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.


Outbreaks of foodborne illness caused by Clostridium perfringens are not usually the result of intoxication and testing of suspected menu items for colony count can often identify the causative item. We describe a large outbreak at a county correctional facility in which the data suggest that illness by intoxication contributed substantially to the outbreak: 29 out of 108 surveyed cases (26.9%) developed symptoms within 2.5 hr of when meal service began. Inmate testimony further suggests advanced food decay. Bacterial analyses of food samples indicated a smaller population of C. perfringens in the chicken taco meat mixture (<10 CFU/g, enterotoxin positive) compared with other items. Statistical analyses of food history data provided substantially more support for the chicken taco meat mixture as causative (odds ratio = 55.79, 95% confidence interval [19.72, 157.83], p < .001) than other menu items. Environmental investigation and testimony from inmates provided additional support implicating the chicken taco meat mixture.

July 2017
July/August 2017
80.1 | 8-13
Adam E. London, MPA, RS, DAAS, Kent County Health Department, Julie A. Payne, MPH, Kent County Health Department, Brian Hartl, MPH, Kent County Health Department
Additional Topics A to Z: Pathogens and Outbreaks

Article Abstract

During the summer of 2005 an outbreak of norovirus acute gastroenteritis occurred in a residential college summer camp and was reported to the local health department. The outbreak spread rapidly to several other groups concurrently sharing the same facilities. During the investigation, fomites were sampled at different times in dorm rooms and tested for norovirus. The number of norovirus-positive rooms increased after the first room cleaning, from 40% to 73%. After the initial cleaning, the staff was instructed on proper cleaning and disinfection procedures and provided with disposable disinfecting wipes to reduce cross contamination, and the number of norovirus-positive rooms decreased to 30%. These findings reinforce the need for appropriate cleaning and disinfection procedures during a norovirus outbreak.

April 2014
76.8 | 20-26
Charles P. Gerba, PhD, Sonia L.M. Fankem, MS, MPH, PhD, Stephanie A. Boone, MS, PhD, Marlene Gaither, MPA, ME, RS
Additional Topics A to Z: Pathogens and Outbreaks


Silicosis is the oldest know occupational pulmonary disease. It is a progressive disease and any level of exposure to respirable crystalline silica particles or dust has the potential to develop into silicosis. Silicosis is caused by silica particles or dust entering the lungs and damaging healthy lung tissue. The damage restricts the ability to breathe. Exposure to silica increases a worker’s risk of developing cancer or tuberculosis. This special report will provide background history of silicosis in the U.S., including the number of workers affected and their common industries. Over the years, these industries have impeded government oversight, resulting in silicosis exposure clusters. The risk of acquiring silicosis is diminished when industry implements safety measures with oversight by governmental agencies. Reputable authorities believe that the current innovative drilling techniques such as fracking will generate future cases of silicosis in the U.S. if safety measures to protect workers are ignored.

January 2017
January/February 2017
79.6 | 20-27
M. Thomas Quail, MS, RN, LNC
Additional Topics A to Z: Hazardous Materials

Swimming is the second most popular sport in the United States. It is estimated that there are 360,000 public pools in the U.S. where public health must be protected. This session will discuss ozone system sizing, component details, and design parameters, in conjunction with Good Manufacturing Practices (GMP) and the Model Aquatic Health Code (MAHC), for four categories of swimming venues. Evaluate and determine if and when ozone is an appropriate choice for providing a safe and healthy swimming environment.

Presented at NEHA 2015 AEC

July 2015
Additional Topics A to Z: Recreational Waters


Toilets contaminated with infectious organisms are a recognized contact disease transmission hazard. Previous studies indicate that toilet bowl water can remain contaminated for several flushes after the contamination occurs. This study characterized contamination persistence over an extended series of flushes using both indicator particles and viable bacteria. For this study, toilets were seeded with microbe-size microbial surrogates and with Pseudomonas fluorescens or Clostridium difficile bacteria and flushed up to 24 times. Bowl water samples collected after seeding and after each flush indicated the clearance per flush and residual bowl water contaminant concentration. Toilets exhibited 3 + log10 contaminant reductions with the first flush, only 1–2 logs with the second flush, and less than 1 log thereafter. Contamination still was present 24 flushes postcontamination. Clearance was modeled accurately by a two-stage exponential decay process. This study shows that toilet bowl water will remain contaminated many flushes after initial contamination, posing a risk of recurring environmental contamination and associated infection incidence.

October 2017
October 2017
80.3 | 34-39
David L. Johnson, PhD, Department of Occupational and Environmental Health, University of Oklahoma Health Sciences Center, Robert A. Lynch, PhD, Department of Occupational and Environmental Health, University of Oklahoma Health Sciences Center, Stephanie M. Villanella, MS, Department of Occupational and Environmental Health, University of Oklahoma Health Sciences Center, Jacob F. Jones, MS, Department of Occupational and Environmental Health, University of Oklahoma Health Sciences Center
Additional Topics A to Z: Pathogens and Outbreaks


Combined exposure to tobacco smoke and radon increases lung cancer risk, and renters are disproportionately exposed to secondhand smoke (SHS). A quota sample of renters (N = 47) received free radon and airborne nicotine test kits in a primary care setting to explore the impact of a personalized environmental report-back intervention on home exposure. Half of the sampled renters reported smokers living in the home. Taking actions to reduce radon and SHS exposure were assessed at baseline, and at 3-, 9-, and 15-months postintervention; home testing occurred at baseline and at 15 months. Stage of action in home testing and in adopting a smoke-free (SF) home policy increased from baseline to 3 months; we observed no further changes in stage of action over time. Airborne nicotine declined from baseline to 15 months (p = .031; n = 9). More research is needed to evaluate interventions to motivate renters and landlords to test and mitigate for radon and adopt SF policies.


May 2018
May 2018
80.9 | 8-14
Ellen J. Hahn, PhD, RN, FAAN, University of Kentucky College of Nursing, Kathy Rademacher, University of Kentucky College of Nursing, Amanda Wiggins, PhD, University of Kentucky College of Nursing, Mary Kay Rayens, PhD, University of Kentucky College of Nursing
Additional Topics A to Z: Radon

Many developed countries around the world have implemented regulations to phase out or greatly restrict the use of pesticides. Pesticides are still utilized with minimal restrictions, however, in fumigating agricultural commodities in developing countries such as Grenada. This special report presents the case of a nutmeg factory worker in Grenada who worked with various pesticides including methyl bromide, magnesium phosphide (magtoxin), and aluminum phosphide (phostoxin) without the proper awareness and utilization of health and safety measures. The nutmeg factory worker later developed metastatic bladder cancer, which may have been triggered by a combination of individual risk factors along with long-term occupational exposure to these pesticides. In this special report, the occupational health importance of prevention in a work environment with significant exposure to pesticides is highlighted as well as some of the fundamental deficiencies in awareness among workers in developing nations concerning the deleterious effects of frequent exposure to pesticides.

January 2016
January/February 2016
78.6 | 62-64
Muge Akpinar-Elci, MPH, MD, MyNgoc Thuy Nguyen, MS, Satesh Bidaisee, MPH, DVM, Omur Cinai Elci, MD, PhD
Additional Topics A to Z: Hazardous Materials

The omnipresence of legal and illegal pesticides still impact the lives of children living in low-income subsidized housing and may significantly impact asthma-related pediatric health. This study aimed to characterize the presence of pesticides, this potential health link, and policy implications for pest control and healthy communities in multifamily dwellings.

July 2015
Miranda Engberg, MPH
Potential CE Credits: 1.00