irritability, memory loss, insomnia, mood swings, weakness, and sen- sory-motor peripheral neuropathy. Kidney effects range from transient proteinuria to acute tubular necrosis. High concentrations of vapor received acutely can cause cough, dyspnea, and pneumonitis. Dermal manifesta- tions of mercury vapor exposure may include an erythematous, pruritic rash or acrodynia (a rare, nonallergic hypersensitivity reaction seen FIGURE 2 in some children). In general, children are more sensitive to health effects from mercury Agency for Toxic Substances and Disease Registry’s Don’t Mess than adults (ATSDR, 1999). With Mercury Initiative Unfortunately many people, especially children, are not aware of the dangers of mercury exposure, and mercury spills are common throughout the country. In 2008, Congress directed ATSDR to characterize elemental mercury exposures to children across the U.S. The report, “Children’s Exposure to Elemen- Take action to protect your home tal Mercury,” summarized numerous mercury and school from mercury spills. spill exposures and other sources of chil- Visit the website where you will find: mercury beads under floor tile dren’s exposure to mercury (ATSDR, 2009). Mercury video game Don’t Mess With Mercury video While no comprehensive surveillance system Material on mercury spill prevention More info about mercury exists for elemental mercury spills, numerous For more information, visit: sources were used to document hundreds of www.atsdr.cdc.gov/dontmesswithmercury/ spills ranging in size from broken thermom- or contact ATSDR at 1-800-CDC-INFO. eters reported to poison control centers (1,825 calls in 2012) to mercury spills of one pound or more (two tablespoons by volume) that professional cleaning up mercury beads must be reported to the U.S. Coast Guard’s National Response Center (at least 50 school- CS244745 related spills documented in a six-year period) (ATSDR, 2009; Mowry, Spyker, Cantilena, Bai- ley, & Ford, 2013).

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Consequences of mercury spills range from and staff, to further reduce the number of If you see mercury, don’t mess with it. Mer- minor inconveniences to major, potentially spills and exposures and improve the manage- cury is anything but cool. harmful exposures that are expensive to reme- ment of spills that do occur. diate. Cleanup of even relatively small spills ATSDR launched an expanded DMWM Corresponding Author: Michelle Watters, Medi- that had initially been improperly managed Web site (www.atsdr.cdc.gov/dontmesswith- cal Officer, Division of Community Health have cost thousands of dollars and resulted in mercury) in late 2013. The site’s goals are to Investigations, Agency for Toxic Substances days to months of unplanned school closures. prevent mercury spills from happening and and Disease Registry, 77 W. Jackson Blvd., Chi- In 2003, a large spill at a Washington, DC, area to minimize harm if spills do occur. For the cago, IL 60604. E-mail: [email protected]. high school resulted in school closure for 35 primary prevention goal, the site provides days and a remediation cost of about $1.5 mil- instructional material on eliminating mer- References lion (U.S. Environmental Protection Agency, cury in schools, finding alternative products Agency for Toxic Substances and Disease Reg- 2013). In this incident, a student took mercury for use in school science classes and facili- istry. (1999). Toxicological profile for mercury. from a science laboratory and distributed it to ties, and creating a school mercury policy. Atlanta, GA: U.S. Department of Health and other students. In 2013, two children required Interactive educational materials for students Human Services. chelation therapy when they developed symp- include a web-based video game and an inter- Agency for Toxic Substances and Disease Reg- toms consistent with mercury exposure and active graphic of the effects of mercury on the istry. (2009). Children’s exposure to elemental elevated blood mercury levels. They had human body. The DMWM Web site also pro- mercury: A national review of exposure events obtained mercury from a neighbor’s shed and vides step-by-step instructions on proper spill (reported by the Agency for Toxic Sub- spilled it at home and on the school bus. Four cleanup and disposal, including how to create stances and Disease Registry and Centers other family members also had blood mercury a spill kit for small spills. Supporting materials for Disease Control and Prevention Mercury levels exceeding the human health risk thresh- include speaking points for communicating Workgroup). Atlanta, GA: U.S. Department old of 50 µg/L (ATSDR, 1999; Centers for Dis- with parents and the media about exposure of Health and Human Services. ease Control and Prevention, 2014). concerns and fact sheets for health providers Centers for Disease Control and Prevention. ATSDR started the DMWM initiative after a for counseling patients. While the materials (2014). Notes from the field: Elemental U.S. Environmental Protection Agency (U.S. are targeted to the education system, much of mercury spill in school bus and residence— EPA) Region 9 request in 2008 for health the information is applicable for other venues North Carolina, 2013. Morbidity and Mor- education outreach. The region’s emergency such as homes, clinics, and offices. tality Weekly Report, 63(60), 131. response workers had responded to multiple ATSDR is not alone in the effort to elimi- Mowry, J.B., Spyker, D.A., Cantilena, J.R., mercury spills caused by young teens and nate mercury spills. Many state health depart- Jr., Bailey, J.E., & Ford, M. (2013). 2012 preteens handling mercury found in homes, ments, U.S. EPA, and other nonprofit orga- Annual report of the American Association garages, schools, or abandoned buildings. nizations have created educational materials of Poison Control Centers’ National Poison ATSDR created a 30-second DMWM public on preventing mercury spills. These initia- Data System (NPDS): 30th annual report. service announcement in English and Spanish tives will empower schools with knowledge Clinical Toxicology, 51, 949–1229. to increase awareness of mercury and encour- of spill response plans and educational and United Nations Environment Programme. age behavioral change among middle school emergency contacts. Ultimately, the reduc- (2014). Minamata convention on mercury. children. The public service announcement tion in the number and the extent of mercury Retrieved from http://www.mercuryconven was posted on a joint U.S. EPA-ATSDR Web spill incidents in schools will reflect a suc- tion.org site. ATSDR recognized, however, that schools cessful public health outreach. With educa- U.S. Environmental Protection Agency. (2013). needed additional educational material, as tion, this health hazard can be relegated to a Mercury in schools case studies. Retrieved from well as outreach to administrators, teachers, historical footnote. http://www.epa.gov/hg/casestudies.htm#1

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ADVANCEMENT OF THE PRACTICE

 DIRECT FROM CDC ENVIRONMENTAL HEALTH SERVICES BRANCH

Impact of Budget Cuts to Environmental Health Services at Local Health Departments:

Jennifer Li, Andrew Elligers, Key Findings MHS MA, JD

Editor’s Note: NEHA strives to provide up-to-date and relevant According to one information on environmental health and to build partnerships in the respondent, personnel profession. In pursuit of these goals, we feature a column from the Environmental Health Services Branch (EHSB) of the Centers for Disease reductions due to Control and Prevention (CDC) in every issue of the Journal. budget cuts had “put In this column, EHSB and guest authors from across CDC will highlight an enormous strain on a variety of concerns, opportunities, challenges, and successes that we all providing customary share in environmental public health. EHSB’s objective is to strengthen the role of state, local, tribal, and national environmental health programs and environmental professionals to anticipate, identify, and respond to adverse environmental health services.” exposures and the consequences of these exposures for human health. The conclusions in this article are those of the author(s) and do not necessarily represent the views of the CDC. sons. In addition, respondents indicated that Jennifer Li is the director of Environmental Health and Health and some environmental health services that were Disability at the National Association of County and City Health Officials. not reduced or eliminated were still negatively impacted by budgetary constraints. Andrew Elligers is a senior program analyst for Environmental Health at the Key findings from the survey are summa- National Association of County and City Health Officials. rized in the following categories.

Changes in Environmental Health Revenue he recent economic recession and its To learn specifically about changes to envi- • Of the 75% of LHDs that were able to sepa- aftermath negatively impacted many ronmental health funding and the impacts of rate environmental health revenue from T local health departments (LHDs) these changes on the environmental health overall LHD revenue, 34.5% realized lower across the U.S. Seven surveys conducted by workforce and services at LHDs, NACCHO environmental health revenue than in the the National Association of County and City surveyed a nationally representative sample previous fiscal year. Health Officials (NACCHO) between August of LHDs in March and April 2012. The study • Eighteen and a half percent of LHDs real- 2009 and February 2012 produced informa- assessed changes between each respondent’s ized higher environmental health revenue tive data (NACCHO, 2012). Each wave of the most recently completed fiscal year and prior in their most recently completed fiscal year study showed that in comparing the current fiscal year. The study data indicated that than in the previous fiscal year. and prior fiscal years about 40% of LHDs na- environmental health revenue decreased for tionwide had lower budgets, about 50% cut a substantial percentage of LHDs and that Impact on Environmental at least one program, and about 45% experi- significant cuts to the environmental health Health Workforce enced staff reduction. Since 2008, LHDs lost workforce and to valuable environmental • Nearly three out of 10 (29.1%) LHDs expe- almost 40,000 employees. health services were made for budgetary rea- rienced a reduction of their environmental

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not replaced because of hiring freezes or budget cuts). TABLE 1 • LHDs reported that job losses negatively Percentages of Local Health Departments That Reduced or affected their abilities to provide environ- Eliminated Environmental Health Services for Budgetary Reasons mental health services, increased stress on (N = 280–291) the remaining workforce, and resulted in low employee morale. According to one Environmental Health Service Reduced or Eliminated (%) respondent, personnel reductions due to At least one service 33.7 budget cuts had “put an enormous strain Food safety 12.8 on providing customary environmental Vector control 12.7 health services.” Ground water 10.7 Surface water 8.5 Reduction and Elimination of Drinking water 10.0 Environmental Health Services Recreational water 8.3 • Many LHDs reduced or eliminated envi- Indoor air 7.8 ronmental health services for budgetary Outdoor air 3.2 reasons (Table 1). Over one-third (33.7%) Pollution prevention 5.3 of LHDs reduced or eliminated at least one Land use 5.6 environmental health service. Hazardous material 2.6 • Environmental health services that were Air pollution 1.6 reduced or eliminated by the largest per- Hazardous waste 5.3 centages of LHDs included food safety Animal control 6.8 (12.8%) and vector control (12.7%). Climate change 1.5 • Environmental health services related to water (ground, drinking, surface, and recreational) were reduced or eliminated by the next largest percentages of LHDs. TABLE 2 • Multiple respondents noted reduced inspections of food establishments due to Percentages of Local Health Departments for Which Budgetary budgetary constraints. For example, one Constraints Negatively Impacted Environmental Health Service LHD “reduced food inspections from four Outcomes (N = 289–307) times per year to three.” • Several respondents indicated reduced vec- Environmental Health Service Negative Impact (%) tor control services and described impacts Any service 39.6 to mosquito control. Some examples Food safety 20.7 included eliminating mosquito surveil- Vector control 16.8 lance trapping, not spraying for mosqui- Ground water 14.9 toes as frequently, and not providing any Surface water 13.5 mosquito control services. Drinking water 15.6 Recreational water 13.6 Environmental Health Indoor air 8.9 Service Outcomes Outdoor air 3.2 • More than one-third (39.6%) of LHDs Pollution prevention 6.9 reported that budgetary constraints nega- Land use 7.1 tively impacted environmental health ser- Hazardous material 3.5 vice outcomes (Table 2). Air pollution 1.8 • Food safety, vector control, and services Hazardous waste 5.9 related to water were the top three areas for Animal control 8.8 which LHDs reported that budgetary con- Climate change 1.1 straints negatively impacted service outcomes. • Some respondents described decreased qual- health staff for budgetary reasons in the • The number of job losses for the environ- ity of work in attempting to meet unchanged form of layoffs or employee attrition where mental health workforce at LHDs nation- or increasing workloads. Respondents also employees were not replaced because of wide was estimated to be 1,350 (550 were indicated that budget constraints had led to hiring freezes or budget cuts. laid off and 800 were lost to attrition and “reduced education and training.”

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Moving Forward With diminished resources, LHDs may be Quick Links: National Association of County and City Health Offi cials less able to provide customary services and (NACCHO) Resources to Support Environmental Health respond to emergencies quickly and compre- hensively. Recognizing the challenging conditions illustrated by the survey data, NAC- NACCHO environmental health program: Environmental health–related tools, CHO supports staff at LHDs to advance the publications, policy statements, and other resources. practice of environmental health by provid- http://www.naccho.org/topics/environmental ing innovative resources to address existing Toolbox: Free, online collection of local public health tools produced by members and emerging issues and encourages LHDs to of the public health community. Current examples of tools include case examples, consider the following actions (see Sidebar): presentations, fact sheets, drills, evaluations, protocols, templates, reports, and • learn from peers through NACCHO’s model training materials. Check out environmental health–related toolkits on climate change, practices program; environmental health in all policies, food safety, healthy community design, and Protocol for Assessing Community Excellence in Environmental Health (PACE EH). use and share existing tools and resources • http://www.naccho.org/toolbox developed by and for LHDs; and • communicate, illustrate, and quantify the Model practices database: Online, searchable collection of innovative, peer-reviewed impact of budget cuts on environmental best practices across public health areas that allows users to bene t from their health service outcomes by telling their colleagues’ experiences to learn what works, get strategies on how to implement effective programs with good results, and save time and resources. stories to the public and policy makers. http://www.naccho.org/topics/modelpractices/ For the full survey report, more information about NACCHO’s environmental health work, Stories from the fi eld Web site: Web site that enables local health departments to share and links to additional resources, please visit their experiences and demonstrate the value of public health. Stories from the eld can be www.naccho.org/topics/environmental. used to support advocacy, peer learning, and collaboration with state and federal partners. http://www.nacchostories.org/ Corresponding Author: Jennifer Li, Director, Environmental Health and Health and Dis- ability, National Association of County and Reference uary 2012 survey. Retrieved from http://www. City Health Offi cials, 1100 17th Street, N W, National Association of County and City Health naccho.org/topics/infrastructure/lhdbudget/ 7th Floor, Washington, DC 20036. Offi cials. (2012). Local health department job upload/Research-Brief-Final.pdf E-mail: [email protected]. losses and program cuts: Findings from the Jan-

NEHA is coordinating with the Centers for Disease Control and Prevention Did You Know? to offer four more Integrated Pest Management Workshops in the upcoming months. Learn more? at www.neha.org/research/irprogram.html.

The Journal of Environmental Health (JEH) is now being delivered to you via e-mail. Starting October 1, members will need to choose between the print or electronic version. Check it out! • Access web links and e-mail addresses found in articles, ads, and listings • Read it on any computer or mobile device such as a tablet or smart phone • Quickly nd information using the search feature • View video content • Bookmark pages and articles for quick reference As a NEHA member, you will receive the E-Journal in addition to the hard copy—absolutely free—for all issues of the JEH through September 2014 while your membership is active! Look for it in your inbox and be sure to add [email protected] to your list of safe senders.

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ADVANCEMENT OF THE PRACTITIONER

 GUEST COMMENTARY

I Am an Environmental Health Pracademic (And So Can You!)

Ken Runkle, MA, DPA, REHS

ith apologies to Stephen Colbert Additionally, EHAC requires that each department and pool safety visits with state for the title above (Colbert, 2009), accredited program have an advisory commit- inspectors. The photos and stories obtained W let me confess that I am an tee that typically has members who are prac- from the field help make class lectures timely, environmental public health pracademic. titioners from both public and private sectors practical, and more real to my students. What’s a pracademic? I’m glad you asked. of environmental health. Programs benefit At UIS, pracademics serve as adjunct fac- Popularized by Paul Posner in the field of from an active and knowledgeable advisory ulty teaching courses in the MPH curriculum public administration, a pracademic is a per- team of pracademics working in public health as need arises. While working at IDPH, I had son who spans the boundaries between prac- agencies and businesses because they can see the opportunity to teach environmental and titioners and academics in ways that “enrich the academic program from a practitioner’s occupational health each spring semester for both theory and practice (Posner, 2009).” perspective and help ensure the curriculum is 17 years. An IDPH deputy director has taught Roles range from practitioners who super- appropriate for preparation for careers in the public health policy, an IDPH epidemiologist vise internships, to practitioners who teach, environmental health field (EHAC, 2013). has taught epidemiology, an IDPH health asses- train, or serve on college advisory boards, to Jessica Thoron, food program supervisor for sor has taught environmental risk assessment, academics who practice and conduct envi- the Sangamon County Health Department in a CDC public health advisor has taught online ronmental health research. These are all roles Springfield, Illinois, is a local pracademic. She courses, and an environmental communica- that I have played in my career as an envi- serves on the UIS advisory committee and has tion specialist with a local engineering firm has ronmental toxicologist and as the director of supervised several UIS student interns who taught environmental risk communication. the Division of Environmental Health at the have gained environmental health experience Teaching a college-level course is not easy, Illinois Department of Public Health (IDPH) at the county level. “The interns not only get but it will keep a professional fresh in the and as an assistant professor at the Univer- me out of the rut of my day-to-day activities,” practice and refreshed on the science of the sity of Illinois Springfield (UIS) in the public Thoron explained, “they tend to remind me of field. Students enjoy instructors who make health department. why I entered this field in the first place. We’ve the subject matter in textbooks come alive At UIS, partnerships with pracademics also found some good employees this way!” with stories of real-world environmental produce benefits for masters of public health Because of a growing online MPH program public health experiences. Environmental (MPH) students. As a department offering at UIS, students are looking for internship health pracademics also can teach introduc- an MPH with an environmental health con- opportunities outside Springfield in their tory science classes at local community col- centration fully accredited by the National individual locales. Nationwide, 32 under- leges, raising awareness of the field for a new Environmental Health Science and Protec- graduate and 8 graduate environmental generation of students. tion Accreditation Council (EHAC), UIS health programs are accredited by EHAC, so Lastly, pracademics have the unique oppor- has a regular need for practitioners to serve internship opportunities are needed through- tunity to conduct useful and pragmatic envi- as internship supervisors. EHAC requires out the U.S. and even on other continents ronmental public health research. Too often that graduate students have an environmen- (EHAC, 2013). This pracademic role is one academics are reluctant to enter the world tal health internship experience of at least that can be very rewarding and can help proof practice and practitioners do not have the 180 contact hours (National Environmental fessionals be reminded of the “why” behind time or inclination to publish the results of Health Science and Protection Accreditation the “what” of their daily practice. data gathered, but the pracademic can bridge Council [EHAC], 2013). Many of the UIS Academic faculty need practical experi- the gap between these territories to design students take internships with little or no pay ences in environmental health as well to stay and conduct research that can produce ratio- that are purposed for the career growth, edu- fresh in the practice. Sometimes educators nal and useful results. In addition, research cation, and hands-on experience of the stu- can get trapped inside the bubble of aca- partnerships between academia and practice dent. Meanwhile, supervisors and agencies demia, so field opportunities with local prac- provide much-needed data for informed deci- get the benefit of some low-cost or no-cost titioners are welcome. I have participated in sions with which to improve environmental short-term professional help. food safety activities with our local health public health in our communities.

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So, consider becoming an environmental References grams. Retrieved from http://www.ehac health pracademic. The field and future pra- Colbert, S. (2009). I am America (and so can office.org cademics will benefit. You will too! you!). New York: Grand Central Publish- Posner, P.L. (2009). The pracademic: An agenda ing/Hachette Book Group USA. for re-engaging practitioners and academics. Corresponding Author: Ken Runkle, 1428 N. National Environmental Health Science and Public Budgeting & Finance, 29(1), 12–26. 6th St., Springfield, IL 62702. Protection Accreditation Council. (2013). E-mail: [email protected]. Accreditation guidelines and accredited pro-

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June 2014 • Journal of Environmental Health 43

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ADVANCEMENTADVANCEMENT OF OF THE THE PRACTITIONER PRACTICE

 DEMYSTIFYING THE FUTURE

Passing the Fortune Cookie Test

Thomas Frey

And so it was that I became sucked into Editor’s Note: Signifi cant and fast-paced change is occurring across the world of fortune cookies as I attempted to society in general and our profession in particular. The clearer our sense for move this ancient delicacy into the digital age. First a disclaimer. This is not an attempt the future is, the more able we are to both understand and take advantage to reinvent the fortune cookie industry (yes, of trends working their way through virtually every aspect of our lives today. it is), or rid the world of badly written for- To help us see what these trends are and where they appear to be taking us, tunes (all fortune cookie writers must have NEHA has made arrangements to publish the critical thinking of the highly failed kindergarten), or even an excuse for regarded futurist, Thomas Frey. me to eat more of them (I’m on my second bag now). Rather, my goal is to show how the The opinions expressed in this column are solely that of the author and coming digital age will permeate even cen- do not in any way refl ect the policies and positions of NEHA and the Journal tury-old industries like fortune cookies (no, of Environmental Health. it won’t) (yes, it will). Thomas Frey is Google’s top-rated futurist speaker and the executive If only I had a cookie that could end all these director of the DaVinci Institute®. At the Institute, he has developed original arguments! Anyway, here are some thoughts research studies enabling him to speak on unusual topics, translating trends on creating the ultimate fortune cookie. into unique opportunities. Frey is a powerful visionary who is revolutionizing First a Little Background our thinking about the future. The true origin of the fortune cookie has been disputed several times in the courts, but they fi rst showed up in the late 1800s and came ecently my wife Deb and I had lunch enter brainstorming mode and she wanted from Kyoto, Japan, not China. at one of our favorite Chinese restau- no part of it, I added, “Maybe I should Up until World War II, fortune cookies R rants, and afterwards we were given have gotten a fortune cookie that predicted were known as “fortune tea cakes,” refl ecting the typical fortune cookies that come with I was about to invent the ultimate fortune their Japanese origins of being served in the the bill. Jokingly I broke open the fi rst one cookie!” tea gardens. and asked, “I wonder if it’d be possible to cre- It was at this point that she made the hand The industry changed dramatically with ate a real fortune sometime in the future and gesture that she wanted to strangle herself. the invention of the automated fortune cookie put it into these cookies?” That was her way of saying it may be a good machine. Some claim it started with the fold- Naturally Deb gave me the standard “not idea but she had too much workload to entering machine invented by Shuck Yee in Oakland again” look that I often get when asking tain some random thoughts that would dis- in 1973, but others have traced its true origins weird questions like this. tract her from the all-important task of bal- to the 1964 invention of Edward Louie of San I quickly countered with, “If someone were ancing our checkbooks once we got back to Francisco’s Lotus Fortune Cookie Company. to combine information from smartphones the offi ce. Louie invented a machine that automatically and a few Internet of Things devices and tied It occurred to me that she would have inserted the paper fortunes into the golden it into an anticipatory computing algorithm, thought differently if she’d gotten a fortune wafers as they came off the griddle. it might be possible to spit out some mean- cookie telling her that balancing the check- Today there are roughly three billion for- ingful predictions.” book was far less important than helping me tune cookies made each year, with the vast Just when she was about to change the with my idea, but I decided there are times majority of them served in the U.S. The larg- subject because she saw that I was about to when silence is the better course of action. est manufacturer is Wonton Foods, head-

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quartered in Brooklyn, New York. They pro- only select items that you like and things that claims of fiscal responsibility are also exag- duce over 4.5 million fortune cookies per day. fall within your diet. gerated. A vote for Betsy Green is more in Another large manufacturer is Peking Noodle As you order your food and enjoy the meal, line with your values. based in the Los Angeles area. the anticipatory computing system is cross- 5. Arthur is about to propose to you. But referencing appointments, places you’ve before you agree to marry him, you should Anticipatory Computing been, projects you’ve been working on, rela- ask him why he left his last four jobs after To better grasp my logic here, it’s best to tionships, e-mails, and telephone conversa- less than a year. understand the fast-emerging field of antici- tions. The end result is a meaningful fortune 6. Your son Jonathan is having difficulty with patory computing. printed on a small piece of paper and sent to his new job but doesn’t want to tell you We are entering a world that is filled with the cookie machine. about it. A simple phone call from you connected devices. In this world, when we The cookie machine consists of a 3D food would help him immensely. need information, we will no longer have to printer that instantly syncs up with your pre- 7. Your washing machine will fail sometime resort to typing a query or asking a question. ferred flavors and dietary requirements and within the next three months. Best to put Instead, we will allow our devices and apps prints a perfect cookie around the all-impor- aside money for a new one. to pay attention continuously to the things tant fortune. 8. You will receive a call tomorrow from the we read and write, the places we visit, and the During this process, no people are aware Greenland Corporation offering you a dif- things we say and hear. of any of the details throughout the process, ferent position than what you’d applied for, By interpreting these contextual signals, nor have any of them seen your fortune. Your and also for less money. If you emphasize our apps and devices will become much better privacy is still perfectly intact. your marketing background you’ll be able at finding the information we need, in some At the end of your meal, the waiter brings to get the job you want. cases, before we even know enough to ask. out a finely decorated plate with the cookie As you read through each of these examples, An early example of anticipatory com- as the centerpiece. Your name has been care- some will seem more plausible than others. puting is an app called MindMeld that lis- fully printed along the edge in lightly colored tens to group conversations and anticipates confectionery cream so there is no mistaking Final Thoughts what will be talked about next by pulling whose cookie it is. Whatever the mind can conceive and believe, it up documents, photos, and videos to add Once you open the cookie and read the for- can achieve.—Napoleon Hill, author of Think to the conversation. tune, it immediately causes a series of events and Grow Rich. to unfold, giving direction to your ideas, giv- In much the same way we can predict the The Fortune Cookie Test ing answers to your uncertainties, and giving weather less than 24 hours in the future with Creating the ultimate fortune cookie is no motion to seemingly unmovable situations. ever-increasing accuracy, anticipatory com- small task, and there are virtually millions of This one seemingly innocent fortune cookie puting will be able to predict near-term per- ways to get it wrong. For this reason I’ve taken has changed your life in profound ways. sonal events with far greater precision. the liberty of creating a few of the parameters Any restaurant serving this kind of fortune that will help guide people’s thinking. Eight Examples cookie would instantly have people standing 1. Has a less than 24-hour event horizon. While I’m surely missing many of the possi- in line to get in. 2. Correlates three or more seemingly unre- bilities, I thought it would be helpful to give The fortune cookie, however, is really just lated data points in the life of the person you a few examples of the kind of fortunes a tool that we can all relate to for giving us a receiving it. you might receive. tiny glimpse of the world ahead. 3. Recommends a single course of action and 1. If you call Frank, the CFO at Acme com- The combination of old-school products predicts meaningful results. puting, tomorrow, you will be able to solve and digital-age thinking will unleash far more 4. Can be demonstrated to be at least 80% the valuation dispute you’re having with opportunities than ever before in history. accurate. the Mango Tiberius Corporation. He’ll be But I only know that because I paid atten- 5. Advises the recipient to do something he or free for one hour starting at 11:00 a.m. tion to my fortune cookie yesterday—what it she would not have previously considered. 2. On your next date with Sharon, if you ask represented, not what was inside it. I suggest her about the product shipment failure you do the same. The Ultimate Fortune Cookie under her previous boss, Charles, you’ll be Interested in sharing your thoughts? Go to Scenario able to understand her reluctance to form www.FuturistSpeaker.com. So let’s pull it all together with this scenario. an intimate relationship. You enter the famous Tao Fusion restau- 3. The Nissan Altima you’re considering Corresponding Author: Thomas Frey, Senior rant with great anticipation. You are joined buying has brake problems that the seller Futurist and Executive Director, DaVinci by a group of friends because tapping into hasn’t told you about. Be wary of purchas- Institute®, 511 East South Boulder Road, your “friend network” often produces better ing this vehicle. Louisville, CO 80027. fortunes. 4. Before you vote in tomorrow’s election, E-mail: [email protected]. The waiter hands you a smart menu that please understand the attack ads against automatically changes the menu items to Joe Wilson are highly distorted, but his

June 2014 • Journal of Environmental Health 45

JEH6.14_PRINT.indd 45 Corresponding Author: Thomas Frey, Senior Futurist5/1/14 4:08and PM Executive Director, DaVinci Institute®, 511 East South Boulder Road, Louisville, CO 80027. E-mail: [email protected].

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Albuquerque, NM Minneapolis, MN Where the "best of the best" consult...  CDPmobile ‐ the most Baltimore, MD Mississauga, ON, Canada Lodging Billings, MT Owatonna, MN NEHA's intuitive form‐filling Bismarck, ND Phoenix, AZ Career Center data‐capture interface Boise, ID Pittsburgh, PA imaginable on the market today for use Boston, MA Pocatello, ID First job listing FREE for city, county, and state health Buffalo, NY Puerto Rico on tablets. Butte, MT Rochester, NY departments with a NEHA member, Cleveland, OH Spearﬁsh, SD and for Educational and Sustaining members. Septic  All development Dallas, TX St. Louis, MO performed in U.S. El Paso, TX St. Paul, MN For more information, please visit Little Rock, AR Washington, DC  Data centers are CDP neha.org/job_center.html Wells Past or current food safety inspecting is required. owned and operated in Interested applicants can send their resume to: Bill Flynn the U.S. Complaints at Fax: 818-865-0465. E-mail: [email protected]. Service  Fully‐staffed software Requests development and maintenance line of business providing architecture,  Portfolio includes 30 years of Did You Know? design, development and requirements, system implementation of large Interoperable design, coding, testing, If you can’t make it to scale workflow management, Systems and implementation Las Vegas for the NEHA data collection, transaction and support services. Hosting ‐ 2014 AEC, you can access processing and business intelligence solutions for use Network it online instead! About 30 within the government Operations educational sessions will health management CDP‐Owned be recorded live, and you environment. Tier 3 Data can participate online by Centers  Specializing in redundant registering for the Virtual system componentry AEC. It’s the next best thing designed for high availability to being there! You can also and supported by multiple, fully independent and earn continuing educational redundant credits for participating in telecommunications links. CDPʼs success is based on a fundamental set of beliefs: since our clients serve the sessions. To register the public - we must uphold the highest level of support, value, and ethics. for your access to the  Only Environmental Health Evidence of this success can be found in our longevity of service, our reputation, Software vendor with Virtual AEC, visit and our references - none more valuable than our longstanding clients. experience/breadth of full www.neha2014aec.org. suite of Public Health programs: . Clinic . WIC cdpehs.com ? . WIC EBT [email protected] . Public Financials 46 Volume 76 • Number 10 800.888.6035

JEH6.14_PRINT.indd 46 5/1/14 4:08 PM

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JEH6.14_PRINT.indd 47 5/1/14 4:08 PM ADVANCEMENT OF THE PRACTITIONER EH CALENDAR

UPCOMING NEHA CONFERENCE Iowa October 14–15, 2014: Fall Conference, sponsored by the Iowa July 7–10, 2014: NEHA’s 78th Annual Educational Conference Environmental Health Association, Best Western, Marshalltown, & Exhibition in Partnership with the International Federation IA. For more information, visit www.ieha.net. of Environmental Health, The Cosmopolitan of Las Vegas, N V. For more information, visit www.neha2014aec.org. New Hampshire September 3–4, 2014: 52nd Annual Yankee Conference on Environmental Health—Moving Forward by Building NEHA AFFILIATE AND REGIONAL LISTINGS Partnerships, Radisson Manchester, NH. For more information, visit www.nhhealthofﬁ cers.org. Alaska North Dakota September 30–October 3, 2014: Annual Educational Conference, sponsored by the Alaska Environmental Health October 21–23, 2014: Fall Education Conference, sponsored by Association, BP Energy Center, Anchorage, AK. For more the North Dakota Environmental Health Association, Bismarck, information, visit https://sites.google.com/site/aehatest/. ND. For more information, visit http://ndeha.org/wp/conferences. Colorado Texas September 24–26, 2014: Annual Education Conference & October 7–10, 2014: 59th Annual Education Conference, Exhibition, sponsored by the Colorado Environmental Health sponsored by the Texas Environmental Health Association, Association, Steamboat Grand, Steamboat Springs, CO. For more Double Tree Hotel, Austin, TX. For more information, visit information, visit www.cehaweb.com/aec.html. www.myteha.org. Florida Wyoming July 28–30, 2014: Annual Educational Meeting, sponsored by September 9–11, 2014: Annual Education Conference, sponsored the Florida Environmental Health Association, Florida Mall Hotel by the Wyoming Environmental Health Association and the Wyo- and Conference Center, Orlando, FL. For more information, visit ming Food Safety Coalition, The Peaks Conference Center, Lander, www.feha.org. WY. For more information, visit www.wehaonline.net. Georgia July 16–18, 2014: 68th Annual Environmental Health Seminar, hosted by the Georgia Environmental Health Association, Hyatt Regency, Savannah, GA. For more information, visit www.geha-online.org/Pages/Conference/htm.

New REHS/RS Exam Offered in July NEHA recently updated the exam for the Registered Environmental Health Specialist/Registered Sanitarian (REHS/RS) in order to ensure that the credential exam tests on the most up-to-date and relevant information. Candidates who are preparing for or are eligible to take the REHS/RS exam must apply by May 30, 2014, to take the exam at the NEHA 2014 AEC in Las Vegas. Visit NEHA’s Web site to nd details on: • Updated Candidate Information Brochure • New Content Outline • Revised Reference/Study Materials

48 Volume 76 • Number 10

JEH6.14_PRINT.indd 48 5/1/14 4:08 PM for AmericanThank Academy YouB. Robert Supportingof Sanitarians Rothenhoefer,the NEHA/ RS, Lawrenceville, GA REHS, CP-FS Falls Church, VA AASAmerican Scholarship Public Fund University Walter P. Saraniecki, Manassas, VA MS, LDN, LEHP, REHS/RS Bruce Clabaugh, RS La Grange, IL Greenwood Village, CO James M. Speckhart, Dion L. Lerman MS Philadelphia, PA Norfolk, VA COL Wendell A. Moore Ned Therien Davidsonville, MD Olympia, WA George A. Morris, RS Clayton Tolson Dousman, WI Baltimore, MD Richard L. Roberts, Dale H. Truesdell MPH Yakima, WA Grover Beach, CA Lisa A. Windross Welford C. Roberts, Port Saint Lucie, FL PhD, RS, REHS, DAAS South Riding, VA

4good reasons to promptly renew your National Environmental Health Association (NEHA) membership!

1. You won’t miss a single issue of this Journal! 2. Your membership beneﬁ ts continue. 3. You conserve NEHA’s resources by eliminating costly renewal notices. Did You Know? 4. You support advocacy on New Membership Options! Beginning October 1, 2014, NEHA will behalf of environmental health. offer exciting, new membership choices that allow you to pick the best option to meet your needs. Since 1937 NEHA has strived to help environmental health professionals excel and advance Renew today! their careers. Stay tuned for details or visit Call 303.756.9090, ext. 300, www.neha.org/membership for more information. or e-mail [email protected].

?June 2014 • Journal of Environmental Health 49

JEH6.14_PRINT.indd 49 5/1/14 4:08 PM ADVANCEMENT OF THE PRACTITIONER RESOURCE CORNER

Resource Corner highlights different resources that NEHA has available to meet your education and training needs. These timely resources provide you with information and knowledge to advance your professional development. Visit NEHA’s online Bookstore for additional information about these, and many other, pertinent resources!

Handbook on Household Hazardous Waste Food Safety: Theory and Practice Edited by Amy D. Cabaniss (2008) Paul L. Knechtges (2012) According to the U.S. Environmental Authored by a NEHA member! Written Protection Agency, Americans generate from a “farm-to-fork” perspective, this 1.6 million tons of household hazardous book provides a comprehensive over- waste (HHW) every year. This book pro- view of food safety and discusses the vides solid waste management profes- biological, chemical, and physical agents sionals, municipal ofﬁcials, chemical of foodborne diseases. Topics covered waste handlers, environmental students, include risk and hazard analysis of and others with a comprehensive look at goods; the prevention of foodborne ill- the state of HHW management. Readers nesses and diseases; safety management will learn answers to questions such as of the food supply; food safety laws, reg- what is hazardous household waste and ulations, enforcement, and responsibili- why do we collect it; what are the main concerns; how are HHW ties; and the pivotal role of food sanitation/safety inspectors. collections held and the material managed; what are some best Early chapters introduce readers to the history and fundamental management practices; how can I motivate behavior change; and principles of food safety. Later chapters provide an overview of how can a product-stewardship approach increase collections, the risk and hazard analysis of different foods and the important cover costs, and promote better products? advances in technology that have become indispensable in con- 269 pages / Paperback / Catalog #1113 trolling hazards in the modern food industry. Member: $64 / Nonmember: $69 460 pages / Paperback / Catalog #1120 Member: $78 / Nonmember: $83 Social Marketing and Public Health: Theory and Practice Food Alert! The Ultimate Sourcebook Jeff French, Clive Blair-Stevens, Dominic McVey, for Food Safety (Second Edition) and Rowena Merritt (2010) Morton Satin (2008) Social marketing is the application of It is estimated that more than 100 mil- tools and principles for the design, imple- lion food-related illnesses occur in the mentation, and evaluation of health and U.S. every year, several thousand of social behavior change programs. Social which prove fatal. This book explains marketing is increasingly recognized as a the history and science of food contami- valuable tool within public health, where nation; the causes, dangers, and types of it can improve health. This book sets out foodborne diseases; and everything you new thinking on social marketing within need to know to understand the risk of a strategic as well as operational context. foodborne illness and how to protect It adopts a whole-system ecological yourself and others from it. It also cov- approach drawing on the latest interna- ers primary food contaminants; how to tional learning and thinking. It covers both theory and practical recognize a foodborne illness; and step-by-step planning, enhanced by case examples that illustrate proper food preparation, handling, and storage. the beneﬁts and challenges involved in applying social marketing. 350 pages / Paperback / Catalog #842 It will appeal to a broad policy, academic, and practitioner reader- Member: $17 / Nonmember: $20 ship, from public sector and business backgrounds, including those working in policy, public and environmental health, health promotion, public sector management, nursing, medicine, allied health, communications, and marketing. 349 pages / Paperback / Catalog #1118 Member: $67 / Nonmember: $72

50 Volume 76 • Number 10

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JEH6.14_PRINT.indd 51 5/1/14 4:08 PM YOUR ASSOCIATION

he NEHA Endowment Foundation was established to enable NEHA to do more for the environ- T mental health profession than its annual budget might allow. Special projects and programs supported SUPPORT by the foundation will be carried out for the sole purpose of advancing the profession and its practitioners.

THE NEHA Individuals who have contributed to the foundation are listed below by club category. These listings are based on what people have actually donated to the foundation—not what they have pledged. Names ENDOWMENT will be published under the appropriate category for one year; additional contributions will move indi- FOUNDATION viduals to a different category in the following year(s). For each of the categories, there are a number of ways NEHA recognizes and thanks contributors to the foundation. If you are interested in contributing to the Endowment Foundation, please ﬁll out the pledge card or call NEHA at 303.756.9090. Thank you.

DELEGATE CLUB ($25–$99) 21st CENTURY CLUB ($500–$999) George A. Morris, RS Dousman, WI Name in the Journal for one year and Name in AEC program book, name submitted in drawing for a free one-year NEHA endowment pin. Welford C. Roberts, PhD, RS, REHS, DAAS membership, name in the Journal for one year, South Riding, VA Freda W. Bredy and endowment pin. Alexandria, VA Walter P. Saraniecki, MS, LDN, LEHP, REHS/RS Scott M. Golden, RS, MSEH La Grange, IL George F. Pinto Grove City, OH Elgin, IL Bette J. Packer AFFILIATES CLUB Ham Lake, MN ($2,500–$4,999) HONORARY MEMBERS CLUB Name in AEC program book, name submitted in ($100–$499) Peter M. Schmitt Shakopee, MN drawing for a free AEC registration, name in the Letter from the NEHA president, name in the Journal for one year, and endowment pin. Journal for one year, and endowment pin. Dr. Bailus Walker, Jr. Arlington, VA Michele R. DiMaggio EXECUTIVE CLUB AND ABOVE Martinez, CA SUSTAINING MEMBERS CLUB ($5,000–$100,000) H. Harold Lehman ($1,000–$2,499) Name in AEC program book, special invitation to Potomac Falls, VA Name in AEC program book, name submitted the AEC President’s Reception, name in the Journal for in drawing for a free two-year NEHA member- one year, and endowment pin. B. Robert Rothenhoefer, RS, REHS, CP-FS ship, name in the Journal for one year, and Falls Church, VA endowment pin. James M. Speckhart, MS James J. Balsamo, Jr., MS, MPH, MHA, RS, CP-FS Norfolk, VA Metairie, LA

NEHA ENDOWMENT FOUNDATION PLEDGE CARD

I pledge to be a NEHA Endowment Foundation Contributor in the following category: H Delegate Club ($25) H Afﬁliates Club ($2,500) H Visionary Society ($50,000) H Honorary Members Club ($100) H Executive Club ($5,000) H Futurists Society ($100,000) H 21st Century Club ($500) H President’s Club ($10,000) H You have my permission to disclose the fact and H Sustaining Members Club ($1,000) H Endowment Trustee Society ($25,000) amount (by category) of my contribution and pledge.

I plan to make annual contributions to attain the club level of over the next years.

Signature Print Name

Organization Phone

Street Address City State Zip

H Enclosed is my check in the amount of $ payable to NEHA Endowment Foundation.

H Please bill my: MasterCard/Visa Card # Exp. Date

Signature MAIL TO: NEHA, 720 S. Colorado Blvd., Suite 1000-N, Denver, CO 80246, or FAX to: 303.691.9490 . 1406JEHEND

52 Volume 76 • Number 10

JEH6.14_PRINT.indd 52 5/1/14 4:08 PM YOUR ASSOCIATION YOUR ASSOCIATION SPECIAL NEHA MEMBERS

Sustaining Members EcoSure National Environmental Health Sonoma County Permit and Resource [email protected] Science and Protection Accreditation Management Department, Wells and American Academy Elite Food Safety Training Council Septic Section of Sanitarians (AAS) www.elitefoodsafety.com www.ehacoffice.org www.sonoma-county.org/prmd Gary P. Noonan National Registry of Food Safety St. Johns Housing Partnership www.sanitarians.org English Sewage Disposal, Inc. (756) 358-4771 Professionals www.sjhp.org American Chemistry Council Lawrence Lynch Stater Brothers Market www.americanchemistry.com Erie County Department of Health www.nrfsp.com www.erie.gov/health www.staterbros.com Arlington County Public Health National Restaurant Association StateFoodSafety.com Food Marketing Institute Division www.restaurant.org www.StateFoodSafety.com www.arlingtonva.us www.fmi.org National Swimming Pool Foundation Sweeps Software, Inc. Gass Weber Mullins LLC Ashland-Boyd County Health Michelle Kavanaugh Kevin Thrasher www.gasswebermullins.com [email protected] www.nspf.org www.sweepssoftware.com Gila River Indian Community, Association of Environmental Health New Jersey State Health Department, Texas Roadhouse Environmental Health Services Academic Programs Consumer and Environmental Health www.texasroadhouse.com www.aehap.org www.gilariver.org Services The Steritech Group, Inc. GLO GERM/Food Safety First Joe Eldridge CDP, Inc. www.steritech.com Joe D. Kingsley www.njeha.org www.cdpehs.com Tri-County Health Department www.glogerm.com New York City Department of Health Chemstar Corporation www.tchd.org www.chemstarcorp.com HealthSpace USA Inc. & Mental Hygiene Joseph Willmott www.nyc.gov/health Underwriters Laboratories, Inc. City of Bloomington Gus Schaeffer www.healthspace.com North Bay Parry Sound District www.ci.bloomington.mn.us www.ul.com Industrial Test Systems, Inc. Health Unit City of Fall River Health Waco-McLennan County Public www.sensafe.com www.healthunit.biz & Human Services Health District Nova Scotia Department of Agriculture (508) 324-2410 Inspect2Go [email protected] www.inspect2go.com www.gov.ns.ca City of Houston West Virginia Office of Economic NSF International Environmental Health InspekPro LLC Opportunity Stan Hazan www.houstontx.gov/health/Environmental www.inspekpro.com www.oeo.wv.gov www.nsf.org City of Milwaukee Health Department, Jefferson County Health Department Winn-Dixie Stores, Inc. Omaha Healthy Kids Alliance Consumer Environmental Health (Missouri) www.winn-dixie.com Joe Hainline www.omahahealthykids.org http://city.milwaukee.gov/Health YUM! Brands, Inc. www.jeffcohealth.org Oneida Indian Tribe of Wisconsin Coconino County Public Health [email protected] www.oneidanation.org www.coconino.az.gov Jefferson County Public Health www.yum.com (Colorado) Orkin Colorado Department of Public [email protected] Zia Siddiqi Health and Environment, Division http://jeffco.us/health www.orkincommercial.com Educational Institution of Environmental Health, Delegated Programs Unit Kansas Department of Health Ozark River Hygienic Hand-Wash Members & Environmental Station Therese Pilonetti American Public University [email protected] www.ozarkriver.com [email protected] Tatiana Sehring Columbia County Health Department LaMotte Company PerkinElmer, Inc. www.StudyatAPU.com/NEHA www.lamotte.com www.perkinelmer.com www.columbiacountyny.com/depts/health2 Colorado State University, Department Pinnacle Health Childhood Lead Decade Software Company LLC Linn County Public Health of Environmental/Radiological Health Poisoning Prevention Program Darryl Booth [email protected] www.colostate.edu www.pinnaclehealth.org/Conditions--- www.decadesoftware.com Maricopa County Environmental Treatments/Services/Children-s-Health/ East Tennessee State University, DEH Services DEH Child Care Services/Childhood-Lead-Poisoning- Phillip Scheuerman [email protected] www.denvergov.org/DEH Prevention-Program.aspx www.etsu.edu Mars Air Doors DeltaTrak, Inc. Prometric Eastern Kentucky University www.marsair.com Vallierie Cureton www.prometric.com [email protected] www.deltatrak.com Merced County Public Health, http://eh.eku.edu Racine City Department of Health Division of Environmental Health Department on Disability Services, www.cityofracine.org/Health.aspx Georgia State University District of Columbia [email protected] Christine Stauber San Jamar http://dds.dc.gov Mesothelioma Lawyer Center [email protected] www.sanjamar.com Digital Health Department, Inc. www.mesotheliomalawyercenter.org University of Illinois Springfield Seattle & King County Sharron LaFollette www.dhdinspections.com Mid-Iowa Community Action Public Health www.uis.edu/publichealth Diversey, Inc. www.micaonline.org Michelle Pederson Steve Hails Mid-Ohio Valley Health Department [email protected] University of Wisconsin–Oshkosh www.uwosh.edu/llce www.diversey.com [email protected] Shat-R-Shield Inc. DuPage County Health Department www.movhd.com Anita Yost University of Wisconsin–Stout, www.dupagehealth.org Mitchell Humphrey www.shat-r-shield.com College of Science, Technology, Engineering, and Mathematics Ecolab www.mitchellhumphrey.com Sneezeguard Solutions Inc. www.uwstout.edu [email protected] Mycometer Bill Pfeifer www.ecolab.com www.mycometer.com www.sneezeguard-solutions.com

June 2014 • Journal of Environmental Health 53

JEH6.14_PRINT.indd 53 5/1/14 4:08 PM updated from ﬁnal 5.14; + edited 4.8

YOUR ASSOCIATION SPECIAL LISTING

Affiliate Presidents Massachusetts—Heidi Porter, Bedford The board of directors includes Board of Health, Bedford, MA. NEHA’s nationally elected offi- Alabama—Cindy Goocher, [email protected] Montgomery, AL. cers and regional vice presidents. [email protected] Michigan—Carolyn Kreiger, REHS, Affiliate presidents (or appointed Environmental Quality Analyst, Michigan Alaska—Ryan Autenrieth, REHS, Dept. of Environmental Quality, representatives) comprise the Affili- Environmental Health Officer, Yukon- Kalamazoo, MI. ate Presidents Council. Technical Kuskokwim Health Corporation, Bethel, AK. [email protected] [email protected] advisors, the executive director, and Minnesota—Kimberley Carlton, Planner Arizona—Shikha Gupta, Environmental all past presidents of the association Edward L. Briggs, Dick Pantages Principal, Minnesota Dept. of Health, MPH, MS, REHS NEHA Historian Operations Program Supervisor, Maricopa St. Paul, MN. are ex-officio council members. This Region 9 Vice President County, Phoenix, AZ. [email protected] [email protected] list is current as of press time. Mississippi—Queen Swayze, Food Arkansas—Jeff Jackson, Camden, AR. Program Specialist, Mississippi State [email protected] Dept. of Health, Jackson, MS. Region 4—Keith Johnson, RS, Administrator, National Officers California—Sarah Crossman, REHS, [email protected] Custer Health, 210 2nd Avenue N W, Environmental Health Specialist I V, Missouri—Paul Taylor, Environmental President—Alicia Enriquez Collins, REHS Mandan, ND 58554. Riverside County Dept. of Environmental Representative, St. Louis County Health, [email protected] Phone: (701) 667-3370 Health, Riverside, CA. St. Louis, MO. [email protected] [email protected] President Elect—Carolyn Hester Harvey, [email protected] Iowa, Minnesota, Nebraska, North Dakota, Colorado—Mindi Ramig, Environmental PhD, CIH, RS, DAAS, CHMM, Professor, Montana—Laurel Riek, RS, Program South Dakota, and Wisconsin. Health Supervisor, Jefferson County Public Director of MPH Program, Department of Manager, Lewis & Clark City/County Term expires 2016. Health, Golden, CO. Environmental Health, Eastern Kentucky Health Dept., Helena, MT. [email protected] University, Dizney 220, 521 Lancaster Region 5—Sandra Long, REHS, RS, [email protected] Connecticut—Marco Palmeri, RS, Chief Avenue, Richmond, KY 40475. Inspection Services Supervisor, City of Plano National Capitol Area—Shannon Sanitarian, Plainville-Southington Regional Phone: (859) 622-6342 Health Department, 1520 K Avenue, Suite McKeon, Environmental Health Specialist, Health District, Plainville, CT. [email protected] 210, Plano, TX 75074. Phone: (972) 941-7143 Fairfax, VA. [email protected] ext. 5282; Cell: (214) 500-8884 [email protected] First Vice President—Bob Custard, [email protected] Florida—Robert Maglievaz, Nebraska—Kathy King, Environmental REHS, CP-FS, Environmental Health Arkansas, Kansas, Louisiana, Missouri, Environmental Specialist III, Florida Dept. Manager, Alexandria Health Department, Health Specialist II, Lincoln-Lancaster New Mexico, Oklahoma, and Texas. of Health, DeLand, FL. 4480 King Street, Alexandria, VA 22302. Health Dept., Lincoln, NE. Term expires 2014. robert_maglievaz@flhealth.gov Phone: (703) 746-4970 [email protected] Georgia—Kathleen Worthington, [email protected] Region 6—Adam London, RS, MPA, Nevada—Tamara Giannini, Compliance Specialist, Georgia Dept. Environmental Health Director, Kent Environmental Health Supervisor, Southern Second Vice President—David E. Riggs, of Agriculture–Food Safety Division, County Health Department, 700 Fuller NE, Nevada Health District, Las Vegas, N V. REHS/RS, MS, 2535 Hickory Avenue, Claxton, GA. Grand Rapids, MI 49503. [email protected] Longview, WA 98632. Phone: (360) 430-0241 [email protected] Phone: (616) 632-7266 New Jersey—Marconi Gapas, Health [email protected] Hawaii—John Nakashima, Sanitarian I V, [email protected] Officer, Township of Union and Borough of Food Safety Education Program, Hawaii Illinois, Indiana, Kentucky, Michigan, Kenilworth Dept. of Health, Union, NJ. Immediate Past President—Brian Collins, Dept. of Health, Hilo, HI. and Ohio. Term expires 2016. [email protected] MS, REHS, DAAS, Director of [email protected] Environmental Health (ret) New Mexico—Michael Broussard, CP-FS, Region 7—John A. Steward, REHS, MPH, Idaho—Patrick Guzzle, MA, MPH, REHS, Program Specialist, NMED, Santa Fe, NM. CAPT, USPHS (ret), Institute of Public Food Protection Program Manager, Idaho NEHA Executive Director—Nelson E. [email protected] Fabian (non-voting ex-officio member of Health, Georgia State University, P.O. Box Dept. of Health and Welfare, Boise, ID. the board of directors), 720 S. Colorado 3995, Atlanta, GA 30302-3995. [email protected] New York—Contact Region 9 Vice President Edward L. Briggs. Blvd., Suite 1000-N, Denver, CO 80246. Phone: (404) 413-1137 Illinois—Adam Dotson, MPA, LEHP, eb.health@ridgefieldct.org Phone: (303) 756-9090, ext 301 [email protected] Community Development Director, [email protected] Alabama, Florida, Georgia, Mississippi, City of Oak Forest, Oak Forest, IL. North Carolina—Jesse Dail, North Carolina, South Carolina, and [email protected] Environmental Health Specialist, Morehead City, NC. Tennessee. Term expires 2014. Indiana—Michael Mettler, Indiana State Regional Vice Presidents [email protected] Region 8—LCDR James Speckhart, MS, Dept. of Health, Indianapolis, IN. Region 1—Vacant North Dakota—Jane Kangas, USPHS, Occupational Safety and Health [email protected] Environmental Scientist II, North Dakota Region 2—Marcy A. Barnett, MA, Specialist, USDA/FSIS/EHSB, Mellon Iowa—Sandy Heinen, Environmental Health Officer, Black Hawk County Health Dept. of Health, Fargo, ND. MS, REHS, Emergency Preparedness Independence Center, 701 Market Street, [email protected] Liaison, California Department of Public Suite 4100C, Philadelphia, PA 19106. Dept., Waterloo, IA. Northern New England Environmental Health, Center for Environmental Health, Phone: (215) 430-6221 [email protected] Health Association—Co-president Brian Sacramento, CA. Phone: (916) 449-5686 [email protected] Jamaica—Paul Ximines Lockard, Health Officer, Town of Salem [email protected] Delaware, Maryland, Pennsylvania, Virginia, [email protected] Health Dept., Salem, NH. Arizona, California, Hawaii, and Nevada. Washington, DC, West Virginia, and Kansas—Bronson Farmer, RS, HHS, [email protected] Term expires 2015. members of the U.S. armed forces residing Salina-Saline County Health Dept., Salina, KS. Co-president Thomas Sloan, RS, outside of the U.S. Term expires 2015. [email protected] Region 3—Roy Kroeger, REHS, Agricultural Specialist, New Hampshire Dept. of Agriculture, Concord, NH. Environmental Health Supervisor, Cheyenne/ Region 9—Edward L. Briggs, MPH, MS, Kentucky—Stacy Roof, Kentucky Restaurant Association, Louisville, KY. [email protected] Laramie County Health Department, REHS, Director of Health, Town of [email protected] 100 Central Avenue, Cheyenne, WY 82008. Ridgefield Department of Health, 66 Prospect Ohio—Eric J. Zgodzinski, MPH, RS, Phone: (307) 633-4090 Street, Ridgefield, CT 06877. Louisiana—John Koury, MS, COO, CPH, Director of Community and [email protected] Phone: (203) 431-2745 KourCo Enivironmental Services, Inc., Environmental Health, Toledo-Lucas Colorado, Montana, Utah, Wyoming, and eb.health@ridgefieldct.org Lafayette, LA. County Health Dept., Toledo, OH. members residing outside of the U.S. Connecticut, Maine, Massachusetts, New [email protected] [email protected] (except members of the U.S. armed forces). Hampshire, New Jersey, New York, Rhode Maryland—James Lewis, Westminster, MD. Oklahoma—Matthew Brosh, RPES, Term expires 2015. Island, and Vermont. Term expires 2016. [email protected] Public Health Specialist, Oklahoma City-

54 Volume 76 • Number 10

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County Health Dept., Oklahoma City, OK. Aquatic Venues/Recreational Health— Injury Prevention—CAPT Alan J. Laura Brister, Customer & Member [email protected] Colleen Maitoza, REHS, Supervising Dellapenna, Jr., RS, MPH, DAAS, Services Specialist, AEC Registration Oregon—Delbert Bell, Klamath Falls, OR. Environmental Specialist, Environmental Historian, Indian Health Service, Coordinator, ext. 309, [email protected] [email protected] Management Dept., County of Sacramento, Rockville, MD. Patricia Churpakovich, Credentialing Mather, CA. [email protected] Past Presidents—Mel Knight, REHS, Coordinator, ext. 317, [email protected] Folsom, CA. Institutions/Schools—TBD [email protected] [email protected] Children’s Environmental Health—M.L. International—Sylvanus Thompson, Ginny Coyle, Grants/Projects Specialist, Tanner, HHS, Environmental Health Pennsylvania—Joseph “Jay” S. Tarara, PhD, CPHI(C), Associate Director, Research and Development (R&D), Manager III, Bureau of Environmental Greensburg, PA. Toronto Public Health, Toronto, ext. 346, [email protected] Health Services, Division of Food [email protected] ON, Canada. Jill Cruickshank, Chief Operating Officer Protection and Rabies Prevention, [email protected] (COO), ext. 342, Rhode Island—Dottie LeBeau, CP-FS, South Carolina Dept. of Health and Land Use Planning/Design—Felix I. [email protected] Food Safety Consultant and Educator, Environmental Control, Columbia, SC. Zemel, MCP, MPH, RS, DAAS, Health Dottie LeBeau Group, Hope, RI. Vanessa DeArman, Project Coordinator, [email protected] Agent/Administrator, Cohasset Board [email protected] R&D, ext. 311, [email protected] Drinking Water/Environmental Water of Health, Cohasset, MA. Cindy Dimmitt, Receptionist, Customer Saudi Arabia—Zubair M. Azizkhan, Quality—Sharon Smith, RS, West [email protected] & Member Services Specialist, ext. 300, Environmental Scientist, Saudi Arabian Oil Central Region Supervisor, Minnesota Legal—Doug Farquhar, JD, Program [email protected] Company, Saudi Arabia. Dept. of Health, Fergus Falls, MN. Director, National Conference of State Elizabeth Donoghue-Armstrong, Copy [email protected] [email protected] Legislatures, Denver, CO. Editor, Journal of Environmental Health, South Carolina—Trey Reed, Regional [email protected] Emergency Preparedness and [email protected] Environmental Health Director, Response—Martin A. Kalis, Public Mentorship—Sheila D. Pressley, DrPH, Nelson Fabian, Executive Director, ext. South Carolina Dept. of Health and Health Advisor, CDC/NCEH/DEEHS/ REHS/RS, Associate Professor, Eastern 301, [email protected] Environmental Control, Aiken, SC. EHSB, Atlanta, GA. Kentucky University, Richmond, KY. [email protected] [email protected] [email protected]. Eric Fife, Learning Content Producer, NEHA EZ, ext. 344, [email protected] South Dakota—John Osburn, Pierre, SD. Emergency Preparedness and Mentorship—Marie Woodin, REHS, [email protected] Response—Vince Radke, MPH, REHS, Deputy Division Chief, Sacramento Soni Fink, Strategic Sales Coordinator, Tennessee—David Garner, Nashville, TN. CP-FS, DAAS, Sanitarian, CDC/NCEH/ County Environmental Management ext. 314, [email protected] [email protected] DEEHS/EHSB, Atlanta, GA. Dept., Sacramento, CA. Michael Gallagher, IFSS Logistics and Texas—Cindy Corley, REHS, CP-FS, [email protected] [email protected] Training Coordinator, NEHA EZ, ext. 343, Environmental Health Manager, City of Emerging Pathogens—Lois Maisel, RN, Occupational Health/Safety—D. Gary [email protected] Garland Health Dept., Garland, TX. CP-FS, Environmental Health Specialist II, Brown, DrPH, CIH, RS, DAAS, Professor, TJay Gerber, Credentialing Specialist, ext. [email protected] Fairfax County Health Dept., Fairfax, VA. Eastern Kentucky University, Richmond, KY. 328, [email protected] Uniformed Services—Joseph Hout, [email protected] [email protected] Genny Homyack, Executive Associate, Environmental Science Officer, The Environmental Justice—Welford C. Radiation/Radon—TBD [email protected] Uniformed Services University of the Roberts, PhD, DAAS, RS/REHS, Subject Risk Assessment—TBD Dawn Jordan, Customer Service Manager, Health Sciences, Bethesda, MD. Matter Expert, Office of the Air Force Sustainability—Tom R. Gonzales, MPH, Office Coordinator, HR and IT Liaison, [email protected] Surgeon General, ERP International, LLC., REHS, Environmental Health Director, ext. 312, [email protected] Utah—Ronald Lund, Salt Lake County South Riding, VA. El Paso County Public Health, Colorado Erik Kosnar, Learning Content Health Dept., Murray, UT. [email protected] Springs, CO. Production Assistant, NEHA EZ, ext. 318, [email protected] Food (including Safety and Defense)— [email protected] [email protected] Virginia—Christopher Gordon, Executive Eric Bradley, MPH, REHS/RS, CP-FS, Technology (including Computers, Elizabeth Landeen, Assistant Manager, Advisor-Public Health, Virginia Dept. of Environmental Health Specialist, Scott Software, GIS, and Management R&D, (860) 351-5099, [email protected] Health, Richmond, VA. County Health Dept., Davenport, IA. Applications)—Darryl Booth, MBA, Matt Lieber, Marketing and [email protected] [email protected] President, Decade Software Company, Communications Assistant, ext. 338, Fresno, CA. Washington—Kay Massong, Tenino, WA. Food (including Safety and Defense)— [email protected] [email protected] [email protected] John A. Marcello, REHS, CP-FS, Pacific Larry Marcum, Managing Director, Regional Food Specialist, FDA, Tempe, AZ. Vector Control—Zia Siddiqi, PhD, BCE, West Virginia—Elizabeth Green, R&D and Government Affairs, ext. 307, [email protected] Director of Quality Systems, Orkin, Inc., Parkersburg, WV. [email protected] Atlanta, GA. [email protected] General Environmental Health—Ron de Marissa Mills, Project Assistant, R&D, [email protected] Burger, Retired Director, Toronto Public ext. 304, [email protected] Wisconsin—Laura Temke, REHS, Wastewater—Craig Gilbertson, RS, Health, Toronto, ON, Canada. Eileen Neison, Credential Department CP-FS, HHS, Environmentalist, City of Environmental Planner, TrackAssist- [email protected] Customer Service Representative, ext. 310, West Allis Health Dept., West Allis, WI. Online, Walker, MN. General Environmental Health—Eric [email protected] [email protected] [email protected] Pessell, REHS, Environmental Health Wyoming—Terri Leichtweis, Carol Newlin, Credentialing Specialist, Division Director, Kent County Health Workforce Development, Management, Environmental Health Specialist, ext. 337, [email protected] Dept., Grand Rapids, MI. and Leadership—CAPT Michael Jefferson County Public Health, Terry Osner, Administrative Coordinator, [email protected] E. Herring, REHS, MPH, Senior Lakewood, CO. Environmental Health Scientist/Training ext. 302, [email protected] Global Climate Change and Health— [email protected] and Technical Assistance Team Leader, Barry Porter, Financial Coordinator, ext. Steve Konkel, PhD, MCP, AICP, FRIPH, CDC, Atlanta, GA. 308, [email protected] Associate Professor, Environmental Health NEHA Historian [email protected]. Kristen Ruby, Content Editor, Journal Sciences, University of Alaska Anchorage, of Environmental Health, ext. 341, Dick Pantages, NEHA Past President, Anchorage, AK. Workforce Development, Management, [email protected] Fremont, CA. [email protected] and Leadership—George Nakamura, [email protected] MPA, REHS/RS, DAAS, President/CEO, Michael Salgado, Assistant Manager, Hazardous Materials/Toxic Nakamura Leasing, Sunnyvale, CA. NEHA EZ, ext. 315, [email protected] Substances—Priscilla Oliver, PhD, [email protected] Technical Advisors Life Scientist/Program Manager, U.S. EPA, Jill Schnipke, Education Coordinator, ext. Air Quality—Scott E. Holmes, REHS, Atlanta, GA. 313, [email protected] NEHA Staff: Joshua Schrader, Sales & Training MS, Environmental Public Health [email protected] (303) 756-9090 Manager, Lincoln-Lancaster County Healthy Homes and Healthy Support, NEHA EZ, ext. 340, Health Dept., Lincoln, NE. Communities—Sandra Whitehead, Rance Baker, Program Administrator, [email protected] [email protected] MPA, Environmental Public Health NEHA Entrepreneurial Zone (EZ), Clare Sinacori, Marketing and Aquatic Venues/Recreational Health— Planner, Division of Environmental ext. 306, [email protected] Communications Manager, ext. 319, Tracynda Davis, MPH, Environmental Health, Florida Dept. of Health, Trisha Bramwell, Customer & Member [email protected] Health Consultant, Colorado Springs, CO. Tallahassee, FL. Services Specialist, ext. 336, Christl Tate, Project Coordinator, [email protected] [email protected].fl.us [email protected] R&D, ext. 305, [email protected]

To update information, contact Terry Osner at [email protected]. June 2014 • Journal of Environmental Health 55

JEH6.14_PRINT.indd 55 5/1/14 4:08 PM YOUR ASSOCIATION NEHA NEWS

NEHA General Election 2014—Results • Region 1—Ned C. Therien (term expires 2017) Elections are a critical part of the democratic process and are one • Region 5—Sandra Long (term expires 2017) way to provide members a voice in the running of their organiza- • Region 7—Tim Hatch (term expires 2017) tion. National officers of NEHA’s board of directors serve a one- Second Vice President year term in each officer position—progressing from second vice There were four qualified candidates for the second vice president president to board president and then immediate past president— position: for a total of five years. Regional vice presidents serve a three-year • Stan Hazan term. NEHA voting members have an opportunity to vote for can- • Adam London didates of a contested board of director’s office. • Gary P. Noonan For more information about NEHA elections and the critical • John Steward deadlines for nomination forms, eligibility dates to become a NEHA In addition to the candidate profiles that appeared in the March voting member, and ballot dates, please visit the election page on the JEH issue and NEHA Web site (www.neha.org/about/election_can- NEHA Web site at www.neha.org/about/elections.html. didates.html), all candidates had the same or different profiles For the 2014 NEHA general election, the results are as follows. posted on the online ballot. Eligible voters were encouraged to Regional Vice Presidents vote during the month of March. The deadline to vote was March The terms of three regional vice presidents (RVP) expired in 2014: 31, 2014, at 11:59 p.m. (MDT). • Region 1—Vacant Voters elected Adam London as the second vice president. Lon- • Region 5—RVP Sandra Long don will become the second vice president at the closing of NEHA’s • Region 7—RVP John Steward 2014 Annual Educational Conference & Exhibition in Las Vegas. There was a single candidate for the Region 1 vacancy. There London’s ascension to this position leaves a vice president vacancy were no opposing candidates to RVP Long. RVP Steward vacated in Region 6. This position will be filled in accordance to NEHA his Region 7 vice president position to seek the second vice presi- board policy. If interested in being considered for this position, dent position and there was a single candidate for that position. please contact Terry Osner at [email protected]. Board policy does not require an election if candidates are unop- posed. The vice presidents for the three regions are as follows:

IN MEMORIAM

William Keene California at Berkeley, where he graduated in 1989 with a master’s NEHA was saddened to learn of the passing of William Keene in degree in public health and a doctorate in microbiology. He had December 2013. Keene was Oregon’s senior state epidemiologist worked as Oregon’s top food detective ever since. for the past two decades. He was a nationally known and respected NEHA wishes to express its deepest sympathies to Keene’s fam- figure in food safety and foodborne disease outbreak investigations. ily, colleagues, and friends. He was an exemplary figure in food In a profile published in The Oregonian in 2010, colleagues called safety and will be missed tremendously. Keene everything from “one of the food safety heroes in the U.S.” Source: Food Safety News, A Food Safety Hero: Oregon’s William to “zealous, energetic, dedicated, and diligent.” Keene Dead at 56, December 2, 2013. Keene, 56, graduated from Yale University in 1977 with a bachelor’s degree in anthropology. He spent two years in India Editor’s Note: The Journal will publish the In Memoriam sec- and Pakistan studying rhesus monkeys. Returning to the states, tion twice a year in the June and December issues. If you would he became interested in parasites while working as a lab techni- like to share information on the passing of a noteworthy envi- cian at the University of California at San Francisco. His inter- ronmental health professional, please contact Kristen Ruby at est in parasites led Keene back to graduate school, first at Johns [email protected]. Hopkins University in Baltimore and then at the University of

56 Volume 76 • Number 10

JEH6.14_PRINT.indd 56 5/1/14 4:08 PM We ensure the water is clean outside the building.

So you can focus on food safety inside.

PuraMax® Moving Bed Biological Reactor Recycled Plastic Biocarriers

The PuraMax moving bed biological reactor (MBBR) is an attached growth process designed to achieve a high quality effluent within a small overall footprint. It employs thousands of recycled plastic biocarriers to ensure

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June 2014 • Journal of Environmental Health 57

JEH6.14_PRINT.indd 57 5/1/14 4:08 PM Choose from the most complete library of environmental health resources available—more than 150 texts, as well as recent Journal of Environmental Health (JEH) articles and E-Journal issues. NEHA’s Bookstore allows you to search for resources by topic and gives you the opportunity to peruse resource descriptions and table of contents.

AEC & Exhibition JEH Articles and E-Journal Issues Air Quality NEHA Merchandise All-Hazards Preparedness Occupational Health Clearance Books Sustainability Credential Study References Swimming Pools/Spas Epidemiology Toxicology Food Safety and Protection Vector Control Food Safety Training Resources Water Quality General Environmental Health Workforce Development Hazardous Materials

Purchase online or call www.neha.org/store 303.756.9090

58 Volume 76 • Number 10

JEH6.14_PRINT.indd 58 5/1/14 4:08 PM JEH6.14_PRINT.indd 59 5/1/14 4:08 PM AEC SPONSORS & PARTNERS The National Environmental Health Association would like to recognize the following sponsors for their generous support of the Annual Educational Conference & Exhibition:

Don’t miss this unique experience: The NEHA 2014 AEC is being held in collaboration with the International Federation of Environmental Health! This is an unprecedented and exciting opportunity to explore innovative ideas, approaches, and methods with environmental health professionals from all over the world.

Visit neha2014aec.org for more information and a justiﬁcation/ROI letter for your employer.

CONTINUING EDUCATION (CE) CREDITS CONTINUING EDUCATION CREDITS FOR Earn up to 24 hours of CE contact hours (enough to OTHER ORGANIZATIONS meet your full two-year NEHA professional credential Professionals who attend the 2014 AEC may apply for requirement) by attending and participating in the NEHA continuing education (CE) hours from other organizations. AEC. CEs can be fulfilled by attending: NEHA has been recognized as a provider of CE hours for: • First Time Attendee Workshop • American Council for Accredited Certification (ACAC) In addition, we thank the following partners for their continued eff orts to • Training and Educational Sessions • Board of Certified Safety Professionals (BCSP) • The Keynote Session enrich the environmental health profession: • California Registered Environmental Health Specialists • Pre-Conference Workshops (CA REHS) • Credential Review Courses Association of Pool & Spa Professionals • Educational sessions via the Virtual AEC while they are Centers for Disease Control and Prevention being shown live during the AEC or as an archive after the AEC is over State Onsite Regulators Alliance and Captains of Industry

Uniformed Services Environmental Health Association

See neha2014aec.org/why-you-should-attend for additional details. U.S. Department of Agriculture Food and Nutrition Service

U.S. Environmental Protection Agency

U.S. Food and Drug Administration

ANNUAL EDUCATIONALEDUCATIONAL CONFERENCECONFERENCE && EXHIBITIONEXHIBITION || LASLAS VEGAS,VEGAS, NVNV || JULYJULY 7–10,7–10, 20142014 COMPLETE ANDAND UP-TO-DATEUP-TO-DATE INFORMATIONINFORMATION CANCAN BEBE FOUNDFOUND ONLINEONLINE ATAT NEHA2014AEC.ORG.NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 60 5/1/14 4:08 PM AEC SPONSORS & PARTNERS The National Environmental Health Association would like to recognize the following sponsors for their generous support of the Annual Educational Conference & Exhibition:

Visit neha2014aec.org for more information and a justiﬁcation/ROI letter for your employer.

Uniformed Services Environmental Health Association

See neha2014aec.org/why-you-should-attend for additional details. U.S. Department of Agriculture Food and Nutrition Service

U.S. Environmental Protection Agency

U.S. Food and Drug Administration

ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 61 5/1/14 4:08 PM PRE CONFERENCE CREDENTIALANDCERTIFICATIONCREDENTIAL AND CERTIFICATION WORKSHOPS COURSESANDEXAMSCOURSES AND EXAMS

Schedule is subject to change. Schedule is subject to change. Advance your expertise and career potential by obtaining a Registered Environmental Health Specialist/ NEHA credential or certification at the AEC. You may choose Registered Sanitarian (REHS/RS) to take just a credential/certification course, just an exam, or Friday & Saturday, July 11 and 12, 8:00am – 5:00pm both a course and an exam while at the NEHA AEC. Sunday, July 13, 8:00am – 12:00pm (Note: Only qualified applicants will be able to sit for an exam.) This two and a half day refresher course is designed to enhance your preparation for the NEW 2014 NEHA REHS/RS credential exam. Certified Professional of Food Safety (CP-FS) Participants are expected to have a solid foundation of environmental health knowledge and training equal to the eligibility requirements to Friday & Saturday, July 11 and 12, 8:00am – 5:00pm sit for the REHS/RS credential exam. This course alone is not enough This two-day refresher course is designed to enhance your to pass the REHS/RS credential exam. The class will cover exam preparation for the NEHA CP-FS credential exam. Participants are content areas as described in the job task analysis. The instructor will expected to have prior food safety knowledge and training equal to be available during and after the course for questions. Industry-Foodborne Illness Investigation Training Springboard to Prevention: The Model Aquatic the eligibility requirements to sit for the CP-FS exam. The course will Cost: $499 for members and $599 for non-members, which includes and Recall Response (I-FITT-RR) Workshop Health Code, 1st Edition cover exam content areas as described in the job task analysis. The the newly revised and updated REHS/RS Study Guide, a $179 value. instructor will be available during and after the course for questions. Monday, July 7, 8:00am – 5:00pm Monday, July 7, 1:00 – 5:00pm Exam: Sunday, July 13 1:00 – 6:00pm Do you and your staff know what to do if a foodborne Over the past six years a group of public health, academic, Cost: $325 for members and $425 for non-members, which includes Separate application and exam fee required. $265 member/$450 non- illness or food recall occurs? If not, you need to attend this and industry experts have been working with CDC to develop the CP-FS Study Package (newly revised and updated CP-FS manual, member. Deadline to apply to take the exam is May 30, 2014. workshop to get the critical training needed to respond to the first comprehensive public health guidance for swimming NEHA’s Professional Food Manager book, and the 2009 and 2013 these issues. pools and aquatic venues in the U.S. This workshop will FDA Food Codes on CD), a $145 value. The July 13 REHS/RS exam is newly revised. Visit neha.org/credential/ rehs2014 for new course outline, updated study guide, and other details. This NEHA/FDA supported workshop is designed to bridge present the first completed version of the Model Aquatic Exam: Sunday, July 13, 8:00 – 10:30am the gap between the retail food industry and local and state Health Code (MAHC). The MAHC will be a guidance Separate application and exam fee required. $245 member/$390 nonregulatory officials in an effort to create stronger working document that can help local and state authorities update member. Deadline to apply to take the exam is May 30, 2014. Certified Pool/Spa Operator® Certification Course (CPO®) or implement swimming pool and spa codes or standards relationships prior to a potential foodborne incident or recall Friday & Saturday, July 11 and 12, 8:00 am – 5:00 pm without having to “recreate the wheel.” The workshop will occurring. It will help you (includes exam) cover Certified in Comprehensive Food Safety (CCFS) • understand the steps for responding to a potential Wednesday & Thursday, July 9 and 10, 8:00am – 5:00pm This two-day course is designed to provide individuals with the basic • illness outbreak, common health concerns at aquatic venues, knowledge, techniques, and skills of pool and spa operations. The NEHA is pleased to offer the introductory course for the Certified in • key concepts influencing lifeguarding staffing plans, CPO® certification program includes pool and spa chemistry, testing, • know what to do when you get customer or Comprehensive Food Safety (CCFS) credential at the 2014 AEC. The treatment, filtration, maintenance, automatic feeding equipment, and product complaints, • secondary disinfection, and CCFS is a strong core credential for food safety professionals with government requirements. The CPO® certification program requires an • a primary concern of overseeing the producing, processing, and • learn what’s involved in food recalls and what you need a science-based operational and communication support open book written examination and certification is valid for five years. to do, and toolkit for aquatic and pool programs. manufacturing environments of the U.S. food supply. It has been designed to meet the increasing need for highly qualified food safety Cost: $300 for members and non-members, which includes the NSPF Cost is free with a full or one-day conference registration to ® • be more familiar with the different agencies that work professionals from both industry and the regulatory community Pool & Spa Operator Handbook and CPO certification fee, a $115 the NEHA 2014 AEC. together to help you get through a food-related crisis. that provide oversight in preventing food safety breaches at U.S. combined value. This workshop is designed for retail food stores and food production and manufacturing facilities and abroad. The credential service establishments (restaurants, grocery stores, casinos, course will cover exam content areas as described in the job task etc.); single unit to large chains; mid-level managers and analysis. The course will utilize different learning modalities from Recently Added Courses! above; and quality assurance/quality control professionals. critical thinking exercises to small group breakouts and videos. HACCP for Retail Food Service HACCP for Manufacturers/Processors Cost to attend is $39 per person and space is limited Cost: $325 for members and $425 for non-members, which includes Visit neha2014aec.org for details. to 30 people. NEHA’s brand new CCFS Preparation Guide. Exam: Friday, July 11, 8:00 – 10:30am Separate application and exam fee required. $245 member/$390 nonmember. Deadline to apply to take the exam is May 30, 2014.

ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 62 5/1/14 4:08 PM PRE CONFERENCE CREDENTIALANDCERTIFICATIONCREDENTIAL AND CERTIFICATION WORKSHOPS COURSESANDEXAMSCOURSES AND EXAMS

ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 63 5/1/14 4:08 PM risk. Attend this group exercise to discuss How to Deliver Effective Food Safety care providers. A community organization and debate possible approaches to and roles Programs on a Tight Budget created a new healthy child care assessment environmental health professionals play in Due to the worldwide economic downturn and program based on the Healthy Homes Rating INNOVATION & mitigating the risks of disaster. its effect on government spending, existing UK System. The program rates 29 environmental, delivery models for food hygiene inspections health, and safety hazards for their potential ENVIRONMENTAL JUSTICE are now in need of review. This session will to harm residents and enables those risks to 101 Ways to Improve Health Equity quantifiably describe the economic and be mitigated. The local fire department even INTERNATIONAL SESSIONS IFEH works to disseminate knowledge programmatic challenges agencies are facing accepts the assessment as equivalent to a fire concerning environmental health and using Wales as the example. The session inspection. Attend this session to learn how a promote cooperation between countries will examine the traditional food hygiene program like this can benefit your community. Building a World of Innovative Ideas for Environmental Health where environmental health issues are inspection program model and then evaluate transboundary. IFEH recently adopted Policy contemporary adaptive approaches that are LAND USE PLANNING: SCIENCE TO POLICY 10, based on the WHO report “Closing the more innovative, imaginative, and targeted. Outside-the-Box Advocacy: Organizing Public Gap in a Generation,” which aims to improve These techniques may help your agency Health’s Engagement in Built Environment Incorporating Emergency Preparedness into This year’s combined NEHA and IFEH health equity through action on the social provide a quality service while protecting public Advocacy Retail Food Facility Inspections event will offer sessions that help determinants of health. The session will health. The buzz phrase “Health in All Policies” What can you do to make food facilities environmental health professionals showcase how colleagues around the world has almost become ubiquitous, especially strong and capable of moving forward after adapt to and excel in the ever-changing are making a difference! What problem are Catch Me If You Can–Misbranding, in public health’s efforts to come to the a disaster? This session will describe how to economic, professional, and global they addressing? What actions have been Adulterating, and Counterfeiting Foods: land use planning and infrastructure design efficiently address emergency preparedness landscape by learning the best tips, taken? What outcomes are being delivered? A National/International Food Incident discussion. Tulsa Health Department will with operators during routine food facility Workshop tricks, and tweaks needed to thrive in And, how can YOU make a difference where share their project’s success using community inspections and will provide resources for Recent food fraud incidents involving YOU are? engagement and collaborative relationships. their positions. your reference. This approach provides an melamine, horse meat, and rat meat They’ll provide you with some innovative opportunity for the regulator and operator to FOOD PROTECTION AND DEFENSE necessitate that local, national, and techniques to use when resources are limited CHILDREN’S EH partner not only to increase chances of the international government and industry Foods Without Frontiers to educate and advocate for health with facility’s success after a disaster, but to reduce stakeholders have knowledge of response Keeping Children Safe and Healthy Through “Farm to Fork” is a great slogan, but how do decision makers, the public, and your own time spent on post-disaster assessment, and when an incident occurs in their jurisdictions. Comprehensive Child Care Center Regulations we really ensure food safety when the farm agency. protect the public’s health at the same time. Are your children protected against is in one country, processing in another, The newest FDA Food Related Emergency Exercise Bundle (FREE-B) exercise explores Annoyance and Perception of Noise in Rural secondhand smoke, scalding hot water, and Protecting the Living Environment of and consumers in a third, fourth, or more such a food fraud scenario. When faced with and Urban Areas of France shigellosis outbreaks in the child care center Survivors in Congregate Shelters During countries? Using the recent international this situation, what are the risks? Who gets Traffic, urban, and occupational noises where they spend a great deal of time? Are Disasters: Is Public Health Ready? food safety recall of Karicare Whey Protein involved? What are the handoffs to different are now described as major environmental they assured of receiving healthy meals and Shelters play an important role in providing Concentrate for a contaminated ingredient, national or international government agencies? problems, which can greatly interfere regular outdoor exercise in a safe playground? safety and basic human needs for survival you’ll see that simply knowing about an This workshop includes live participation with health. This session will discuss the Learn in this session how one county during disaster situations and are an important adverse event in your country is no longer of international stakeholders via a web results of a survey conducted to identify the developed environmental health regulations priority for public health agencies responding enough. This session will identify gaps in platform. In addition, related multi-lingual perception of noise pollution in occupational to ensure protections against these and other to any disaster. This session will describe the international incident notification systems educational materials will provide attendees and domestic environments. Attend this environmental hazards and how you can do current knowledge and use of assessments as such that attendees will be equipped to act with immediately applicable resources for the presentation to identify possible interventions the same in your jurisdiction. well as the importance and benefits of using to fill those gaps and respond promptly and stakeholders in their own jurisdictions. and recommendations that may alleviate them as a data collection tool for decision efficiently to the next incident that arrives at EMERGENCY PREPAREDNESS & health risks from noise pollution. making and occupant protection. Attend this the shipping dock. RESPONSE HEALTHY HOMES AND COMMUNITIES session to see how to implement assessment Focusing Disney Magic on Food Safety Clever Software Tools That Advance Health in Environmental Health and Disaster procedures and tools in your jurisdiction’s NEHA and SORA are again partnering This Learning Lab will demonstrate how Homes Management: An International Effort for disaster response. the latest Disney technologies and smart Get an introduction to the Housing Health to bring together onsite regulators Training and Awareness temperature probes are being used in Disaster Management Challenges From Non- and Safety Rating System (HHSRS) and and industry leaders for decentralized Globally, environmental health professionals food service food safety and impacting Communicable Diseases: Lessons Learned English housing enforcement work. Then try and onsite wastewater treatment. have a critical role in mitigating public inspections. When you put your hands on and Questions Going Forward two useful software tools to help with using The sessions offered by the NEHA health risks before and after disasters. these technologies in this session, you’ll have Due to population aging and an increase in HHSRS. Hunt for hazards in a virtual home, and SORA partnership will focus on To build this capacity, IFEH, CDC, and a FASTPASS for food safety. Bypass the longevity, there has been a disease transition a tool which can be taken away for free. topics such as sustainability, reuse, NEHA have collaborated to develop the complexity. Go straight to the critical control to non-communicable diseases (NCDs), which Then try an online tool to justify budgets by reciprocity, and other emerging issues. course “Environmental Health and Disaster points. Take your process for a ride. And are the challenge for the 21st century. This calculating the cost savings from using the Management,” which was heavily guided when it’s all over, you get a digital “picture” is a new concept for environmental health HHSRS. Bring your laptops and tablets! by CDC’s successful Environmental Health for your records. This session will give you the ONSITE WASTEWATER and disaster management to explore, as the Training in Emergency Response course. skills and confidence you need to conduct Implementing a Community-Based Child Care focus has traditionally been on communicable Sustainability Is the Name of the Game: EPA’s Attend this session to see how this type of inspections or audits in facilities using these Program Utilizing the Healthy Homes Rating diseases in the disaster setting. Today, Decentralized Wastewater Program Efforts course promotes the profession and ensures types of technologies. System that professionals are adequately equipped to damages to public health infrastructure This session will review a case study of There are small and underserved rural prepare, respond, recover, and mitigate the such as food, water, and sanitation place the the expansion of the local healthy homes communities across the U.S. in need of adverse impacts of disasters internationally. vulnerable population with NCDs at great program to home-based and small child first-time and adequate access to water and

ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 64 5/1/14 4:08 PM risk. Attend this group exercise to discuss How to Deliver Effective Food Safety care providers. A community organization and debate possible approaches to and roles Programs on a Tight Budget created a new healthy child care assessment environmental health professionals play in Due to the worldwide economic downturn and program based on the Healthy Homes Rating INNOVATION & mitigating the risks of disaster. its effect on government spending, existing UK System. The program rates 29 environmental, delivery models for food hygiene inspections health, and safety hazards for their potential ENVIRONMENTAL JUSTICE are now in need of review. This session will to harm residents and enables those risks to 101 Ways to Improve Health Equity quantifiably describe the economic and be mitigated. The local fire department even INTERNATIONAL SESSIONS IFEH works to disseminate knowledge programmatic challenges agencies are facing accepts the assessment as equivalent to a fire concerning environmental health and using Wales as the example. The session inspection. Attend this session to learn how a promote cooperation between countries will examine the traditional food hygiene program like this can benefit your community. Building a World of Innovative Ideas for Environmental Health where environmental health issues are inspection program model and then evaluate transboundary. IFEH recently adopted Policy contemporary adaptive approaches that are LAND USE PLANNING: SCIENCE TO POLICY 10, based on the WHO report “Closing the more innovative, imaginative, and targeted. Outside-the-Box Advocacy: Organizing Public Gap in a Generation,” which aims to improve These techniques may help your agency Health’s Engagement in Built Environment Incorporating Emergency Preparedness into This year’s combined NEHA and IFEH health equity through action on the social provide a quality service while protecting public Advocacy Retail Food Facility Inspections event will offer sessions that help determinants of health. The session will health. The buzz phrase “Health in All Policies” What can you do to make food facilities environmental health professionals showcase how colleagues around the world has almost become ubiquitous, especially strong and capable of moving forward after adapt to and excel in the ever-changing are making a difference! What problem are Catch Me If You Can–Misbranding, in public health’s efforts to come to the a disaster? This session will describe how to economic, professional, and global they addressing? What actions have been Adulterating, and Counterfeiting Foods: land use planning and infrastructure design efficiently address emergency preparedness landscape by learning the best tips, taken? What outcomes are being delivered? A National/International Food Incident discussion. Tulsa Health Department will with operators during routine food facility Workshop tricks, and tweaks needed to thrive in And, how can YOU make a difference where share their project’s success using community inspections and will provide resources for Recent food fraud incidents involving YOU are? engagement and collaborative relationships. their positions. your reference. This approach provides an melamine, horse meat, and rat meat They’ll provide you with some innovative opportunity for the regulator and operator to FOOD PROTECTION AND DEFENSE necessitate that local, national, and techniques to use when resources are limited CHILDREN’S EH partner not only to increase chances of the international government and industry Foods Without Frontiers to educate and advocate for health with facility’s success after a disaster, but to reduce stakeholders have knowledge of response Keeping Children Safe and Healthy Through “Farm to Fork” is a great slogan, but how do decision makers, the public, and your own time spent on post-disaster assessment, and when an incident occurs in their jurisdictions. Comprehensive Child Care Center Regulations we really ensure food safety when the farm agency. protect the public’s health at the same time. Are your children protected against is in one country, processing in another, The newest FDA Food Related Emergency Exercise Bundle (FREE-B) exercise explores Annoyance and Perception of Noise in Rural secondhand smoke, scalding hot water, and Protecting the Living Environment of and consumers in a third, fourth, or more such a food fraud scenario. When faced with and Urban Areas of France shigellosis outbreaks in the child care center Survivors in Congregate Shelters During countries? Using the recent international this situation, what are the risks? Who gets Traffic, urban, and occupational noises where they spend a great deal of time? Are Disasters: Is Public Health Ready? food safety recall of Karicare Whey Protein involved? What are the handoffs to different are now described as major environmental they assured of receiving healthy meals and Shelters play an important role in providing Concentrate for a contaminated ingredient, national or international government agencies? problems, which can greatly interfere regular outdoor exercise in a safe playground? safety and basic human needs for survival you’ll see that simply knowing about an This workshop includes live participation with health. This session will discuss the Learn in this session how one county during disaster situations and are an important adverse event in your country is no longer of international stakeholders via a web results of a survey conducted to identify the developed environmental health regulations priority for public health agencies responding enough. This session will identify gaps in platform. In addition, related multi-lingual perception of noise pollution in occupational to ensure protections against these and other to any disaster. This session will describe the international incident notification systems educational materials will provide attendees and domestic environments. Attend this environmental hazards and how you can do current knowledge and use of assessments as such that attendees will be equipped to act with immediately applicable resources for the presentation to identify possible interventions the same in your jurisdiction. well as the importance and benefits of using to fill those gaps and respond promptly and stakeholders in their own jurisdictions. and recommendations that may alleviate them as a data collection tool for decision efficiently to the next incident that arrives at EMERGENCY PREPAREDNESS & health risks from noise pollution. making and occupant protection. Attend this the shipping dock. RESPONSE HEALTHY HOMES AND COMMUNITIES session to see how to implement assessment Focusing Disney Magic on Food Safety Clever Software Tools That Advance Health in Environmental Health and Disaster procedures and tools in your jurisdiction’s NEHA and SORA are again partnering This Learning Lab will demonstrate how Homes Management: An International Effort for disaster response. the latest Disney technologies and smart Get an introduction to the Housing Health to bring together onsite regulators Training and Awareness temperature probes are being used in Disaster Management Challenges From Non- and Safety Rating System (HHSRS) and and industry leaders for decentralized Globally, environmental health professionals food service food safety and impacting Communicable Diseases: Lessons Learned English housing enforcement work. Then try and onsite wastewater treatment. have a critical role in mitigating public inspections. When you put your hands on and Questions Going Forward two useful software tools to help with using The sessions offered by the NEHA health risks before and after disasters. these technologies in this session, you’ll have Due to population aging and an increase in HHSRS. Hunt for hazards in a virtual home, and SORA partnership will focus on To build this capacity, IFEH, CDC, and a FASTPASS for food safety. Bypass the longevity, there has been a disease transition a tool which can be taken away for free. topics such as sustainability, reuse, NEHA have collaborated to develop the complexity. Go straight to the critical control to non-communicable diseases (NCDs), which Then try an online tool to justify budgets by reciprocity, and other emerging issues. course “Environmental Health and Disaster points. Take your process for a ride. And are the challenge for the 21st century. This calculating the cost savings from using the Management,” which was heavily guided when it’s all over, you get a digital “picture” is a new concept for environmental health HHSRS. Bring your laptops and tablets! by CDC’s successful Environmental Health for your records. This session will give you the ONSITE WASTEWATER and disaster management to explore, as the Training in Emergency Response course. skills and confidence you need to conduct Implementing a Community-Based Child Care focus has traditionally been on communicable Sustainability Is the Name of the Game: EPA’s Attend this session to see how this type of inspections or audits in facilities using these Program Utilizing the Healthy Homes Rating diseases in the disaster setting. Today, Decentralized Wastewater Program Efforts course promotes the profession and ensures types of technologies. System that professionals are adequately equipped to damages to public health infrastructure This session will review a case study of There are small and underserved rural prepare, respond, recover, and mitigate the such as food, water, and sanitation place the the expansion of the local healthy homes communities across the U.S. in need of adverse impacts of disasters internationally. vulnerable population with NCDs at great program to home-based and small child first-time and adequate access to water and

ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 65 5/1/14 4:08 PM Sessions and schedule are subject to change.

wastewater infrastructure. Through joint demonstrate significant improvements in Integrated Approach to Malaria Prevention in efforts with many government agencies, continuous cleanliness of restroom door Uganda: Experiences From a Pilot Project MORE SESSIONS BY TRACK EPA has developed programs and tools handles. Attend this session and join in the This pilot project promoted an integrated such as workshops in a box to assist these discussion of the possible benefits of applying approach to the prevention of malaria at the Acquire comprehensive information from subject matter experts and communities in creating sustainable solutions this simple, inexpensive technique beyond household level in two rural communities that will meet their current and future needs. clinical and office environments. where malaria is the leading cause of industry leaders, and learn from your peers as you share. Attend this session to gain knowledge and morbidity and mortality. This project resources to implement programs in your RECREATIONAL WATER conducted a baseline survey on malaria community even on a shrinking budget. Rethinking Recreational Water Monitoring: prevention knowledge and practices, trained CHILDREN’S EH • Bet on a Sure Thing: THINK RISK Environment Advocacy community health workers, increased Currumbin–A Community Designed Around Can Predictive Modeling Increase Public • Lessons Learned About Environmental • FDA’s Oral Culture Learner Project: • Levels of Heavy Metals in Traffic-Related Health Outcomes? awareness of the population of an integrated Environmental Sustainability and Wastewater Health in the World of Child Care Helping Food Employees Understand the Particulate Matter Along a Major Motorway Canadian recreational water safety practices approach to malaria prevention, and Reuse in Queensland, Australia Importance of Food Safety in Nigeria are put into an international context by established study demonstration sites. The • Beating the Odds: Eliminating Lead (NEHA/SORA session) Exposure for Kids in the Nation’s Capital On the Gold Coast of Queensland, Australia, comparing them with the EPA and WHO integrated approach to malaria prevention • The Great Food Truck Race ... for Food • Keys to Facilitating Healthy Cities EcoVillage at Currumbin is a community guidelines. A review of the use of a geometric was well received by the study communities • Association Between Risk of Birth Defects Safety Partnership in Indonesia: A Case Study mean will identify the limitations of using and work continues to assess health benefits focused on implementing and teaching and Arsenic Concentrations in Soils of China • Flip the Fear: Food Allergen Lawsuits, • Air Quality Assessments Using Satellite sustainable development principles. bacteriology in general, and the geometric and community perceptions of this approach. mean of E. coli in particular, as the basis of Available data will be shared with attendees Training Requirements, and Tools Derived High Resolution Aerosol Optical Wastewater systems were chosen that created EMERGENCY PREPAREDNESS & RESPONSE recreational water safety decision-making, and Depth Retrievals the lowest total impact to the environment during the session. • Nanotechnology Implications for Food and determine the most appropriate, evidence- • Hurricane Sandy: A Complex Environmental in its manufacturing, construction, and Food Safety based values of the geometric mean for TECHNOLOGY AND EH (SPONSORED BY Health Communications Challenge LEADERSHIP/MANAGEMENT operation. After treatment followed by UV and recreational water to be considered safe. Use MITCHELL HUMPHREY) chlorine disinfection, the wastewater from 144 • Enhancing Planning and Preparedness: HAZARDOUS MATERIALS AND • Building Agency Capacity these results in your organization to create Tools and Data for Identifying Areas With a homes and numerous community facilities Development of an E-Learning Tool for TOXIC SUBSTANCES a comprehensive risk assessment strategy, High Potential for Private Well Contamination • Leadership Development: Key is recirculated to homes for reuse via toilet Chemical Incidents forecasting models, and risk management • Burning to Know: Neighborhood Mercury Considerations for Mentoring Millennials flushing, car washing, garden watering, and In many areas there are concerns about approaches to posting recreational water • Public Health Preparedness: Examination of Exposure From Crematoriums landscape irrigation. Attend this session to see private well water quality, but little data on • Getting Through the Swamp: safety. how these award-winning techniques could levels of contaminants such as nitrate, arsenic, Legal Language Authorizing Responses to • Lead Poisoning Outbreak Resulting From Communicating the Value of Environmental and uranium. We have compiled extensive make a difference in your community. Radiological Incidents Construction and Renovation at an Indoor Health Chlorine Resistant Pathogen Treatment groundwater quality data from national, Strategies for Recreational Water (NEHA/ Firing Range PATHOGENS AND OUTBREAKS state, and local sources and generated maps • Destructive Wildfires and Devastating • Lead, Follow, or Get Out of the Way– APSP session) spanning the U.S. showing where there is Floods: EH’s Response and Role in • Smoke and Ash Deconstructed—Not Just Leadership in Contemporary EH Who’s Missing From the Table? Building Because chlorine resistant pathogens, such the greatest chance of elevated levels of Recovery Particles Partnerships With the Medical Community in as Cryptosporidium, can survive for extended • Building an Environmental Health Program these contaminants. In this session, you Foodborne Illness Surveillance periods of time in even well-maintained • To Tweet or Not To Tweet: Leveraging Social will be shown how to access and interpret of Excellence in a Time of Austerity Detecting increases in self-reported foodborne swimming pools, multi-pronged approaches Media for Environmental Health HEALTHY HOMES AND COMMUNITIES these maps and data for application in your • Organizational Culture Change: Moving the illnesses and low report rates by medical are useful in prevention of disease transmission • Clever Software Tools That Advance Health jurisdiction. providers, Kern County Environmental Health from these pathogens. This session will cover FOOD PROTECTION AND DEFENSE in Homes Needle from Fair to Great implemented an innovative approach to the efficacy and practical application of various • Food Safety Focus Series I: A National • Multi-Agency Approach in the Closure of a • Implications of the Affordable Care Act on enhance collaboration between environmental approaches including UV, ozone, filtration, Collaborative Effort to Support the FDA Motel Environmental Health health, public health, and the medical enhanced filtration, and traditional sanitizers National Retail Food Regulatory Program community. The execution of the Foodborne such as chlorine. Attend the Awards Ceremony Standards (Sponsored by Prometric and • Fungal Bioburden in Foreclosed Homes ONSITE WASTEWATER Illness Surveillance Guidance Training for sm on July 8 to find out who wins Skillsoft) Using ERMI as an Indicator Medical Professionals became a successful VECTOR CONTROL & ZOONOTIC DISEASES • Transfer of Property Requirements: Training, method in communicating with the medical (SPONSORED BY ORKIN) the NEHA Environmental Health • Food Safety Focus Series II: Local • The Public Health Challenge of Hoarding Certification, and Politics community and improving foodborne illness Get Results! Tools for Managing a Public Innovation Award. Experiences With the FDA Retail Food • Pesticide Usage and Pesticide Dust • Greywater and Water Reuse in the Southwest surveillance. This presentation will provide an Health Nuisance Program Program Standards (Sponsored by Prometric Concentrations in Residences of Asthmatic overview of the workshop design, challenges, In its second year, this award is presented • Market Impacts of Product Testing, Product The housing crisis and diminished mental and Skillsoft) Children Living in Subsidized Housing results, and next steps that you may want to health services have resulted in more to an individual, team, or organization Acceptance, and Regulations (NEHA/SORA apply within your community. • Food Safety Apps Can Improve Food Safety session) complaints and public health nuisance for an innovative contribution in the form LAND USE PLANNING: SCIENCE TO POLICY inspections at Franklin County Public Health. Standards Restroom Infection Control: Chlorhexidine, the of a new idea, practice, or product that • Developing Policy to Address Near Roadway • Onsite Wastewater Treatment and the Value See how simple triage and scoring tools were • Applying a Behavior Change Model Proven Final Frontier has had a positive impact on improving Pollution Health Hazards of Independent Certification Pioneering, award-winning work at the Queen used to categorize and prioritize complaints to be Effective in Child Care Settings to environmental public health and the • The Proliferation of Blue-Green Algae: Elizabeth Hospital, UK, has demonstrated the to get results and gain recognition in the Licensed Food Establishments • Annoyance and Perception of Noise in Rural quality of life. Change that promotes or Context, Challenges, and Innovative Solutions remarkable residual antimicrobial activity of community. In this session, you’ll be able to and Urban Areas of France evaluate this approach and test these tools as improves environmental health protection • Investigation of a Large Foodborne Illness chlorhexidine on surfaces, thereby maintaining • Realtors and Environmental Health, Partners in a way for your department to manage public Outbreak in Toronto, Canada their continuous cleanliness over time. In is the foundation of this award. • Outside-the-Box Advocacy: Organizing a Successful Mandatory Point-of-Sale Program this school-setting trial, the presenters will health nuisances with limited funds and staff. Public Health’s Engagement in Built

ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 66 5/1/14 4:08 PM Sessions and schedule are subject to change.

wastewater infrastructure. Through joint demonstrate significant improvements in Integrated Approach to Malaria Prevention in efforts with many government agencies, continuous cleanliness of restroom door Uganda: Experiences From a Pilot Project MORE SESSIONS BY TRACK EPA has developed programs and tools handles. Attend this session and join in the This pilot project promoted an integrated such as workshops in a box to assist these discussion of the possible benefits of applying approach to the prevention of malaria at the Acquire comprehensive information from subject matter experts and communities in creating sustainable solutions this simple, inexpensive technique beyond household level in two rural communities that will meet their current and future needs. clinical and office environments. where malaria is the leading cause of industry leaders, and learn from your peers as you share. Attend this session to gain knowledge and morbidity and mortality. This project resources to implement programs in your RECREATIONAL WATER conducted a baseline survey on malaria community even on a shrinking budget. Rethinking Recreational Water Monitoring: prevention knowledge and practices, trained CHILDREN’S EH • Bet on a Sure Thing: THINK RISK Environment Advocacy community health workers, increased Currumbin–A Community Designed Around Can Predictive Modeling Increase Public • Lessons Learned About Environmental • FDA’s Oral Culture Learner Project: • Levels of Heavy Metals in Traffic-Related Health Outcomes? awareness of the population of an integrated Environmental Sustainability and Wastewater Health in the World of Child Care Helping Food Employees Understand the Particulate Matter Along a Major Motorway Canadian recreational water safety practices approach to malaria prevention, and Reuse in Queensland, Australia Importance of Food Safety in Nigeria are put into an international context by established study demonstration sites. The • Beating the Odds: Eliminating Lead (NEHA/SORA session) Exposure for Kids in the Nation’s Capital On the Gold Coast of Queensland, Australia, comparing them with the EPA and WHO integrated approach to malaria prevention • The Great Food Truck Race ... for Food • Keys to Facilitating Healthy Cities EcoVillage at Currumbin is a community guidelines. A review of the use of a geometric was well received by the study communities • Association Between Risk of Birth Defects Safety Partnership in Indonesia: A Case Study focused on implementing and teaching mean will identify the limitations of using and work continues to assess health benefits and Arsenic Concentrations in Soils of China bacteriology in general, and the geometric and community perceptions of this approach. • Flip the Fear: Food Allergen Lawsuits, • Air Quality Assessments Using Satellite sustainable development principles. Training Requirements, and Tools Derived High Resolution Aerosol Optical Wastewater systems were chosen that created mean of E. coli in particular, as the basis of Available data will be shared with attendees EMERGENCY PREPAREDNESS & RESPONSE Depth Retrievals recreational water safety decision-making, and during the session. • Nanotechnology Implications for Food and the lowest total impact to the environment • Hurricane Sandy: A Complex Environmental in its manufacturing, construction, and determine the most appropriate, evidence- Food Safety TECHNOLOGY AND EH (SPONSORED BY Health Communications Challenge LEADERSHIP/MANAGEMENT operation. After treatment followed by UV and based values of the geometric mean for recreational water to be considered safe. Use MITCHELL HUMPHREY) chlorine disinfection, the wastewater from 144 • Enhancing Planning and Preparedness: HAZARDOUS MATERIALS AND • Building Agency Capacity these results in your organization to create Tools and Data for Identifying Areas With a homes and numerous community facilities Development of an E-Learning Tool for TOXIC SUBSTANCES a comprehensive risk assessment strategy, High Potential for Private Well Contamination • Leadership Development: Key is recirculated to homes for reuse via toilet Chemical Incidents • Burning to Know: Neighborhood Mercury Considerations for Mentoring Millennials flushing, car washing, garden watering, and forecasting models, and risk management In many areas there are concerns about • Public Health Preparedness: Examination of Exposure From Crematoriums landscape irrigation. Attend this session to see approaches to posting recreational water private well water quality, but little data on • Getting Through the Swamp: how these award-winning techniques could safety. levels of contaminants such as nitrate, arsenic, Legal Language Authorizing Responses to • Lead Poisoning Outbreak Resulting From Communicating the Value of Environmental and uranium. We have compiled extensive make a difference in your community. Radiological Incidents Construction and Renovation at an Indoor Health Chlorine Resistant Pathogen Treatment groundwater quality data from national, Strategies for Recreational Water (NEHA/ Firing Range PATHOGENS AND OUTBREAKS state, and local sources and generated maps • Destructive Wildfires and Devastating • Lead, Follow, or Get Out of the Way– APSP session) spanning the U.S. showing where there is Floods: EH’s Response and Role in • Smoke and Ash Deconstructed—Not Just Leadership in Contemporary EH Who’s Missing From the Table? Building Because chlorine resistant pathogens, such the greatest chance of elevated levels of Recovery Particles Partnerships With the Medical Community in as Cryptosporidium, can survive for extended • Building an Environmental Health Program these contaminants. In this session, you Foodborne Illness Surveillance periods of time in even well-maintained • To Tweet or Not To Tweet: Leveraging Social will be shown how to access and interpret of Excellence in a Time of Austerity Detecting increases in self-reported foodborne swimming pools, multi-pronged approaches Media for Environmental Health HEALTHY HOMES AND COMMUNITIES these maps and data for application in your • Organizational Culture Change: Moving the illnesses and low report rates by medical are useful in prevention of disease transmission • Clever Software Tools That Advance Health jurisdiction. providers, Kern County Environmental Health from these pathogens. This session will cover FOOD PROTECTION AND DEFENSE in Homes Needle from Fair to Great implemented an innovative approach to the efficacy and practical application of various • Food Safety Focus Series I: A National • Multi-Agency Approach in the Closure of a • Implications of the Affordable Care Act on enhance collaboration between environmental approaches including UV, ozone, filtration, Collaborative Effort to Support the FDA Motel Environmental Health health, public health, and the medical enhanced filtration, and traditional sanitizers National Retail Food Regulatory Program community. The execution of the Foodborne such as chlorine. Attend the Awards Ceremony Standards (Sponsored by Prometric and • Fungal Bioburden in Foreclosed Homes ONSITE WASTEWATER Illness Surveillance Guidance Training for sm on July 8 to find out who wins Skillsoft) Using ERMI as an Indicator Medical Professionals became a successful VECTOR CONTROL & ZOONOTIC DISEASES • Transfer of Property Requirements: Training, method in communicating with the medical (SPONSORED BY ORKIN) the NEHA Environmental Health • Food Safety Focus Series II: Local • The Public Health Challenge of Hoarding Certification, and Politics community and improving foodborne illness Get Results! Tools for Managing a Public Innovation Award. Experiences With the FDA Retail Food • Pesticide Usage and Pesticide Dust • Greywater and Water Reuse in the Southwest surveillance. This presentation will provide an Health Nuisance Program Program Standards (Sponsored by Prometric Concentrations in Residences of Asthmatic overview of the workshop design, challenges, In its second year, this award is presented • Market Impacts of Product Testing, Product The housing crisis and diminished mental and Skillsoft) Children Living in Subsidized Housing results, and next steps that you may want to health services have resulted in more to an individual, team, or organization Acceptance, and Regulations (NEHA/SORA apply within your community. • Food Safety Apps Can Improve Food Safety session) complaints and public health nuisance for an innovative contribution in the form LAND USE PLANNING: SCIENCE TO POLICY inspections at Franklin County Public Health. Standards Restroom Infection Control: Chlorhexidine, the of a new idea, practice, or product that • Developing Policy to Address Near Roadway • Onsite Wastewater Treatment and the Value See how simple triage and scoring tools were • Applying a Behavior Change Model Proven Final Frontier has had a positive impact on improving Pollution Health Hazards of Independent Certification Pioneering, award-winning work at the Queen used to categorize and prioritize complaints to be Effective in Child Care Settings to environmental public health and the • The Proliferation of Blue-Green Algae: Elizabeth Hospital, UK, has demonstrated the to get results and gain recognition in the Licensed Food Establishments • Annoyance and Perception of Noise in Rural quality of life. Change that promotes or Context, Challenges, and Innovative Solutions remarkable residual antimicrobial activity of community. In this session, you’ll be able to and Urban Areas of France evaluate this approach and test these tools as improves environmental health protection • Investigation of a Large Foodborne Illness chlorhexidine on surfaces, thereby maintaining • Realtors and Environmental Health, Partners in a way for your department to manage public Outbreak in Toronto, Canada their continuous cleanliness over time. In is the foundation of this award. • Outside-the-Box Advocacy: Organizing a Successful Mandatory Point-of-Sale Program this school-setting trial, the presenters will health nuisances with limited funds and staff. Public Health’s Engagement in Built

ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 67 5/1/14 4:08 PM AEHAP = Association of Environmental Health Academic Programs EHAC = National Environmental Health Science & Protection Accreditation Council IFEH Council Meeting A /Jl U /Jl O /Jl U /Jl E /Jl H /Jl 0FI/ uy1 A /Jl 2SUN // July 13 SAT // July 12 FRI // July 11 THU // July 10 WED // July 9 TUE // July 8 MON // July 7 SUN // July 6 SAT // July 5 HCMeigEHAC Meeting EHAC Meeting “Thank You“Thank Luncheon” on Tuesday, July 8. Stay at the designated AEC hotel—The Cosmopolitan of Las Vegas—for two or more nights attend and a free

PATHOGENS AND OUTBREAKS Developing Nationally-Consistent Community

Environmental Health Proﬁles Joint Meeting IFEH AGM Meeting International International Health Faculty Environmental Meeting Health Faculty Environmental Forum & EHAC Be a voice. • Don’t Gamble With Norovirus: Prevention, Forum Business Control, and Containment of a Norovirus • Public Health Mythbusters You Spoke, We Listened... Outbreak in a Casino • Using the Lean Program to Improve NEHA used your participation in our • Issues and Challenges: Investigation of a Efﬁciency in Environmental Health Services Foodborne Outbreak in Jamaica 2014 Abstracts Blog and your responses • Implementation of GIS for Research on to our conference surveys as guidance • Investigation of a Foodborne Illness Outbreak Neural Tube Defects in China AEHAP Annual Meeting Annual UL Event IFEH Regional Meetings Event NEHA Board of First Time Attendee Pre-Conference Directors Meeting Workshop Workshops: Community Volunteer • Industry-Foodborne NEHA/SORA Onsite • in choosing sessions and developing in Toronto, Canada Model Aquatic Health • Training and Recall Illness Investigation Response Workshop Wastewater Field Trip Code Workshop

• Can Technology Improve Hand Washing Schedule is subject to change. the training and education program. SCHEDULE ATAGLANCE RECREATIONAL WATERS Behaviors THANK YOU for giving us feedback so • Chlorine Resistant Pathogen Treatment VECTOR CONTROL & ZOONOTIC DISEASES we can advance the proﬁciency of the Strategies for Recreational Water (NEHA/ (SPONSORED BY ORKIN) environmental health profession AND APSP session)

• GIS Mapping to Get Rid of Rodents— details. for Web site See apply. conditions and terms Certain

help create bottom line improvements NEHA AEC • Gage-Bidwell Law of Puriﬁcation: Old Errors Integrated Pest Management Program

for your organization! Corrected and New Relevance Identiﬁed “Thank You designated hotel & Keynote Address Awards Ceremony at the AEC International nights Exhibition Luncheon” for EH—IFEH Special guests staying Educational Sessions Sessions Success for two or more Grand Opening • Poster Session •

(NEHA/APSP session) & Party FROM THE BLOG • Integrated Approach to Malaria Prevention in • Hot Tub and Spa Inspection Data: The Uganda: Experiences From a Pilot Project • The Great Food Truck Race ... for Food Safety Power to Prevent Illness and Injury • Restroom Infection Control: Chlorhexidine, the • Hantavirus in Northern Arizona: Investigation • Pool and Spa Safety Act Program: Final Frontier and Response Implementation and Findings in Seattle and • Arsenic in Iowa’s Groundwater — The Unknown • Stamping Out Bed Bugs: An Organization American Public International (Sponsored by EH—IFEH Special University) Educational Luncheon Networking Exhibition Open Sessions Sessions Student Research Presentations CCFS Course King County Silent Auction • Poster Session • Threat: A Pilot Study in Cerro Gordo County and Systems Approach in Action • Triggers for Change in the Safest Place on Earth SCHOOLS/INSTITUTIONS • New Urban Rat Control Program • Disaster Management Challenges From Non- Communicable Diseases: Lessons Learned and • Food-Safe Schools: Food Safety Beyond the Development in the Post Recessionary = State OnsiteSORA Regulators Alliance IFEH = International Federation of Environmental Health Questions Going Forward Cafeteria Environment • School Indoor Air Quality Improvement: • Using Heat to Treat for Bed Bugs in a Town Hall International Assembly Banquet EH—IFEH Special Educational Sessions SORA Educational Sessions Sessions President’s FROM CONFERENCE SURVEYS Lessons from Multnomah County, Oregon Homeless Shelter CCFS Course • Inspection technology and use of apps in EH: • Correcting Corrections: Surviving Jail • Get Results! Tools for Managing a Public » Help! Everyone Wants My Data: A Look at Inspections and High Risk Inmate Activities Health Nuisance Program Streamlining Data Collection for Environmental Health Programs » Enhancing Planning and Preparedness: SUSTAINABILITY/CLIMATE CHANGE WATER QUALITY Development of an E-Learning Tool for • Climate Change and Sustainability: • Innovative Methods to Control, Investigate, Certiﬁcations Credentials & HACCP Basics for • CPO • REHS/RS Course • CP-FS Course • CCFS Exam • Chemical Incidents Navigation of Governance, Energy, and Built and Monitor for Legionella: A Panel HACCP: • and Retail Food Manufacturers Managing Risks Operations Processors and for Foodservice Course » Focusing Disney Magic on Food Safety Environment Opportunities Discussion

» Food Safety Apps Can Improve Food Safety ® Course Standards • Triggers for Change in the Safest Place • Containing an Outbreak of Cryptosporidiosis » Using the Lean Program to Improve Efﬁciency on Earth in Galway: The Role of the Environmental in Environmental Health Services Health Service • International Perspectives on Climate • The Leadership/Management track will address Change and the Role of Environmental • Arsenic in Iowa’s Groundwater — The

your concerns related to: Certiﬁcations Credentials & HACCP • CPO® Course & • REHS/RS Course • CP-FS Course • HACCP: •

Unknown Threat: A Pilot Study in Cerro and Retail Food Manufacturers Basics for Managing Risks Exam Operations Exam Processors and » The future of the EH practice Health for Foodservice Gordo County » Demonstrating program effectiveness • Climate Change Impacts and Options: » Value and return on investment for Case Studies in the Northwest Arctic • Broadening the National Dialogue on Public environmental health programs Borough, Alaska Health and Water Quality » Building agency capacity under reduced budgets and stafﬁng collaborations/programs TECHNOLOGY AND EH (SPONSORED BY • An Online Class for Private Well Owners to Protect Public Health Certiﬁcations Credentials & • Hoarding, bed bugs, and rats—we’ve got them MITCHELL HUMPHREY) REHS/RS Course • CP-FS Exam • & Exam covered in our Vector Control & Zoonotic Diseases • Help! Everyone Wants My Data: A Look and Healthy Homes and Communities tracks! at Streamlining Data Collection for • Evaluation of the built environment and its link to Environmental Health Programs public health—check out sessions in the Land Use Planning & Design track! • Building Agency Capacity • Environmental Public Health Tracking:

ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 68 5/1/14 4:08 PM AEHAP = Association of Environmental Health Academic Programs EHAC = National Environmental Health Science & Protection Accreditation Council IFEH Council Meeting A /Jl U /Jl O /Jl U /Jl E /Jl H /Jl 0FI/ uy1 A /Jl 2SUN // July 13 SAT // July 12 FRI // July 11 THU // July 10 WED // July 9 TUE // July 8 MON // July 7 SUN // July 6 SAT // July 5 HCMeigEHAC Meeting EHAC Meeting “Thank You“Thank Luncheon” on Tuesday, July 8. Stay at the designated AEC hotel—The Cosmopolitan of Las Vegas—for two or more nights attend and a free

PATHOGENS AND OUTBREAKS Developing Nationally-Consistent Community

• GIS Mapping to Get Rid of Rodents— details. for Web site See apply. conditions and terms Certain help create bottom line improvements NEHA AEC • Gage-Bidwell Law of Puriﬁcation: Old Errors Integrated Pest Management Program

your concerns related to: Certiﬁcations Credentials & HACCP • CPO® Course & • REHS/RS Course • CP-FS Course • HACCP: •

ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 69 5/1/14 4:08 PM KEYNOTE SPEAKER NETWORKING Strengthen your business and personal relationships and build a network of The National Environmental Health Association is pleased to colleagues in the U.S. and across the world that you can call on at anytime! announce that Mark Keim, MD, with the Centers for Disease

Control and Prevention, will address attendees of the 78th Annual • Before You Arrive: Send meeting requests through the • Wednesday: See exhibitors you missed the day before and Educational Conference (AEC) & Exhibition as the keynote speaker. networking features of the Virtual AEC – Your Meeting chat with colleagues during the Networking Luncheon Companion • Thursday: Collaborate with other professionals at the Town • Monday: Mingle with peers and give back to the community Hall Assembly. Reconnect with everyone you have met hosting the AEC by signing up for the Community Volunteer during the AEC at the President’s Banquet With the expanded international audience at this year’s AEC, you’ll want to hear Event. Reunite with friends at the always-exciting UL Event • After the AEC: Stay connected to your friends and contacts Dr. Keim’s perspective on emerging and contemporary issues, including the in the evening! after leaving the conference through the AEC and NEHA far-reaching health effects of global climate change. • Tuesday: Connect with exhibitors at the Exhibition Grand social media channels Opening & Party Register today for the 2014 AEC so you don’t miss this opportunity! Annual UL Event Monday, July 7, from 6:30 – 10:30pm impersonating turtle; Emma Taylor, the little girl with the big voice; and Monty Join us for the Annual UL Event and get The National Environmental Health Association is pleased to announce that Carlo, the lounge singer. Enjoy comedic ready for an evening with one of the best Mark Keim, MD, Associate Director for Science in the Office for Environmental banter and amazing vocal impressions of entertainers in the industry today. As a Health Emergencies, National Center for Environmental Health/Agency for musical superstars such as Garth Brooks, successful headliner on the Las Vegas Toxic Substances and Disease Registry at the Centers for Disease Control and Dean Martin, Aretha Franklin, Lady Gaga, Strip, Terry Fator captures the hearts Prevention (CDC), will be the keynote speaker for this combined IFEH and NEHA and more. Terry Fator: The VOICE of and funny bones of audiences from environmental health event. Entertainment is a one-of-a-kind experience, around the world with Terry Fator: The only at The Mirage. . Backed by a Dr. Keim will be speaking on emerging and contemporary issues, including the far- VOICE of Entertainment live band, Fator wows audiences nightly The UL Event is not included in the registration reaching health effects of global climate change. A trip to Las Vegas would not with singing, comedy, and unparalled pricing for the AEC. Price is $65 per ticket for In addition to his current role, Dr. Keim has spent many years working for the CDC be complete without enjoying its celebrity impressions. The “America’s Got the fi rst 175 tickets that are purchased and in many capacities including Acting Associate Director in the Office of Terrorism world-class entertainment. Talent” winner brings to life a hilarious $75 for each ticket thereafter. To register for range of characters including Winston, the Preparedness and Emergency Response, Medical Officer and Team Leader at this event, visit neha2014aec.org/register. the International Emergency and Refugee Health Branch, and Acting Associate Director for Science in the Division of Emergency and Environmental Health 4th Annual Community SORTING SOAPS TO CLEAN has put over nine million soap bars and two The keynote speaker Services. He is also an adjunct faculty member at the Rollins School of Public THE WORLD million pounds of bottled amenities back Health at Emory University. is sponsored by NSF Volunteer Event Monday, July 7, from 1:00 – 3:00pm into human use, simultaneously diverting International. over 600 tons of waste from landfi lls. Dr. Keim has provided consultation for the management of dozens of disasters The community volunteer event is designed Network with colleagues and contribute to involving the health of literally millions of people throughout the world. Dr. Keim is to give back to the AEC host city community a local and global cause while participating Check out the sessions in the author of several hundred scientific presentations, 40 journal publications, and and enhance NEHA’s “green” efforts to in volunteer activities which may include the Sustainability/Climate 13 book chapters. reduce the footprint of the NEHA 2014 AEC sorting amenities by content and package Change Track for more and IFEH 13th World Congress. Dr. Keim received numerous awards for his work in CDC’s emergency operations type, cleaning and boxing amenities, on this topic and more of during the World Trade Center, anthrax letter, and Hurricane Katrina emergencies, This year’s community volunteer activity assembling hygiene kits, taking inventory, or helps reclaim and repurpose waste from Dr. Keim! as well as for leading the U.S. health sector response after the Indian Ocean writing educational and inspirational notes the hospitality industry and provides tsunami. to recipients. for people in need. Clean the World is a When you sign up, please be sure to read non-profi t organization that collects and He has been a member of the White House Subcommittee for Disaster Reduction and be prepared with required attire and redistributes personal care items and gives since 2006. He served as a review editor for the United Nations Intergovernmental waiver. Join your fellow environmental health For more details and to sign up as them to domestic homeless shelters and Panel on Climate Change from 2009 to 2011. colleagues at Clean the World’s Las Vegas a volunteer, visit neha2014aec.org. impoverished countries suffering from high Recycling Operations Center and make a death rates due to hygiene-related illnesses. difference locally and internationally! Since its inception in 2009, Clean the World

ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 70 5/1/14 4:08 PM KEYNOTE SPEAKER NETWORKING Strengthen your business and personal relationships and build a network of The National Environmental Health Association is pleased to colleagues in the U.S. and across the world that you can call on at anytime! announce that Mark Keim, MD, with the Centers for Disease

ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 71 5/1/14 4:08 PM THE VIRTUAL EXPERIENCE LAS VEGAS NEVADA The Perfect Destination to Mix Business and Pleasure Enhance your learning experience whether you attend the AEC or participate online from your home or oﬃ ce via the Internet.

How Can the Virtual AEC Help You? Three Ways to Use The Virtual AEC • Stay connected and informed: View interactive maps, session descriptions, 1) Virtual AEC: Your Meeting Companion speakers, exhibitors, and attendee profi les. Get the latest NEHA 2014 AEC Make the most of your time by planning your AEC news and announcements via live social feeds sent directly to you. schedule, events, meetings, and more! Great for both attendees and those participating remotely via • Create your customized conference schedule: Add sessions and events you want the live broadcast. to attend to your schedule. Then export the schedule to your Outlook or other electronic calendar. 2) Virtual AEC: Live Broadcast • Network and converse: “Meet” other attendees, speakers, and exhibitors via For those who are not able to attend the AEC in person, view some of the sessions live as they the chat forums. Request meeting connections, swap digital business cards, or occur! You, too, can schedule your sessions and connect digitally with others in your area of specialty or geographic region. chat with live and remote attendees, speakers, etc. • Learn: Attend some of the educational sessions as they occur via live streaming 3) Virtual AEC: Continuing Education Resource broadcast. Use the chat feature to ask questions, post comments, and When you come to Las Vegas, Nevada, you’ll enjoy access to permanent fixtures of the Las Vegas entertainment industry After the conference, view sessions for up to one communicate with speakers and other attendees. Discover the latest innovative one of the most exciting and entertaining cities in the world, like the Blue Man Group, Cirque du Soleil, or Penn and Teller. products and services shared by AEC exhibitors. After the conference, you year to earn continuing education credits. so it’s no secret why the city welcomes millions of tourists can still access the educational sessions, view presentation slides, and obtain each year. Whether you’re looking for an exciting night life, For people looking to relax and unwind, Las Vegas has you supplemental material through the continuing education resource. covered. Treat yourself to a day at one of the city’s many spas Wireless connections for meeting rooms sponsored by live entertainment, or a place to find some peace and quiet, HealthSpace USA Inc. Las Vegas has everything you could ever want. and resorts, or get out of the city and spend some time on the golf courses. Take a walk down the Vegas Strip and try your luck at one of the many casinos that have made the city famous. And with There’s a reason they call Las Vegas the entertainment capital hundreds of different restaurants, the city can cater to every of the world. Whatever your idea of a good time is, you’re CONFERENCE REGISTRATION taste and craving. almost sure to find it in Las Vegas. Registration information is available at neha2014aec.org. For personal assistance, Las Vegas also plays host to almost any type of live neha2014aec.org entertainment you can imagine. You can see live comedy, contact Customer Service toll free at 866.956.2258 (303.756.9090 local), extension 0. stage shows, and concerts, or take in one of the many Follow NEHA on: Twitter Facebook LinkedIn Before May 30 After May 30 (Member/Non-member) (Member/Non-member) Full Conference Registration $575 / $735 $675 / $835 One Day Registration $310 / $365 $345 / $395 NEHA AEC Venue & Hotel Student/Retired Registration $155 / $230 $185 / $265 The Cosmopolitan of Las Vegas 3708 Las Vegas Boulevard South, Las Vegas, NV 89109 Join NEHA for $95 and get the AEC for $575. Combined that is a over the Special Savings! $65 savings Discounted room rates are now available–$139 USD/night non-member AEC registration rate. Plus, you get a whole year of NEHA member benefi ts! plus taxes and fees. Visit neha2014aec.org/hotel

neha2014aec.org Follow NEHA on: Twitter Facebook LinkedIn ANNUAL EDUCATIONAL CONFERENCE & EXHIBITION | LAS VEGAS, NV | JULY 7–10, 2014 COMPLETE AND UP-TO-DATE INFORMATION CAN BE FOUND ONLINE AT NEHA2014AEC.ORG.

JEH6.14_PRINT.indd 72 5/1/14 4:08 PM THE VIRTUAL EXPERIENCE LAS VEGAS NEVADA The Perfect Destination to Mix Business and Pleasure Enhance your learning experience whether you attend the AEC or participate online from your home or oﬃ ce via the Internet.

JEH6.14_PRINT.indd 73 5/1/14 4:08 PM YOUR ASSOCIATION

Simply the best choice in food safety training. Your Food Safety Solution for Training and Certification

National Environmental Health Association NEPROFESSIONAL FOOD MANAGERHA

Call today - toll free 1-866-956-2258 x340 NEHA [email protected]

74 Volume 76 • Number 10

JEH6.14_PRINT.indd 74 5/1/14 4:08 PM YOUR ASSOCIATION

The go-to resource for students of food safety and industry professionals.

Introducing… NEHA’s ALL-NEW Certiﬁ ed Professional– Food Safety (CP-FS) manual!

NEHA’s Certiﬁ ed Professional– Food Safety manual was developed by experts from across the various food safety disciplines to help candidates prepare for the updated CP-FS credential examination. This 360-page manual contains science-based, in-depth information about:

Causes and prevention of foodborne illness HACCP plans and active managerial control Cleaning and sanitizing Pest control Risk-based inspections

Hundreds of pages of new content to help candidates Sampling food for laboratory prepare for the current CP-FS exam analysis Food defense Updated to the 2013 Food Code Responding to food An integral part of Integrated Food Safety System emergencies and foodborne (IFSS) body of knowledge illness outbreaks Conducting facility plan Includes new Food Safety Modernization Act (FSMA) reviews requirements Legal aspects of food safety Full-color photographs and illustrations throughout

Now available at NEHA’s online bookstore. neha.org/store

June 2014 • Journal of Environmental Health 75

JEH6.14_PRINT.indd 75 5/1/14 4:08 PM YOUR ASSOCIATION

Managing Editor’s Desk personal challenge, I think back to what I’ve continued from page 78 For a science nerd learned about how others have handled simi- door, which is how I honestly feel. To this lar situations and what drove their response. S like myself, it was a Y UST day, I still try to answer every call that comes You have given me this gift. And as I now FET AI into me. I will work deep into the night to leave NEHA, I take great delight in taking A NA ensure that people who write get a response learning experience this gift with me. Each and every encounter S D BI from me. I love visiting with people and get- for me to realize with you has helped to shape the person I am LI ting to know them as real people, as if I were today. As this is the kind of gift that can truly O On Farm T O Life Cycle Analysis Y their closest buddy. And I still vastly prefer that nothing better keep on giving, I fully expect to be shaped by F Food Processing listening over talking. it tomorrow as well. Green Building Products deﬁ nes the human Distribution and Retail In any case, to understand me, it is also I could never fully thank this organization Environmental Declarations important to understand that I have taken and the people who make it happen, from Food Equipment from my deep studies of both science and condition than our wonderful employees to our members to WaterSense® Dietary Supplements philosophy that there are seldom single relationships and our institutional friends to our many volun- Energy Star truths or single answers. For one thing, con- teers and to the many board members over Organic Foods text matters mightily in both understand- meaning to what we the years whom I have had the pleasure of ing and eventually solving a problem. For serving. That is why I have written this col- another, people come to issues with different do with our lives. umn. Just saying thank you seemed woefully PART N W life experiences, cultural groundings, age per- inadequate, given the gift I’ve been given. So S R E spectives, demographic perspectives, values, please accept this column and the explana- A U R A P and so forth. It is therefore hardly surprising tion it offers for why I am so grateful, as my O S

T that people see issues differently, and some- these anxieties by providing you with more more substantive thank you back to you. Performance and Safety Y Individual Onsite

times strongly so! (This was always one of answers about where jobs will exist and how As I said when I began, “The time has E

& Energy Efficiency Wastewater Treatment Systems

the draws for me for getting into public pol- to ﬁ nd them. You’ve shared with me your come.” Susan and I have decided that we W

icy work. The challenge [and reward] to such concerns about paying the family bills on the want to build our own enterprise. Over this S Filtration and Recirculation Advanced Treatment Systems A

L I

work involves ﬁ nding the balance between kinds of salaries available in environmental past year, this exciting creative idea blos- Components H Water Reuse N T

competing yet meritorious viewpoints in the health and why you are conﬂ icted about stay- somed into a shared determination to make it O

T E

crafting of creative public policy. This also ing in this profession. You’ve talked to me work. We have each now chosen to leave our O P L R

explains why, prior to joining NEHA, I ran about the danger you’ve felt to your personal jobs to engage this new life adventure. P U A for and won elective ofﬁ ce, serving as mayor safety when asked to perform certain types of So, the time has come to turn the keys in. B E pro tem for the city of Berkeley, Michigan.) work in areas of town where crime is high. I’m happy to be leaving with a great staff in HACCP L I C H By going about my work as more your You shared with me your fear of technology place and the organization possessing more Allergens friend and colleague and by listening a lot, and how not keeping pace keeps you up at human and ﬁ nancial capital than ever before. boy, did I get exposed to all kinds of perspec- night. You’ve told me many amazing tales Plan Review Residential Point-of-Entry/ tives on issues! And boy, did I love it and did of how work can get accomplished on shoe- SQF, BRC, IFS Point-of-Use Treatment Units I ever learn a lot! string budgets and how those lessons can be From my deepest Municipal Treatment Chemicals Even better, my learning extended far applied in virtually all areas of life. And on Food Equipment beyond just environmental health. and on and on. Distribution System Components reaches, I say, Traceability and Recall R You’ve talked to me about being a single If I were working in a single local envi- T Plumbing and Devices E parent and even though you want communi- ronmental health program, I have no doubt “thank you.” R Supply Chain Food Safety T ties more designed for recreation and exer- that I would learn a lot, since environmental A A IN cise, you’re afraid to let your children play health work touches almost every corner of IN W in the park by themselves or with others for every community in one way or another. But As I move on to the next reinvention of G NG safety reasons. You’ve explained the history I have had the pleasure … and the gift …. of myself and my next professional pursuit, I KI between England and Scotland and why you listening to your stories from all across the will do so as a better person thanks to you. RIN are sensitive to organizations in the other country and even the world. Sometimes my Thank you for allowing me into your lives. D country creating markets in yours. You’ve head gets so full of stories and people that And thank you again for sharing your many told me that you fear for your jobs, which I have to unplug for a while! But it’s great. stories with me with such passion, color, and is why you want to have NEHA’s Registered The lessons, the insights, and the very ways candidness. You have made a huge difference Environmental Health Specialist/Registered in which so many people see the world all in the life of this person. Sanitarian credential become mandatory for combine to teach me about life itself and even work in your department. As a college junior my place in it. or senior, you’ve shared with me the sweep Thanks to you, my awareness now extends of uncertainties you face when you gradu- far beyond the personal life experiences that ate and how NEHA can help relieve some of I’ve had. As I think about a problem or even a [email protected] Standards • Audits • Testing • Certification • Code Compliance • Webinars • Regulatory Support NSF International • 1-800-NSF-MARK • www.nsf.org/regulatory 76 Volume 76 • Number 10

JEH6.14_PRINT.indd 76 5/1/14 4:08 PM REG - NEHA_June 2014_v2.indd 1 4/23/2014 11:41:28 AM SUS ETY TA AF IN S AB D IL O On Farm IT O Life Cycle Analysis Y F Food Processing Green Building Products Distribution and Retail Environmental Declarations Food Equipment WaterSense® Dietary Supplements Energy Star Organic Foods PART N W S R E A U R A P O S

Performance and Safety Y Individual Onsite E

& Energy Efficiency Wastewater Treatment Systems

S Filtration and Recirculation Advanced Treatment Systems A

L I

Components H Water Reuse

N T

T E

O P L R P U B E A HACCP L I C H Allergens Plan Review Residential Point-of-Entry/ SQF, BRC, IFS Point-of-Use Treatment Units Food Equipment Municipal Treatment Chemicals Distribution System Components Traceability and Recall R T Plumbing and Devices R Supply Chain Food Safety E A T I A NI W NG G KIN DRIN

Standards • Audits • Testing • Certification • Code Compliance • Webinars • Regulatory Support NSF International • 1-800-NSF-MARK • www.nsf.org/regulatory

REGJEH6.14_PRINT.indd - NEHA_June 2014_v2.indd 77 1 4/23/20145/1/14 11:41:28 4:08 AMPM x ﬁ gures, x tables

YOUR ASSOCIATION

 MANAGING EDITOR’S DESK Editor’s Note: After 31 years of serving as NEHA’s executive director and managing editor of the Journal, Nelson Fabian announced to NEHA’s board in April that “the time has come” to move The Time on from these positions. Nelson’s ﬁ rst column appeared in the March/April 1984 issue, along with an interview that introduced him to the Has Come … membership. Over the years he has penned around 270 columns—which equates to over Thank You, half a million words written. The thoughts and insights he shared over the years have NEHA! undoubtedly and immeasurably enriched NEHA and the environmental health profession. The Journal bids a fond and sad farewell to its longest and most read columnist—thank you for your Nelson Fabian, MS contributions to this publication!

ver the years, I’ve never given a lot of I have learned so much from so many. I thought to what comes after NEHA My thank you have seen perspectives that I would never O for me. The nature of my work and have otherwise known. I have gained pen- the joy that I have always felt through it kept is for how the etrating insights into experiences that I never me focused and consumed. There just wasn’t knew people went through. I have been time for such idle thought. wonderful people deeply touched with sadness from stories I can’t deny that there have been times, of tragedy and with inspiration from stories however, when I’ve wondered along with my of this wonderful of breaking through frontiers. And best of wife Susan (who over the years has been my all, I have learned that relationships trump confi dant and best friend, especially when it organization everything else when it comes to accomplish- comes to brainstorming ideas and thinking have changed me ing anything. In fact, for a science nerd like through challenges), what I would say when myself, it was a learning experience for me to that day came. What will I tell the NEHA and made me realize that nothing better defi nes the human membership whom I’ve had the pleasure of condition than relationships and meaning to getting to know and sharing this long jour- a better and what we do with our lives. ney with? It’s kind of funny in a way. From day one, Well, the day that was always “sometime more empathetic I’ve never really felt like an “executive direc- down the road” has come. And to my surprise, human being. tor.” I vividly recall just days after being hired, the answer to the question of what I would walking around my offi ce and asking myself, say came to me immediately. In fact, I quickly OK, Nelson, now what are you going to do?! realized that there can only be one answer to There have certainly been times when car- this question. That is so clear to me. From my occurred, I instead need to acknowledge that rying the title felt good to the ego. As I am deepest reaches, I say, “thank you.” it has been your positions that have changed a person who takes nothing for granted, I But I hope you will read on because I think me. I am so very grateful that my work at also admit that I have deeply appreciated the you’ll soon see that my thank you isn’t com- NEHA allowed me to come into contact with doors that this title has opened up for me. ing from the usual place. While I cherish the troves of people who helped me to see the It has been absolutely exhilarating over the experiences, friendships, victories, and lessons light and develop deeper and more empa- years to be able to represent the values, lives, that comprise my 31-year career at NEHA, my thetic understandings of issues … and people and aspirations of the many people who work thank you isn’t about anything I’ve done or … than I ever thought possible. in environmental health in policy conversa- anything I’ve seen or touched in the world out The e-mails, the conversations, the phone tions. And I have certainly appreciated more there. The focus of my thank you is in here— calls, the meetings, the debates, the brain- than I can convey in words the creative lati- that is in the person I am. My thank you is for storming, and most importantly, the listening tude that NEHA boards over the years have how the wonderful people of this wonderful … opened me up to see the world in so many extended to me because I was their “execu- organization have changed me and made me a different ways. No one ever told me or even tive director.” better and more empathetic human being. hinted to me that this would be one of the But I still sign almost all of my communi- Instead of standing on some mountain to greatest rewards of all when I fi rst hired into cations just “Nelson” as if the unknown per- declare that the rightness of my position pre- my position at NEHA. What a resplendently son I am writing to is my good friend next vailed and as a result, some accomplishment beautiful surprise. continued on page 76

78 Volume 76 • Number 10

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