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Home > JEH > 2007 JEH Abstracts

 

2008 Journal of Environmental Health Abstracts

Copyright 2008, National Environmental Health Association.          Printer-friendly PDF       View 2007 Abstracts

 

January/February 2008


March 2008

April 2008

 

May 2008

June 2008

 

January/February 2008, Volume 70, No. 6

Environmental Health Specialists’ Self-Reported Foodborne Illness Outbreak Investigation Practices 
Carol A. Selman, Laura R. Green, Ph.D.

Abstract
To collect qualitative data on the investigation practices of environmental health specialists with respect to foodborne illness outbreaks, the authors convened six focus groups of randomly selected specialists working in public health agencies in eight states. Participants discussed their investigation activities, methods used to identify contributing factors, success in identifying contributing factors, and the difficulties they faced when conducting investigations. Findings revealed substantial variability in the type of activities in which participants engaged during investigations, and the amount and nature of the collaboration between epidemiologists and environmental health specialists during investigations. Many participants indicated that during investigations they often did not identify contributing factors associated with an outbreak. Participants also identified several difficulties associated with outbreak investigations, including difficulties associated with restaurant employees, restaurant customers, and environmental health organizations.


Septic Tank Additive Impacts on Microbial Populations
S. Pradhan, Ph.D., M.T. Hoover, Ph.D., G.H. Clark, M.S., M. Gumpertz, Ph.D., A.G. Wollum, Ph.D., 
C. Cobb, M.S., J. Strock, Ph.D.

Abstract
Environmental health specialists, other onsite wastewater professionals, scientists, and homeowners have questioned the effectiveness of septic tank additives. This paper describes an independent, third-party, field scale, research study of the effects of three liquid bacterial septic tank additives and a control (no additive) on septic tank microbial populations. Microbial populations were measured quarterly in a field study for 12 months in 48 full-size, functioning septic tanks. Bacterial populations in the 48 septic tanks were statistically analyzed with a mixed linear model. Additive effects were assessed for three septic tank maintenance levels (low, intermediate, and high). Dunnett’s t-test for tank bacteria (α = .05) indicated that none of the treatments were significantly different, overall, from the control at the statistical level tested. In addition, the additives had no significant effects on septic tank bacterial populations at any of the septic tank maintenance levels. Additional controlled, field-based research is warranted, however, to address additional additives and experimental conditions.


Randomized Controlled Trials in Environmental Health Research: Ethical Issues
David B. Resnik, J.D., Ph.D.

Abstract
Randomized controlled trials (RCTs) are becoming increasingly common in environmental health research. Like all studies involving human subjects, environmental health RCTs raise many ethical challenges, ranging from obtaining informed consent to minimizing risks to protecting privacy and confidentiality. One of the most important issues raised by these studies is whether it is ethical to withhold effective environmental health interventions from research subjects in order to satisfy scientific objectives. Although environmental health investigators usually do not have professional obligations to provide medical care to research subjects, they have ethical obligations to avoid exploiting them. Withholding interventions from research subjects can be ethical, provided that it does not lead to exploitation of individuals or groups. To avoid exploiting individuals or groups, investigators should ensure that research subjects and study populations receive a fair share of the benefits of research.


The Performance of UASB Reactors Treating High-Strength Wastewaters
Sibel Aslan, M.D., Nusret Şekerdağ, Ph.D.

Abstract
In the study reported here, the authors investigated the influence of hydraulic loading rate, organic loading rate, and recycle rate on the performance of upflow anaerobic sludge blanket (UASB) reactors treating high-strength wastewaters. For this purpose, they used two identical reactors. The removal rates for chemical oxygen demand (COD), total kjeldahl nitrogen (TKN), total phosphorus (TP), total solids (TS), total suspended solids (TSS), and volatile solids (VS) were investigated for various hydraulic loading rates, and COD removal rates were investigated for various organic loading rates. In Reactor 1, a COD removal rate of 84.75 percent was achieved at influent COD of 8,000 mg/L and a hydraulic loading rate of 0.121 cubic meters per cubic meter per day (m3/m3-d). In Reactor 2, a COD removal rate of 82.83 percent was achieved at influent COD of 12,000 mg/L and a hydraulic loading rate of 0.069 m3/m3-d. Although the COD removal rates of the reactors were high, TKN and TP removal rates were low. The removal rates usually decreased when hydraulic and organic loading rates were increased.


Health-Related Quality of Life and Recognition of Desertification Among Inhabitants of the Loess Plateau Region of China: Findings for City and Village Communities
Haosheng Mu, M.D., Youichi Kurozawa, M.D., Ph.D., Kazuhiko Kotani, M.D., Ph.D., Guobin Liu, Ph.D.
Pulin Liu, Ph.D., Atsushi Tsunekawa, Ph.D., Shunichiro Nishino, Takehiko Y. Ito, Ph.D.

Abstract
This article elucidates the health-related quality of life (HRQOL) the recognition of desertification among people living in the semi-arid Loess Plateau of China. HRQOL was assessed with a three-dimensional survey of general health perception, vitality, and general mental health based on a 36-item short-form health survey (SF-36). Scores for general health perception were approximately the same in the city and the village communities. Vitality and mental health scores were significantly lower for women in the village communities than for other groups. In the village communities, HRQOL was significantly and positively correlated with income. The inhabitants of the village communities were more satisfied with their life situation than those in the city, in spite of the economic gap between them. Levels of recognition of desertification were lower in the village communities than in the city. 

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March 2008, Volume 70, No. 7

Shipshape: Sanitation Inspections on Cruise Ships, 1990–2005, Vessel Sanitation Program, Centers for Disease Control and Prevention
Elaine H. Cramer, M.D., M.P.H., Curtis J. Blanton, M.S., Charles Otto, M.S., Vessel Sanitation Program Environmental Health Inspection Team

Abstract
In the course of a successful collaboration between the Centers for Disease Control and Prevention (CDC) and the cruise ship industry on reducing common-source outbreaks, CDC’s Vessel Sanitation Program (VSP) has expanded its training, education, and cruise ship inspection programs. The study reported here evaluated 15 years of ship sanitation inspection data from the National Center for Environmental Health and assessed performance in specific sanitation categories from 1996 to 2005. During the period 1990–2005, scores from cruise ship environmental sanitation inspections steadily improved. The percentage of inspections with violations decreased among five of nine categories. Those five categories were Washing Facilities, Contact Surfaces, Facility Maintenance, Food Handling, and Communicable Disease Practices. Inspection violations increased proportionally in the categories of Swimming Pools and Water System Protection/Chart Recording. Overall continued good performance in most sanitation categories is likely attributable to on-site training during inspections, improvements in ship construction, and a switch from hot-holding temperatures to time limits as a public health control for foods on display.


Determination of the Feasibility of Using a Portable X-Ray Fluorescence (XRF) Analyzer in the Field for Measurement of Lead Content of Sieved Soil
Andrea M. Markey, M.S., C. Scott Clark, Ph.D., C.I.H., Paul A. Succop, Ph.D., Sandra Roda, M.S.

Abstract
Soil samples collected in housing areas with potential lead contamination generally are analyzed with flame atomic absorption spectrometry (FAAS) or other laboratory methods. Previous work indicates that field-portable X-ray fluorescence (XRF) analysis is capable of detecting soil lead levels comparable to those detected by FAAS in samples sieved to less than 125 μm in a laboratory. A considerable savings, both economical and in laboratory reporting time, would occur if a practical field method could be developed that does not require laboratory digestion and analysis. The XRF method also would provide immediate results that would facilitate the provision of information to residents and other interested parties more quickly than is possible with conventional laboratory methods. The goal of the study reported here was to determine the practicality of using the field-portable XRF analyzer for analysis of lead in soil samples that were sieved in the field. The practicality of using the XRF was determined by the amount of time it took to prepare and analyze the samples in the field and by the ease with which the procedure could be accomplished on site. Another objective of the study was to determine the effects of moisture on the process of sieving the soil. Seventy-eight samples were collected from 30 locations near 10 houses and were prepared and analyzed at the locations where they were collected. Mean soil lead concentrations by XRF were 816 ppm before drying and 817 ppm after drying, and by laboratory FAAS were 1,042 ppm. Correlation of field-portable XRF and FAAS results was excellent for samples sieved to less than 125 μm, with R2 values of .9902 and .992 before and after drying, respectively. The saturation ranged from 10 percent to 90 percent. At 65 percent saturation or higher, it was not feasible to sieve the soil in the field without a thorough drying step, since the soil would not pass through the sieve. Therefore the field method with sieving was not practical when the soil was 65 percent or more saturated unless a time-consuming drying process was included. 


Survival and Growth of Foodborne Microorganisms in Processed and Individually Wrapped Cheese Slices
Richard H. Linton, Ph.D., Nigel Harper

Abstract
The objectives of the research reported here were to determine the growth, survival, or inactivation of selected microorganisms on individually wrapped processed cheese (IWC) slices stored at 5°C and 22°C, and to compare quality indices. IWC slices were spot-inoculated with foodborne pathogenic bacteria (Listeria monocytogenes, Staphylococcus aureus, and Salmonella spp.), spoilage bacteria (Pseudomonas spp. and Lactobacillus spp.), and spoilage molds (Penicillium spp. and Cladosporium spp.). Each bacterium was inoculated at 105 CFUs/g for determination of growth, survival, or inactivation. Molds were inoculated at 102 spores per gram and observed for growth. Fifty percent of the inoculated product samples were held at 5°C (to simulate refrigeration), and the other 50 percent were held at 22°C (to simulate ambient temperature) throughout shelf life. Samples taken on days 0, 3, 7, 10, 14, and 28 and after 2, 3, 6, and 9 months, and were evaluated for surviving cells (by means of appropriate selective media), color (with the cheese color guide), and lipid oxidation (by means of peroxide values). Bacterial inactivation was observed in all conditions. At 14 days, a 5-log reduction was observed for Listeria monocytogenes and Salmonella, while a 3-log reduction was observed for Staphylococcus aureus. For Pseudomonas spp. and Lactobacillus spp., a 2-log reduction was observed within 3 days, with an additional 1-log reduction noted after several months. Mold levels showed no change during the first several weeks of storage. At 84 days, mold levels decreased at 5°C, but they showed growth at 22°C, to approximately 105 CFUs/g. Visual color was evaluated on a 10-point National Cheese Institute scale. During storage at 5°C or 22°C, color became darker and values increased from 4 to 5 and 4 to 7, respectively. Higher peroxide values were also obtained for the samples held at 22°C versus 5°C. From a microbiological standpoint, pathogenic and spoilage bacteria were unable to grow in this product; however, long-term storage at 22°C led to lower product quality and mold growth.


Antimicrobial Resistance in Escherichia coli Isolated in Wastewater and Sludge from Poultry Slaughterhouse Wastewater Plants
Paulo Martins da Costa, Ph.D., Paulo Vaz-Pires, Ph.D., Fernando Bernardo, Ph.D.

Abstract
The authors investigated the antimicrobial resistance of Escherichia coli isolates in 22 samples of crude inflow, treated effluent, and sludge collected at the wastewater treatment plants of eight poultry slaughterhouses in Portugal. A total of 549 E. coli strains were recovered and tested for resistance to 12 antimicrobial agents. Multidrug resistance was present in 55.7 percent of the isolates. Resistance to tetracycline, ampicillin, trimethoprim/sulfamethoxazole, streptomycin, and enrofloxacin was found in 80.7 percent, 56.5 percent, 47.5 percent, 39.2 percent, and 18.4 percent of the isolates, respectively. Resistance rates of E. coli to nearly all of the tested antibiotics were higher in the strains obtained from the six slaughterhouses that handled conventional broilers than in the two slaughterhouses that handled free-range broilers. Wastewater treatment resulted in an E. coli decrease of between 0.5 log and 3 log; nevertheless, an average of 5.2 × 105 CFUs/100 mL were present in the outflow of the plants. These data indicate that the use of antimicrobials in poultry production leads to the selection of a large pool of resistance genes and that wastewater treatment processes are unable to inactivate the bacteria and thus will result in dissemination of resistant E. coli into the environment.


A Novel Technology to Improve Drinking Water Quality Using Natural Treatment Methods in Rural Tanzania
Shaaban Aman Mbogo, Ph.D.

Abstract
It is estimated that one billion people worldwide do not have access to treated drinking water. This paper reports on an investigation into the potential of indigenous or natural water treatment methods as alternatives to conventional chemical water treatment methods. The seeds of five natural plant species—Vigna unguiculata, Phaseolus mungo, Glycine max, Pisum sativam, and Arachis hypogea—were evaluated for the removal of turbidity, and their efficiency was compared with that of alum. The use of a solar energy-saving method to disinfect drinking water—leaving it to heat under the sun to reduce bacteria colonies—also was evaluated. The study revealed that for raw water with turbidity of 482 nephelometric turbidity units, coagulation with seed extracts from natural plant species reduced natural turbidity by 96.7 to 100 percent when the seed extract was used as the primary coagulant and by 100 percent when it was used as a coagulant aid. The study showed further that natural coagulants were as effective as commercial alum [Al2(SO4)3] and even superior for clarification because the optimum dosage was low compared with that of alum. Leaving samples of water clarified by natural coagulants on a black-painted roof for 8 hours achieved up to 100 percent bacteria kill.


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April 2008, Volume 70, No. 8
Differential Impacts of Smoke-Free Laws on Indoor Air Quality
Kiyoung Lee, Sc.D., C.I.H., Ellen J. Hahn, Ph.D., Nick Pieper, Chizimuzo T.C. Okoli, Ph.D., James Repace, M.S., Adewale Troutman, M.D.

Abstract
The authors assessed the impacts of two different smoke-free laws on indoor air quality. They compared the indoor air quality of 10 hospitality venues in Lexington and Louisville, Kentucky, before and after the smoke-free laws went into effect. Real-time measurements of particulate matter with aerodynamic diameter of 2.5 µm or smaller (PM2.5) were made. One Lexington establishment was excluded from the analysis of results because of apparent smoking violation after the law went into effect. The average indoor PM2.5 concentrations in the nine Lexington venues decreased 91 percent, from 199 to 18 µg/m3. The average indoor PM2.5 concentrations in the 10 Louisville venues, however, increased slightly, from 304 to 338 µg/m3. PM2.5 levels in the establishments decreased as numbers of burning cigarettes decreased. While the Louisville partial smoke-free law with exemptions did not reduce indoor air pollution in the selected venues, comprehensive and properly enforced smoke-free laws can be an effective means of reducing indoor air pollution.


Potential Health Effects Associated with Residential Proximity to Freeways and Primary Roads: Review of Scientific Literature, 1999–2006
Vickie L. Boothe, Derek G. Shendell, D.Env, M.P.H.

Abstract
This review presents epidemiologic evidence of adverse health effects associated with residential proximity to traffic. Of the 29 peer-reviewed studies that met the authors’ defined criteria, 25 reported statistically significant associations with at least one adverse health effect across a broad range of exposure metrics and diverse geographical locations. Specific pollutants contributing to the associated health effects could not, however, be identified, and uncertainties existed because of the lack of individual exposure assessments that could rule out confounding by other factors. Improved exposure assessments and future studies should be considered for better identification of contributing pollutants and mechanisms of action. In the meantime, additional policies, additional regulations, and improved land use and urban planning can better protect the public and limit exposure, especially for vulnerable populations such as pregnant women, children, and the elderly.

Role of Water-Saving Devices in Reducing Urban Water Consumption in the Mega-City of Tehran, Case Study: A Residential Complex
Gholamreza Nabi Bidhendi, Ph.D., Touraj Nasrabadi, M.Sc., Hamid Reza Sharif Vaghefi, M.Sc., Hassan Hoveidi, M.Sc., Hamid Reza Jafari, Ph.D.

Abstract
Iran is one of 27 countries that are likely to face increasing water shortage crises between now and 2025 unless action is taken to reduce currently high-per-capita urban water consumption. Accordingly, consumption control in the mega-city of Tehran will be an invaluable achievement. A study of Tehran water consumers has determined that household consumers are responsible for 70 percent of the total consumption. Keeping that figure in mind, the authors set out to assess rates of consumption by water fixtures, with an emphasis on household users, and to examine the effects of installing subcounters and reducers.They selected an apartment complex in which it was possible to install water subcounters for each unit. The first step was to evaluate resident attitudes. Block 3, which had 10 units, was selected to cooperate with the project.

The second step was to install counters for all 10 units to determine consumption by different fixtures. (The counters were installed in kitchens, in bathrooms, on toilets, on washing machines, and on flash tanks). In the next step, data entry forms for fixture consumption were completed for a period of 10 days. Then single-handle faucets and reducers were installed, and the outcomes were logged for a period of 10 days. Counter readings were performed by the volunteer residents or by educated personnel every 24 hours, and the total volume of inside consumption was compared with the consumption registered by a base counter placed outside each unit. In the course of the project, the consumption per capita was calculated every 24 hours to yield a real and unbiased model that is applicable to city of Tehran.
The results showed a total reduction in water consumption of about 20 percent. Thus, with suitable planning and application of cultural and technical methods, it is possible to optimize consumption in Tehran in the near future.


Temperature and Direct Effects on Population Health in Brisbane, 1986–1995
Peng Bi, M.Med.Sci., Ph.D., Kevin A. Parton, M.Sc., Ph.D., Jian Wang, M.D., Ph.D., Ken Donald, Ph.D., F.R.A.C.P.

Abstract
To assess the impact of weather on human mortality, particularly among elderly people and people with diseases, the authors conducted an ecological study in Brisbane, Australia. Correlation and autoregressive integrated moving average (ARIMA) regression analyses assessed the relationship between weather and mortality in the general population and the elderly population (65 years of age and older) over the period 1986–1995. In the summer, both cardiovascular diseases and all-cause mortality in the elderly population had significant positive correlations with monthly temperatures. In the winter, negative correlations were found between monthly mean maximum temperatures and cardiovascular-disease mortality, and between monthly mean minimum temperatures and respiratory-disease mortality. Regression models were developed for various target populations and produced similar results.

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May 2008, Volume 70, No. 9
Bedbug Infestations in the News: A Picture of an Emerging Public Health Problem in the United States
Alice L. Anderson, M.S., Ph.D., Korin Leffler

Abstract
Bedbug (Cimex lectularis) infestations have become a major complaint in all but three states in the United States. Increasing infestations have also been reported in Asia, Australia, Europe, and Canada. Newspaper articles often herald the onset of a new health issue for the public, and they can be used for epidemiological tracking of increasing populations of irritating and potentially serious vectoring pests. This news coverage model is useful in validating the typical spread of a new contagious entity, or in predicting the waves of public reaction to the spread of a new pest or health problem. The authors’ analysis covers the years 2001 to 2006, showing the incidence of bedbug news coverage from the East Coast, the Midwest, the South, and the West in the United States. Rural and urban examples are included in a four-year time frame starting with news in the Northeast and ending with an attempt to eradicate the pest from the state of Hawaii.


A Procedure for Detecting Childhood Cancer Clusters Near Hazardous Waste Sites in Florida
Greg Kearney, Dr.P.H., M.P.H., R.S.

Abstract
Despite over 20 years of research on childhood cancer clusters and hazardous waste sites, little evidence has been produced to indicate a causal relationship. Nevertheless, the perception of a childhood cancer cluster being located near a hazardous waste site can raise fear and uncertainty, and it demands attention from health officials. To investigate this public health concern, the author used the spatial-scan statistical software SaTScan to detect childhood cancer clusters and their proximity to National Priority List (NPL), or Superfund, sites in Florida. In the ecological study reported here, “most likely” clusters were defined as those with a p-value of <.05. Distance served as a proxy for exposure; a geographical information system (GIS) was used to determine the number of clusters within a predetermined distance of an NPL site. Spatial clusters were found to occur randomly throughout the state, with most clusters being identified in the more populated counties, and clusters less likely to occur near an NPL site. This article attempts to explain the utility of an emerging public health surveillance tool for detecting cancer clusters near hazardous waste sites. Despite several epidemiological limitations of the study, as well as the fact that there are other environmental exposure hazards such as Toxic Release Inventory facilities and landfills, the SaTScan program proved useful as a surveillance tool for generating more in-depth studies.


An Assessment of Lead Leachability from Lead-Glazed Ceramic Cooking Vessels
Robert Lynch, R.S., Ph.D., Brenda Elledge, Dr.PH., Christopher Peters, M.S.

Abstract
Since the early 1990s, numerous studies in Mexico have demonstrated an association between the use of lead-glazed ceramic cooking ware (LGC) and elevated blood lead levels. We sought to determine whether ceramic ware collected from the Hispanic community in Oklahoma City contained lead and to quantify the amount of lead that leached into foods cooked in those vessels. Lab results were combined with consumer intake levels for foods and compared with the provisional tolerable total intake level (PTTIL) for lead. The authors found that 52 percent of the vessels they tested exceeded the FDA action level for ceramic ware. Consumption of a low-pH food (tomatoes) cooked in 23 of 25 vessels would result in a dose of lead exceeding the PTTIL compared with 3 of 25 vessels and 5 of 25 vessels for a higher-pH foods (hominy and beans, respectively). The results of the study indicate that LGC is still used in the local community and represents a significant public health concern.


Health and Socioeconomic Effects of Groundwater Arsenic Contamination in Rural Bangladesh: New Evidence from Field Surveys
Nurun Nahar, M.A., M.Phil., Ph.D., Faisal Hossain, M.Eng., Ph.D., M. Delawer Hossain, Ph.D.

Abstract 
This report discusses the health and socioeconomic problems that have recently emerged in the Bangladesh countryside because of arsenic contamination of the groundwater. A survey found that men in rural households are generally found to be more susceptible to arsenicosis than women. The survey also indicated that villagers with lower annual income are more likely to experience arsenicosis. About 60 percent of the respondents indicated a willingness to pay up to a dollar of their monthly income for safe water. More than 70 percent of women were found to be willing to walk for five minutes to collect safe water. Awareness campaigns conducted over the last decade seem to have been effective for villagers. Overall, findings from the survey paint a picture of a gradually evolving social and health scenario in rural Bangladesh that health officials must heed to safeguard the public health of the rural public. 


Histological Alterations Observed in the Gills and Ovaries of Clarias gariepinus Exposed to Environmentally Relevant Lead Concentrations
Olanike K. Adeyemo, D.V.M., M.V.P.H., Ph.D.

Abstract
Sublethal levels of pollutants usually cause biochemical or physiological effects at the subcellular level in an organism. Death is too extreme a criterion for determination of whether a substance is harmful or not; it is therefore important to find biomarkers of health and sublethal toxicant effects. In the 11 local-government areas of Ibadan, a large metropolitan area in Nigeria, previous studies of lead levels in surface water and fish ponds revealed surface water levels in ranges of 0.5–2.35 mg/L (mean = 0.76 mg/L) during the dry season and 1.15–2.20 mg/L (mean = 1.34 mg/L) during the rainy season, and a range of 1.09–2.9 mg/L (mean = 1.88 mg/L) in fish ponds.
In the study reported here, Clarias gariepinus was exposed to environmentally relevant concentrations (0.0, 0.05, 0.1, 0.5, and 1 mg/L) of lead nitrate over a period of eight weeks. The goal was to assess histological alterations in the gills and ovaries. The lesions observed in the gills included epithelial hyperplasia, atrophy and fusion of gill filaments, and marked degeneration and necrosis of the epithelial cells, with hemorrhages and marked disorganization and rupture in the secondary lamellae. In the ovaries, diffuse mild degeneration and necrosis of the follicles were initially observed; subsequently, the groups exposed to higher concentrations of lead nitrate showed marked severe degeneration of ovarian follicles.
The results of this work clearly indicate that lead has adverse effects on the gills and ovaries of Clarias gariepinus. The severity of lesions caused by lead nitrate was positively correlated with the concentration.


Environmental Chemicals in People: Challenges in Interpreting Biomonitoring Information
Judy S. LaKind, Ph.D., Leila Barraj, Ph.D., Nga Tran, Ph.D., Lesa L. Aylward, M.S.

Abstract 
Biomonitoring, the measurement of chemicals in blood, urine, and other tissues or fluids, is becoming an increasingly common tool in the study of human exposure to environmental chemicals and the potential health effects of those chemicals. The National Health and Nutrition Examination Survey (NHANES) now includes biomonitoring data for hundreds of chemicals as well as information on other health and demographic endpoints for thousands of individuals in the United States. The NHANES databases provide valuable information for deriving reference ranges and trend information and can be used for hypothesis-generating analyses, but they cannot be used to establish causal relationships between environmental chemicals and health effects. This commentary examines issues unique to the use of such databases and the interpretation of biomonitoring-based epidemiological studies.

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June 2008, Volume 70, No. 10
The Challenge of Multiple Chemical Sensitivity
Taylor R. Spencer, M.D., M.P.H., Paul M. Schur, M.P.H., R.S.

Abstract
Environmental health professionals frequently come across a health-related problem with no clear cause-and-effect relationship. A typical case occurs when a person complains of experiencing symptoms, often in an indoor setting, that may vary from vague to severe. Multiple Chemical Sensitivity (MCS) may be a factor at play in some of these situations. The condition is characterized by persistent symptoms that follow exposure to chemically unrelated compounds at doses well below those that have been established individually to cause harmful effects. An understanding of MCS among environmental health and medical professionals is encouraged. The following article provides a review of the current literature about MCS and discusses the difficulties, from various sources, in resolving health complaints that may be caused by exposure to low doses of multiple chemicals.


The Practice of the 10 Essential Services and Abilities in the 14 Core Competencies of Alabama Environmental Health Practitioners
R. Kent Oestenstad, Ph.D., C.I.H., Elizabeth H. Maples, Ph.D., Christie McCullum-Hill, Dr.P.H.

Abstract
Leading public health agencies have developed guidelines for essential services and core competencies. The study described here was conducted to determine the level of practice of the 10 essential services and abilities in the 14 core competencies among environmental public health practitioners in Alabama. Questionnaires about the practice of the essential services, abilities in the core competencies, and demographics were collected from 255 (88%) practitioners and analyzed by statistical methods. According to the results of this study, these practitioners spent most of their time diagnosing, investigating, enforcing, educating, and linking people to public health services. They had increasing levels of practice as they were promoted to higher-level jobs, and the level of practice was greater in rural counties than in urban. They rated their skill in all of the core competencies to be at least pretty good. Practitioners with high school degrees had lower abilities than those with college degrees. Overall, these professionals were better educated, younger, and had better skills than expected.


PACE EH Post Project Assessment of Quality of Life Changes in a Florida Community Related to Infrastructure Improvements
Laurel Harduar-Morano, M.P.H., Julianne R. Price, R.S., Daniel Parker, M.S.P., Carina Blackmore, D.V.M., Ph.D.

Abstract
The Indian River county health department, environmental health division (IRCHD EH) in Florida implemented the Protocol for Assessing Community Excellence in Environmental Health (PACE EH) in the low-income community of West Wabasso, Florida. Over two and a half years, IRCHD EH worked with the community and various governmental agencies to bring much-needed improvements to the area. At the end of the two and a half years, a survey was conducted to discover if the residents’ quality of life had increased due to the community’s improvements. The survey results yielded high satisfaction rates among residents. The general response was that their feelings of safety and overall well-beingattributed to infrastructure improvements in their communityhad increased significantly. An unforeseen benefit realized by all parties involved was a renewed trust in government. The majority of surveyed residents (91%) felt that governmental agencies were better able to respond to their issues. 


Characterization of Seasonal Indoor and Outdoor Bioaerosols in the Arid Environment of El Paso, Texas
Linda C. Mota, M.P.H., Shawn G. Gibbs, M.S., Ph.D., Christopher F. Green, M.S., Ph.D., Fernanda Payan, Patrick M. Tarwater, M.S., Ph.D., Melchor Ortiz, M.S., Ph.D.

Abstract
The authors conducted a study in the El Paso, Texas, region to assess the seasonal bioaerosol concentrations in a convenience sample of one-story residences. The authors sampled the same houses for each season over the course of a year (March 2005 to February 2006) to determine bacterial and fungal concentrations. They used a two-stage ambient culturable sampler system to collect the bioaerosol samples. They took indoor and outdoor bioaerosol samples and studied meteorological conditions for each house at each season. The study found that most of the measured bioaerosol concentrations differed statistically by season (p < .05). The greatest concentrations throughout the year were found to occur in fine-sized indoor bacteria during the winter. Meteorological conditions were found not to significantly influence bioaerosol concentrations throughout the year. 


Inactivation of Surface Viruses by Gaseous Ozone
Chunchieh Tseng, Ph.D., Chihshan Li, Ph.D.

Abstract
Environmental surfaces may be contaminated with viruses and contribute to their transmission. Concerns have arisen in trying to control viruses because of an increasing incidence of viral infections. Ozone is considered to be a promising method to inactivate viruses on surfaces. In this investigation, the effects of ozone concentration, contact time, different capsid architecture of viruses, and relative humidity (RH) on inactivating viruses by ozone were evaluated. The authors observed that the survival fraction of viruses on surfaces decreased exponentially with increasing ozone dose. Viruses required ozone doses of 20112 min(mg/m3) (contact time [min] multiplied by ozone concentration [mg/m3]) for 90% inactivation and 47223 min(mg/m3) for 99% inactivation. The ozone dose for 99% inactivation was two times higher than for 90% inactivation. The required ozone concentration at 85% RH was lower than at 55% RH. In summary, ozone should be an effective method for reducing the viral number between 1 and 3 logs on surfaces.


The Prevalence of Intestinal Parasites and Nasal S. aureus Carriage among Food Handlers
Turan Gündüz, M.D., Ph.D., M. Emin Limoncu, M.D., Ph.D., Sedat Çümen, Ali Arı, Serdağ Etiz, M.D., Ziya Tay, M.D. 

Abstract
Food handlers play a major role in the transmission of foodborne diseases. Nasal Staphylococcus aureus (S. aureus) carriage and intestinal parasitism are important risk factors in contamination. The purpose of the authors’ study was to determine the prevalence of intestinal parasites and nasal S. aureus carriage among food handlers in Manisa, Turkey. The authors investigated 8,895 people for nasal S. aureus carriage and intestinal parasites. Nasal swab materials and stool samples were examined, and anal cellophane band method was performed. The authors found that S. aureus was isolated in 69 (0.77%) samples. All S. aureus strains were oxacilline sensitive. Intestinal parasites were found in 784 (8.8%) samples. The most common parasites were Entamoeba histolytica (69.9%) and Giardia intestinalis (24.6%). The authors conclude that food handlers should be screened and treated from time to time and that a periodic program of health education on food safety and hygiene should be given.

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