Copyright 2010, National Environmental Health Association.          Printer-friendly PDF       
View 2009 Abstracts  View 2008 Abstracts   View 2007 Abstracts

January/February 2010

• Assessment of Athletic Health Care Facility Surfaces for MRSA in the Secondary School Setting

• Prevalence of Community-Associated Methicillin-Resistant Staphylococcus Aureus in High School Wrestling Environments

• A Pilot Survey of In-Service Home Arsenic Tracked in from Chromated Copper Arsenate–Treated Decks

• The Role of Environmental Health in the Health Care System

• (Compendium): Nitrate and Nitrite Levels of Potable Water Supply in Warri, Nigeria: A Public Health Concern

• (Compendium): Meeting the Environmental Health Training Challenges of the Local Public Health Workforce in Massachusetts

• (Compendium): Exposure to Video Display Terminals and Risk of Small-for-Gestational-Age Birth

• (Compendium): Public Health Ecology

• (Compendium): Urban Heat Island and Air Pollution—An Emerging Role for Hospital Respiratory Admissions in an Urban Area

• (Compendium): Metal Concentrations in Blood and Hair in Pregnant Females in Southern Sweden

• Hospital Emergency Department Visits for Carbon Monoxide Poisoning Following an October 2006 Snowstorm in Western New York

March 2010

• General Public Health Considerations for Responding to Animal Hoarding Cases

• Analyses of the eFORS (Electronic Foodborne Outbreak Reporting System) Surveillance Data (2000–2004) in School Settings

• The National Exposure Registry: History and Lessons Learned

January/February 2010, Volume 72, No. 6

Assessment of Athletic Health Care Facility Surfaces for MRSA in the Secondary School Setting
Kyle Montgomery, LAT, ATC, Timothy J. Ryan, PhD, CIH, CSP, Andrew Krause, PhD, LAT, ATC, Chad Starkey, PhD, LAT, ATC

Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) was once largely a hospital-acquired infection, but increasingly, community-associated MRSA (CA-MRSA) is causing outbreaks among otherwise healthy people in athletic settings. Secondary school athletic trainers, student athletes, and the general student population may be at elevated risk of MRSA infection. To identify the prevalence of MRSA on surfaces in high school athletic training settings, 10 rural high school athletic training facilities and locker rooms were sampled for MRSA. Results showed 90% of facilities had two or more positive MRSA surfaces, while one school had no recoverable MRSA colonies. Of all surfaces tested (N = 90), 46.7% produced a positive result. From this limited sample, it is evident that significant exposure opportunities to MRSA exist in athletic training clinics and adjacent facilities for both the patient and the clinician. Furthermore, the findings point to the need for community hygiene education about skin and soft tissue infections like MRSA.


Prevalence of Community-Associated Methicillin-Resistant Staphylococcus Aureus in High School Wrestling Environments
Bethany Stanforth, LAT, ATC, Andrew Krause, PhD, LAT, ATC, Chad Starkey, PhD, LAT, ATC
Timothy J. Ryan, PhD, CIH, CSP

Abstract
Methicillin-resistant Staphylococcus Aureus (MRSA) was predominantly a hospital-acquired organism; recently, however, community-associated MRSA (CA-MRSA) has been causing outbreaks in otherwise healthy individuals involved in athletics. As such, CA-MRSA is of emerging concern to sanitarians and public health officials. Secondary school athletic trainers and student athletes may be at elevated risk of spreading or contracting MRSA. The absence of proper hygiene protocols or equipment may further increase this risk. In the study discussed in this article, environmental samples were obtained to identify the prevalence of MRSA on surfaces in high school athletic training and wrestling facilities mats in nine rural Ohio high schools. Frequencies and descriptive statistics were prepared. All nine (100%) of the sites tested had at least one positive sample for the presence of MRSA. The need for heightened sanitation, hygiene education of affected persons about skin and soft tissue infections like MRSA, and intervention opportunities for public health professionals are discussed.


A Pilot Survey of In-Service Home Arsenic Tracked in from Chromated Copper Arsenate–Treated Decks
Cole Sigmon, Steve Patch, PhD

Abstract
Arsenic is a known carcinogen. It is also known to be readily dislodgeable from chromated copper arsenate (CCA)–treated lumber. The floors of in-service homes were tested for inorganic arsenic using a wipe method similar to the U.S. Housing and Urban Development (HUD) method for lead dust clearance sampling. Additionally, a hand-sampling method was used that involved direct dermal contact with the indoor floor surface. Amount of dislodgeable arsenic on the decks was highly correlated with arsenic concentrations on the indoor floors. Indoor arsenic concentrations were highest directly adjacent to the door. Concentrations in samples taken from the middle of rooms were less than half the concentrations of door samples, while concentrations in samples taken from untrodden floor space in the corners were mostly below the method detection limit. At a home without a CCA-treated deck, no measurable arsenic was found.


The Role of Environmental Health in the Health Care System
Monroe T. Morgan, DrPH

Abstract
What determines the health of the over 6.7 billion people in the world? What determines the health of the over 306 million individuals who currently inhabit the United States of America? The pressure of rising health care costs increases the need to understand the determinants of health and the role of environmental health in the health care system. In his guest commentary, Dr. Morgan discusses the four basic determinants of health: hereditary or biological factors, medical care, lifestyle, and environment.


(Compendium): Nitrate and Nitrite Levels of Potable Water Supply in Warri, Nigeria: A Public Health Concern
John Kanayochukwu Nduka, Orish Ebere Orisakwe, PhD, Linus Obi Ezenweke

Abstract
In this study, the authors investigated the nitrate and nitrite in different water sources (surface water, shallow well water, and borehole water) in the market and industrialized areas of Warri in the Niger Delta area of Nigeria. The authors’ goal was to find the comparative levels of nitrates and nitrites from these two parts of the community. They selected five sampling sites from industrialized areas and another five from market areas. Nitrate and nitrites were determined using a DR/4000 UV-Vis spectrophotometer. The appreciable quantities of nitrates and nitrites found in these investigations have some public health implications. This study suggests that indiscriminate disposal of waste and poor sanitation may be additional contributing factors in the nitrate pollution of the water supply in the Niger Delta area of Nigeria.


(Compendium): Meeting the Environmental Health Training Challenges of the Local Public Health Workforce in Massachusetts
Kathleen MacVarish, MS, RS/REHS, Donna Moultrup, RN, CHO, Steven J. Ward, MA, MPH, REHS

Abstract
In Massachusetts, the public health delivery system is mainly decentralized with 351 municipalities providing a large array of environmental and public health services through their local health agencies (boards of health or health departments). In many other states these services are delivered at the county or state agency levels, but in Massachusetts they are provided by each city and town. In addition to issues related to staff size and funding of agencies, a major workforce training gap exists in Massachusetts. In an effort to address this training gap with a comprehensive course that would introduce new and current staff members to their roles and responsibilities when working in an LHA in Massachusetts, volunteers from the Coalition for Local Public Health (Coalition), which includes the Massachusetts Environmental Health Association (MEHA), attempted to create a curriculum that would cover the full scope of these responsibilities.


(Compendium): Exposure to Video Display Terminals and Risk of Small-for-Gestational-Age Birth
Fabio Parazzini, MD, Francesca Chiaffarino, ScD, Liliane Chatenoud, ScD, Sonia Cipriani, ScD,
Elena Ricci, ScD, Vito Chiantera, MD, Renata Bortolus, MD, Cristina Maffioletti, MD

Abstract
In this study, the authors analyzed the association between video display terminal (VDT) use before and during the three trimesters of pregnancy and risk of small-for-gestational-age (SGA) birth in a case-control study. The cases for this study were 555 women who delivered SGA births. The controls were 1,966 women who gave birth at term to healthy infants of normal weight. In terms of the length of exposure, the odds ratios (OR) of SGA birth were 1.2 for less than one hour and 1.3 for between two and 20 hours per week. For higher usage (more than 20 hours per week), the OR was 1.2 (95% CI: [Confidence Interval] 0.9–1.7). The authors conclude that this study does not show any association between VDT use and risk of SGA birth.


(Compendium): Public Health Ecology
Christopher J. Coutts, MPH, PhD

Abstract
The objective of this column is to offer public health ecology as a method to conceptualize the deleterious connections between land conservation and human health. A vital part of our efforts in sustainability and creating ecologically sensitive and health-supporting environments is the conservation and rehabilitation of the green infrastructure that delivers not only basic environmental needs essential to sustaining life but also the behaviors that ameliorate chronic disease. Public health ecology adopts the interrelationship between humans and their environment, and the quality of this relationship is measured in the health of the persons who are dependent on its form and structure.


(Compendium): Urban Heat Island and Air Pollution—An Emerging Role for Hospital Respiratory Admissions in an Urban Area
Li-Wei Lai, PhD, Wan-Li Cheng, PhD

Abstract
The aim of the study discussed here was to determine the associations among the urban heat island (UHI), air quality, and hospital respiratory admissions in the warm center of an urban area. The authors collected and analyzed the data regarding air quality parameters, meteorological parameters, and the daily hospital respiratory admissions in the Taichung metropolis in the autumns of 2003 and 2004. By collecting the vertical meteorological parameters and air pollutant concentrations via the tethersonde balloon technique, the authors simulated convergence in Dali using The Air Pollution Model (TAPM) for the atmospheric conditions. The authors also examined the hypotheses with Duncan’s Multiple Range test, and analyzed spatial patterns vis-à-vis air temperature, air quality, and hospital respiratory admissions with GIS. The results indicated that the UHI phenomenon—which generates convergence and then transports air pollutants to a metropolitan area—increases hospital respiratory admissions in the warm center of an urban area.


(Compendium): Metal Concentrations in Blood and Hair in Pregnant Females in Southern Sweden
Lars Gerhardsson, MD, Thomas Lundh, PhD

Abstract
The study described here was comprised of 100 pregnant females from two prenatal care units at the cities of Hassleholm and Simrishamn in southern Sweden. It included a questionnaire as well as whole blood (total mercury, cadmium, and lead) and hair (total mercury) sampling (collection period 2002–2003). The median values of total mercury (B-Hg 0.70 µg/L; range 0.27–2.1 µg/L), cadmium (0.30 µg/L, 0.05–4.8 µg/L) and lead (11.0 µg/L, 4.2–79 µg/L) in whole blood were low in the total material, as were the hair mercury concentrations (Hair-Hg 0.22 µg/g, 0.04–0.83 µg/g). In a multiple linear regression model, B-Hg was related to the number of fish meals per week and to the number of occlusal amalgam fillings (multiple r = 0.51; p < .001). The levels of mercury, cadmium, and lead in whole blood were lower than suggested biological reference intervals, and did not indicate risks for adverse health effects.


Hospital Emergency Department Visits for Carbon Monoxide Poisoning Following an October 2006 Snowstorm in Western New York
Neil A. Muscatiello, MS, Gwen Babcock, MS, Rena Jones, MS, Edward Horn, PhD, Syni-An Hwang, PhD

Abstract
Following an October 2006 snowstorm that caused widespread power outages in western New York State, hospital emergency department (ED) visits for carbon monoxide (CO) poisoning increased. Overall, 264 people representing 155 households were diagnosed with CO poisoning during the power outages. Telephone interviews were conducted with a subset of these individuals. Respondents provided information about exposure sources, CO alarms, and awareness of CO warnings. In many households, portable generators were operated in an enclosed area. Awareness of CO warnings may have contributed to knowledge about locating portable generators outside. When operated outside, however, portable generators were generally located too close to the home. Gas kitchen ranges were used for heat by numerous households. In the short term, CO education and improved clarity of CO warning information is important for increasing awareness about power outage–related CO risks. Improvements in the combustion efficiency of portable generators should be a long-term goal.


 

March 2010, Volume 72, No. 7


General Public Health Considerations for Responding to Animal Hoarding Cases
Louisa Castrodale, DVM, MPH, Yvonne M. Bellay, DVM, MS, Catherine M. Brown, DVM, MSc, MPH, Fredric L. Cantor, DVM, MPH, John D. Gibbins, DVM, MPH, Marcia L. Headrick, DVM, MPH, Mira J. Leslie, DVM, MPH, Kathleen MacMahon, DVM, MS, Jeanette M. O’Quin, DVM
Gary J. Patronek, MS, VMD, PhD, Rodrigo A. Silva, MVZ, MPH, James C. Wright, DVM, PhD
Diana T. Yu, MD, MSPH

Abstract
Animal hoarding is an under-recognized problem that exists in most communities and adversely impacts the health, welfare, and safety of humans, animals, and the environment. These guidelines address public health and worker safety concerns in handling situations where animal hoarding or other dense concentrations of animals have caused unhealthy and unsafe conditions. Because animal hoarding situations are often complex, a full response is likely to be prolonged and require a cross-jurisdictional multiagency effort. Each animal hoarding case has unique circumstances related to the types and numbers of animals involved, the physical structure(s) where they are being kept, and the health status of the animals, among other factors that must be taken into account in planning a response. Some general public health considerations and associated recommendations for personal protective equipment use are presented that apply to all cases, however.


Analyses of the eFORS (Electronic Foodborne Outbreak Reporting System) Surveillance Data (2000–2004) in School Settings
Margaret Venuto, MA, MPH, Brenda Halbrook, MS, RD, Marion Hinners, MS, Audrina Lange,
Stephanie Mickelson, MHS

Abstract
Frequently cited statistics indicate that the burden of foodborne disease is a serious public health problem, particularly for vulnerable populations such as children. The purpose of the descriptive retrospective study discussed in this article was to analyze data collected within the Electronic Foodborne Outbreak Reporting System (eFORS) in school settings in order to examine the magnitude of foodborne disease etiologies and to recommend strategies for prevention. Data on foodborne outbreaks (N = 96) and illnesses (N = 6,567) were extracted and analyzed from the Centers for Disease Control and Prevention’s (CDC’s) eFORS spanning the years 2000 to 2004.


The National Exposure Registry: History and Lessons Learned
Myron G. Schultz, MD, FACP, James H. Sapp II, MS, Caroline D. Cusack, MSPH, Jennifer M. Fink, MPH, CHES

Abstract
The National Exposure Registry (NER) was created as a comprehensive group of data repositories that sought, over time, to relate specific environmental exposures to dioxin, trichloroethylene (TCE), benzene, and trichloroethane (TCA) to registrants’ health conditions. Some parts of the NER were well conceived, whereas others were not. The most important design deficiency of the NER was its inability to adequately assess exposure. This was the key missing element and the Achilles heel of the NER program. At least three other important issues were never satisfactorily resolved in the design of the NER. They were unverified self-reporting, appropriate control groups, and the use of biomarkers. The many health effects that were observed to be in excess when compared with national norms might be explained by methodological differences in data analysis and reliance on self-reported nonverified data. Creating and maintaining a population-based chemical exposure registry is a more difficult challenge than creating and maintaining an outcome registry, such as a cancer registry.

Back to top