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 methicillin-resistant Staphylococcus aureus (MRSA) are becoming increasingly frequent in the athletic community. Skin–fomite contact represents a putative mechanism for transmission of MRSA. The objective of this study was to demonstrate the prevalence and transmissibility of S. aureus in three surfaces commonly encountered in the gymnasium setting: the court floor, the sports ball, and the athlete’s hands. Three sports scenarios were simulated by dribbling a sports ball within a designated area; the surfaces were cultured before and after play using media selective for S. aureus. There was significant transfer of S. aureus from the native, contaminated surface towards two disinfected surfaces. In a fourth experiment, survival of S. aureus on sports balls was evaluated over time. S. aureus was found to be viable on the ball for at least 72 hr. This study demonstrates the significance of the sports ball as a vector for pathogen transmission. Interventions aimed at reducing athletic outbreaks should therefore include routine disinfection of sports balls during and after play.

January 2018
January/February 2018
80.6 | 8-13
Brandon A. Haghverdian, MD, Hospital of the University of Pennsylvania, Nimesh Patel, Touro University College of Osteopathic Medicine in California, Lisa Wang, RN, CCRN, Stanford University Medical Center, Joshua A. Cotter, PhD, California State University, Long Beach
Additional Topics A to Z: Pathogens and Outbreaks

This step-by-step guide explains how to create a sustainability plan and sustainability report. Each chapter contains two vital sections. The first contains background reading, tips, and case examples to help you be successful. The second presents a set of methods each with step-by-step instructions and a selection matrix to help choose the best methods. The book also contains sample worksheets and exercise materials that can be copied for organization-wide use.

Additional Topics A to Z: Sustainability

NEHA attendees are invited to use their imaginative power to envision and design the next cartoon in the food defense series. Participants will engage in a collaborative brainstorming session to identify a scenario and develop the storyline as a professional cartoonist brings these visions to life in a multi-paneled storyboard. By the end of the session, participants, working alongside the cartoonist, will have collaboratively created a complete training cartoon, to be the fifth installment of the current food defense series.

Presented at NEHA 2015 AEC

July 2015

We've all read the peer-reviewed evidence and heard countless compelling success stories from healthy homes demonstration projects across the country. So why aren't these services available in more communities? Why can't doctors write prescriptions for healthy housing for patients with housing-related illnesses? Many states are exploring Medicaid reimbursement as a strategy for bringing healthy homes interventions to scale and integrating home-based interventions into a patient's usual care. Using asthma as a case study, this session will explore the opportunities and challenges associated with seeking Medicaid reimbursement for home-based interventions.

July 2015
Amanda Reddy, MS
Potential CE Credits: 1.00

Article Abstract

Septic systems are considered a source of groundwater contamination. In the study described in this article, the fate of microbes applied to a sandy loam soil from North Carolina coastal plain as impacted by water table depth was studied. Soil materials were packed to a depth of 65 cm in 17 columns (15-cm diameter), and a water table was established at 30, 45, and 60 cm depths using five replications. Each day, 200 mL of an artificial septic tank effluent inoculated with E. coli were applied to the top of each column, a 100-mL sample was collected at the water table level and analyzed for E. coli, and 100 mL was drained from the bottom to maintain the water table. Two columns were used as control and received 200 mL/day of sterilized effluent. Neither 30 nor 45 cm of unsaturated soil was adequate to attenuate bacterial contamination, while 60 cm of separation appeared to be sufficient. Little bacterial contamination moved with the water table when it was lowered from 30 to 60 cm. 

Aziz Amoozegar, PhD, Christopher Stall, MS, David Lindbo, PhD, Alexandria Graves, PhD
Additional Topics A to Z: Wastewater


On October 29, 2012, Hurricane Sandy made landfall in New Jersey, causing major power outages, flooded roads, and disruption of public transportation. Individuals diagnosed with diabetes may be especially vulnerable to natural disasters because of limited access to medications or use of glucose monitoring devices. We examined changes in emergency room visits (ERVs) for type II diabetes mellitus potentially associated with Hurricane Sandy in New Jersey. Data analyzed in 2014 included ERVs to general acute care hospitals in New Jersey among residents of three counties with a primary or secondary type II diabetes diagnosis (PDD or SDD) in 2011–2012. Compared to the previous year, results showed an 84% increased rate of PDD ERVs during the week of Hurricane Sandy, after adjusting for age and sex (rate ratio (RR) = 1.84, 95% confidence interval (CI) 1.12, 3.04). Results were nonsignificant for SDD (RR = 0.94, 95% CI 0.83, 1.08). Spatial analysis showed the increase in visits was not consistently associated with flood zone areas. We observed substantial increases in ERVs for primary type II diabetes diagnoses associated with Hurricane Sandy in New Jersey. Future public health preparedness efforts during storms should include planning for the healthcare needs of populations living with diabetes.

September 2016
September 2016
79.2 | 30-37
Enid M. Velez-Valle, MPH, Derek Shendell, MPH, DEnv, Sandra Echeverria, MPH, PhD, Melissa Santorelli, MPH, PhD

Article Abstract

Household bleach is typically used as a disinfectant for water in times of emergencies and by those engaging in recreational activities such as camping or rafting. The Centers for Disease Control and Prevention recommend a concentration of free chlorine of 1 mg/L for 30 minutes, or about 0.75 mL (1/8 teaspoon) of household bleach per gallon of water. The goal of the study described in this article was to assess two household bleach products to kill waterborne bacteria and viruses using the test procedures in the U.S. Environmental Protection Agency’s Guide Standard and Protocol for Testing Microbiological Purifiers. Bleach was found to meet these requirements in waters of low turbidity and organic matter. While the test bacterium was reduced by six logs in high turbid and organic-laden waters, the test viruses were reduced only by one-half to one log. In such waters greater chlorine doses or contact times are needed to achieve greater reduction of viruses. 

May 2014
76.9 | 22-25
Charles P. Gerba, PhD, Sherif Abd Elmaksoud, Nikita Patel, Sherri L. Maxwell
Additional Topics A to Z: Drinking Water