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.


In the U.S., 60% of norovirus outbreaks are attributed to long-term care facilities (LTCFs). A descriptive study of 26 LTCFs in South Carolina was conducted to determine the presence of environmental factors associated with transmission of human noroviruses. Sanitary conditions in one common area, one staff/visitor bathroom, and the main kitchen were assessed using two audit forms. While surfaces in all kitchens were in good sanitary condition, 23 LTCFs used quaternary ammonium-based sanitizers and three LTCFs used chlorine bleach for kitchen sanitization. All common areas were also clean and in good condition; however, 20 LTCFs had upholstered chairs, and five LTCFs had carpeted floors. Seven facilities used quaternary ammonium-based disinfectants exclusively, whereas six LTCFs used chlorine bleach exclusively, and eight LTCFs used both to disinfect common areas. Seven staff/visitor bathrooms were accessible to residents, and hand washing signage was missing from 10. These results reveal the presence of environmental factors that might facilitate norovirus transmission within LTCFs.

September 2016
September 2016
79.2 | 22-29
Lalani Jayasekara, MS, Cortney M. Leone, MS, Julia Sharp, PhD, Morgan Getty, MS
Additional Topics A to Z: Pathogens and Outbreaks


Previous research has suggested differences between public and professional understanding of the field of environmental health (EH) and the role of EH services within urban and rural communities. This study investigated EH priority differences between 1) rural and urban residents and 2) residents and EH professionals, and presents quantitative and qualitative methods for establishing locality-specific EH priorities. Residents (N = 588) and EH professionals (N = 63) in Alabama identified EH priorities via a phone or online survey. We categorized rurality of participant residences by rural–urban commuting area codes and population density, and tested whether or not EH priorities were different between urban and rural residents. Built environment issues, particularly abandoned houses, and air pollution were high priorities for urban residents—whereas, water and sanitation issues, and paper mill-related pollution were high priorities in rural communities. EH professionals ranked food safety and water and sanitation issues as higher priorities than residents did. Results highlight the importance of urbanicity on environmental risk perception and the utility of simple and inexpensive engagement methods for understanding these differences. Differences between residents and EH professionals suggest improving stakeholder participation in local-level EH decision making might lead to greater awareness of EH services, which might in turn improve support and effectiveness of those services

December 2017
December 2017
80.5 | 28-36
Connor Y.H. Wu, PhD, Department of Population Health Sciences, Virginia–Maryland Regional College of Veterinary Medicine, Virginia Tech, Mary B. Evans, MA, Center for the Study of Community Health, School of Public Health, University of Alabama at Birmingham, Paul E. Wolff, Survey Research Unit, School of Public Health, University of Alabama at Birmingham, Julia M. Gohlke, PhD, Department of Population Health Sciences, Virginia–Maryland Regional College of Veterinary Medicine, Virginia Tech

Article Abstract

The study described in this article evaluated surface survivability of culturable Pseudomonas aeruginosa by time and type (glass, stainless steel, and laminate) using two sampling techniques: contact plates and surface swabs. Recovery of P. aeruginosa decreased logarithmically over time and varied by surface type. P. aeruginosa survival averaged 3.75, 5.75, and 6.75 hours on laminate, glass, and stainless steel, respectively. Culturable P. aeruginosa loss on stainless steel and glass were not different (p > .05); however, laminate had significantly greater loss at each time point than either glass or stainless (p < .05). A comparison of surface swab and contact plate collection efficiencies found no significant difference for laminate surfaces. Swabs, however, had a higher collection efficiency than contact plates (p < .05).

For the first time, the authors report P. aeruginosa mean survival time of 3.75–6.75 hours on clinically relevant surfaces, with P. aeruginosa on stainless steel surviving the longest. Their data also indicate that culturable surface sampling appears to most accurately represent actual P. aeruginosa surface loading when swab sampling is used.


May 2014
76.9 | 16-20
Eric A. Lutz, PhD, Tia M. Jones
Additional Topics A to Z: General Environmental Health

Article Abstract

Extensive literature has already documented the deleterious effects of heavy metal toxins on the human brain and nervous system. These toxins, however, represent only a fraction of the environmental hazards that may pose harm to cognitive ability in humans. Lead and mercury exposure, air pollution, and organic compounds all have the potential to damage brain functioning yet remain understudied. In order to provide comprehensive and effective public health and health care initiatives for prevention and treatment, we must first fully understand the potential risks, mechanisms of action, and outcomes surrounding exposure to these elements in the context of neurocognitive ability. This article provides a review of the negative effects on cognitive ability of these lesser-studied environmental toxins, with an emphasis on delineating effects observed in child versus adult populations. Possible differential effects across sociodemographic populations (e.g., urban versus rural residents; ethnic minorities) are discussed as important contributors to risk assessment and the development of prevention measures. The public health and clinical implications are significant and offer ample opportunities for clinicians and researchers to help combat this growing problem.


Jan/Feb 2014
76.6 | 130-138
Jianghong Liu, PhD, Gary Lewis
Additional Topics A to Z: Children's Environmental Health

Book: Essentials of Environmental Health (Second Edition)Essentials of Environmental Health (Second Edition) provides a clear and comprehensive study of the major topics in environmental health.

Environmental threats are occurring on a worldwide scale. Dramatic pictures showing the devastating effects of natural disasters lead the nightly news. Stories of oil spills, contaminated groundwater, deforestation, and depleted fisheries appear in the pages of newspapers daily.

National and international policymakers are concerned about the potential impact on the health of the world’s population and, as a result, much progress has been made in informing the public and introducing regulations with the hopes of containing these hazards.

Robert H. Friis
Additional Topics A to Z: General Environmental Health


Preventable foodborne diseases are a significant problem in the U.S. and 9.4 million illnesses per year are associated with contaminated food. For this study, 86 Western Carolina University students living on campus or in the state of North Carolina participated using a nonprobability, snowball sampling technique. We collected data using a Qualtrics survey regarding demographics, basic knowledge of food safety, and expectations of food service regulations. This study found that college students lack basic knowledge of food safety and have excessive expectations of the food service regulatory system. Food service operators and managers have the ultimate responsibility of providing a safe product to consumers, and the role of health officials is to promote prevention through consultation and education to employees and owners of food service facilities. Educating college students about the limitations of the food service regulatory system will allow for more informed decisions in the interest of their health and wellness.


July 2018
July/August 2018
81.1 | 16-20
Nathan McNeilly, MHS, REHS, Cleveland County Health Department, Brian Raming, PhD, NREMT-P, Western Carolina University