Topics A to Z

As part of NEHA's continuos effort to provide convenient access to information and resources, we have gathered together for you the links in this section. Our mission is "to advance the environmental health and protection professional for the purpose of providing a healthful environment for all,” as well as to educate and inform those outside the profession.


During July–August 2013, a gastroenteritis outbreak occurred among rafters at Idaho’s Middle Fork of the Salmon River. To identify the agent, source, and risk factors for illness, we solicited ill and well persons who rafted during July 1–September 23 to respond to an online survey, and conducted a case-control study. Cases were defined as nausea, vomiting, or diarrhea ≤25 days after rafting; control subjects were rafters who did not have these symptoms. Illness was associated with having consumed filtered river water—70% of (69/98) case subjects and 38% of (106/280) control subjects had consumed filtered water (odds ratio [OR] = 3.9; 95% confidence interval [CI] [2.4, 6.4]). In a follow-up online survey of 33 case subjects and 73 control subjects, boiling water for drinking was protective against illness; 2/18 case subjects, compared with 15/33 control subjects, had boiled their drinking water (OR = 0.2; 95% CI [0.03, 0.9]). From ill rafters, norovirus (n = 3) and Giardia (n = 8) were detected in stool specimens. Norovirus was detected on surfaces and E. coli in surface water used for drinking. Adherence to backcountry drinking water treatment recommendations is advised.

July 2017
July/August 2017
80.1 | 14-21
Mariana Rosenthal, MPH, PhD, Epidemic Intelligence Service, Centers for Disease Control and Prevention, Idaho Department of Health and Welfare , Michael Taylor, MHE, CHES, Eastern Idaho Public Health District, Kenneth S. Anderson, III, MSPH, Eastern Idaho Public Health District, Kris K. Carter, MPVM, DVM, DACVPM, Centers for Disease Control and Prevention, Idaho Department of Health and Welfare
Additional Topics A to Z: Recreational Waters

Studies about environmental burdens often explore overall community risk. Increasing evidence suggests, however, differential burdens by gender and age. The purpose of the authors’ research was to determine if gender-related difference exists among children in a region plagued with poor air quality and if increased exposure to pollutants from a major goods movement rail yard influences the relationship. Using a cross-sectional study design, the authors provided respiratory screening for children at two elementary schools. Compared to females, males were at significantly greater odds of exhibiting elevated fractional exhaled nitric oxide (FeNO) but less likely to exhibit reduced lung volume. Even in an area of overall poor air quality, the authors found that male children were a vulnerable subpopulation for greater elevated FeNO, while females were at increased risk for reduced lung capacity. Understanding differential burdens in vulnerable subpopulations is critical to providing timely and responsive strategies targeted towards health-based prevention and intervention activities.

January 2016
January/February 2016
78.6 | 8-16
Rhonda Spencer-Hwang, DrPH, Sam Soret, PhD, Mark Ghamsary, PhD, Nico Rizzo, PhD
Additional Topics A to Z: Children's Environmental Health


Lake County, California, is in a high geothermal-activity area. Over the past 30 years, the city of Clearlake has reported health effects and building evacuations related to geothermal venting. Previous investigations in Clearlake revealed hydrogen sulfide at levels known to cause health effects and methane at levels that can cause explosion risks. The authors conducted an investigation in multiple cities and towns in Lake County to understand better the risk of geothermal venting to the community. They conducted household surveys and outdoor air sampling of hydrogen sulfide and methane and found community members were aware of geothermal venting and some expressed concerns. The authors did not, however, find hydrogen sulfide above the California Environmental Protection Agency air quality standard of 30 parts per billion over one hour or methane above explosive thresholds. The authors recommend improving risk communication, continuing to monitor geothermal gas effects on the community, and using community reports and complaints to monitor and document geothermal venting incidents.

December 2015
December 2015
78.5 | 14-21
Cindy H. Chiu, MPH, PhD, Matthew J. Lozier, MPH, PhD, Tesfaye Bayleyegn, MD, Karen Tait, MD


Often during an outbreak of foodborne illness, there are health officials who have data indicating that there is a risk prior to notifying the public. During the lag period between the first public health signal and some release of public information, there are decision makers who are weighing evidence with the impacts of going public. Multiple agencies and analysts have lamented that there is not a common playbook or decision tree for how public health agencies determine what information to release and when. Regularly, health authorities suggest that how and when public information is released is evaluated on a case-by-case basis without sharing the steps and criteria used to make decisions. Information provision on its own is not enough. Risk communication, to be effective and grounded in behavior theory, should provide control measure options for risk management decisions. There is no indication in the literature that consumers benefit from paternalistic protection decisions to guard against information overload. A review of the risk communication literature related to outbreaks, as well as case studies of actual incidents, are explored and a blueprint for health authorities to follow is provided.

March 2017
March 2017
79.7 | 8-14
Benjamin Chapman, PhD, Maria Sol Erdozaim, Douglas Powell, PhD

A Minnesota study found higher levels of ammonia and total organic carbon than expected in groundwater sources. During this session, we will identify the issues ammonia can cause in water distribution systems and develop a free ammonia management, disinfection, and/or nitrification control strategy to minimize undesirable consequences caused by these contaminants.

July 2015
David Schultz, PE
Potential CE Credits: 1.00

Book: HACCP for Processors: A Step-By-Step GuideFood safety is everyone’s concern—especially facilities that produce, manufacture, distribute, ship, or import food products. Hazard analysis and critical control point (HACCP) principles are required for many of these operations. HACCP for Processors: A Step-By-Step Guide provides you with the necessary knowledge for understanding, writing, and implementing a food safety management system based on HACCP principles. This risk-based and proactive food safety management system was originally developed for NASA to ensure safe food for astronauts. It is now an international standard for controlling foodborne risks. This comprehensive textbook is designed teach the principles of HACCP and also to be a valuable reference book for your food safety library. It can be used on its own or in conjunction with NEHA’s online HACCP course.

For more information please contact Trisha Bramwell,, 303.802.2166


January 2011
Additional Topics A to Z: HACCP