The ecological study described in this article assessed morbidity and mortality excesses in the eight municipalities surrounding the municipal solid waste landfill of Barengo (Novara, northwest Italy). The resident populations living in this area on December 31, 1991, and December 31, 2005, were assessed. Standardized incidence and mortality ratios were calculated using data from hospital discharge forms, death forms, and regional databases. For congenital malformations (2003–2009 period), incidence excesses were found in females. Concerning morbidity (2003–2009 period) and mortality (2000–2009 period) for all causes, the observed cases and deaths largely exceeded the expected ones. During the 1980–2000 period, incidence excesses of deaths were reported for small intestine cancer, Hodgkin’s lymphoma, and soft tissue sarcomas. Although morbidity and mortality excesses were found in the authors’ study, further studies are needed to better identify the health-risk factors present in the area.
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E-Journal Bonus Article: Morbidity and Mortality of Residents Living Near a Municipal Solid Waste Landfill in Northwest Italy From 1980 to 2009
78.6 | E1-E8
E-Journal Bonus Article: Pollution Characteristics and Potential Ecological Risk Assessment of Polycyclic Aromatic Hydrocarbons in Wastewater Irrigated Soil
Soil contamination by polycyclic aromatic hydrocarbons (PAHs) is an increasing problem. We wanted to determine the characteristics and ecological risk of PAHs in wastewater-irrigated soil, provide a theoretical basis for the prevention of PAH contamination in soils, and inform the formulation of guidelines and standards for critical limits of PAHs. We collected soil samples from two typical wastewater-irrigated farmlands, Farmlands A and B, in Tangshan, China, and used a clean-water irrigated farmland, Farmland C, as the control area. A total of 15 samples were analyzed for 16 PAHs by high-performance liquid chromatography. The results showed that the total amount of PAHs in samples from Farmlands A and B were 1046.2 μg/kg and 1308.1 μg/kg, respectively—significantly higher than Farmland C’s 189.1 μg/kg. The PAHs from wastewater-irrigated soil mainly consisted of PAHs of 4-rings or higher, accounting for 83.1% and 60.2% of total PAHs for Farmlands A and B, respectively. The evaluation of the ecological risk of PAHs using the single-factor index method and Nemerow comprehensive index (Pn) method revealed the main PAHs exceeding the critical limits were pyrene, dibenz[a,h]anthracene, and benzo[g,h,i]perylene. The Pn for the two wastewater-irrigated soils were 3.05 and 3.16, respectively, for Farmlands A and B, reaching a heavy pollution level versus Farmland C’s 0.34, classified as a clean level. We conclude that wastewater irrigation has led to ecological risk, and the wastewater-irrigated soil is carcinogenic, teratogenic, and mutagenic.
79.9 | E1-E6
E-Journal Bonus Article: Prevention of Tick Exposure in Environmental Health Specialists Working in the Piedmont Region of North Carolina
Environmental health specialists (EHS) conduct many occupational activities outdoors that may place them at increased risk for contracting a vectorborne disease. We conducted a risk assessment for tick exposure in EHS by analyzing job description, tick exposure, and the extent to which personal protective measures (PPM) were used. This pilot study focuses on eight counties in the central Piedmont region of North Carolina and follows 29 EHS during May through August 2014. A survey was administered to participants at the beginning of the study and showed that participants used PPM while working outdoors in environments conducive to tick exposure. Participants reported wearing PPM only 16% of the time they spent working outdoors. More than 28% of respondents self-reported having previously experienced a tickborne disease (primarily Rocky Mountain spotted fever) and one participant reported receiving medical treatment for a tickborne disease during the course of the study. Participants were exposed to two tick species (Amblyomma americanum Linnaeus; Dermacentor variabilis Say) and 279 ticks were submitted to researchers during the study. Although 70% of respondents reported being knowledgeable about tickborne disease, low PPM usage indicates either EHS do not believe the threat is significant, or they believe PPM available to them are ineffective.
78.10` | E1-E7
E-Journal Bonus Article: Reducing Risk of Respiratory Illness Associated With Traditional Cookstoves in a Rural Community in India: An Initial Assessment
Unvented biomass cookstoves present a recognized respiratory health risk in developing countries. The purpose of this study was to characterize fine particle indoor air pollution (IAP) concentrations in dwellings using traditional cookstoves in a rural community in India. It also aimed to understand if a culturally acceptable clean cookstove intervention was needed to reduce the risk of respiratory illnesses from exposure to combustion products from traditional cookstoves. We took PM2.5 concentrations and ≤0.5 µm particle counts inside a sample of dwellings during the use of traditional cookstoves. The data were analyzed to indicate the magnitude of IAP. In households with traditional cookstoves, average PM2.5 concentrations were 172.8 µg/m3, and the particle counts ≤0.5 µm averaged 346,150. The PM2.5 concentrations from the traditional cookstoves were shown as unhealthy per the PM2.5 air quality index (AQI) of the U.S. Environmental Protection Agency. Partnering with local community members, an improved prototype metal cookstove was designed to be fuel-efficient and vent the smoke out of the dwellings. We found PM2.5 concentrations and ≤0.5 µm particle counts for the new stove averaged 21.5 µg/m3 and 60,812, respectively. The PM2.5 concentrations from the new stove are at an acceptable level per the AQI.
80.3 | E1-E7
E-Journal Bonus Article: Rural Community Viewpoint on Long-Term Research Participation Within a Uranium Mining Legacy, Grants Mining District, New Mexico
Well-constructed epidemiologic studies provide information about environmental risks and inform interventions and public health policies. Using focus groups, this pilot project examined the attitudes, beliefs, and concerns of rural-dwelling adults toward participating in a longitudinal cohort study. Focus group participants who were 40 years or older, residents in the Grants Mining District, and had no previous diagnosis of diabetes (except gestational diabetes) were recruited from a local physician’s office in the Grants Mining District. Participants provided insight into local health concerns, willingness to participate in long-term research and to provide biological specimens, and consent form expectations. For this population, the uranium mining legacy in the Grants Mining District is a contextual factor that can be addressed via community engagement and in the study design to minimize misinterpretation or bias and to maximize the ability to detect causal risk factors for health outcomes.
79.1 | E1-E4
E-Journal Bonus Article: Simultaneous Influence of Geology and System Design on Drinking Water Quality in Private Systems
Between 2012 and 2014, almost 3,000 point-of-use water samples from private water systems (e.g., wells, springs) in Virginia were analyzed for common contaminants of human health and aesthetic concern. In addition, each sample was accompanied by a brief questionnaire detailing system characteristics. Approximately 55% of samples exceeded at least one health-based drinking water standard. This study evaluated the interactions between local geology and private system types to understand variations in water quality, which is critical when evaluating and prioritizing efforts to protect public health. In the context of lead, sodium, and total coliform bacteria, this study illustrated the importance of considering local geology as it dictates groundwater flow, private system type as it determines the source aquifer and raw groundwater quality, and household treatment devices as potential sources of additional water quality constituents.
79.2 | E1-E9
E-Journal Bonus Article: The Path to Informed Policies: Environmental Health Indicators and the Challenges of Developing a Surveillance System in Lebanon
There are multiple factors that affect human health and well-being and the environment is among the major determinants. Nevertheless, health research and interventions are generally isolated from environmental research. The main objective of this research work is to assess the challenges of developing a national surveillance system that can bridge the knowledge gaps among environmental hazards/stressors, human exposure, health outcomes and interventions. Various environmental health frameworks and approaches to developing environmental health indicators (EHIs) were examined. Semistructured interviews with key stakeholders were conducted to assess the feasibility of collecting EHIs and the challenges of developing an environmental health surveillance system (EHSS). Thematic analysis was employed to examine and evaluate the transcripts comprehensively. Based on the outcomes of the interviews, we were able to identify various indicators in Lebanon that were scrutinized with regards to availability, quality, and usefulness—as well as applicability to the context of Lebanon. Stakeholders reported that the most significant solutions consist of institutionalizing the system within the government, raising awareness of the private and public sector on EHSS, centralizing one entity responsible for leading implementation of the system, establishing a national council for environmental health surveillance, and developing a comprehensive database.
79.8 | E1-E7
Electronic waste (e-waste) generation is increasing worldwide, and its management becomes a significant challenge because of the many toxicants present in electronic devices. The U.S. is a major producer of e-waste, although its management practice and policy regulation are not sufficient to meet the challenge. We reviewed e-waste generation, current management practices and trends, policy challenges, potential health impact, and toxicant exposure prevention in the U.S. A large amount of toxic metals, flame retardants, and other persistent organic pollutants exist in e-waste or can be released from the disposal of e-waste (e.g., landfill, incineration, recycling). Landfill is still a major method used to dispose of obsolete electronic devices, and only about half of the states have initiated a landfill ban for e-waste. Recycling of e-waste is an increasing trend in the past few years. There is potential, however, for workers to be exposed to a mixture of toxicants in e-waste and these exposures should be curtailed. Perspectives and recommendations are provided regarding managing e-waste in the U.S. to protect public health, including enacting federal legislation, discontinuing landfill disposal, protecting workers in recycling facilities from toxicant exposure, reducing toxicant release into the environment, and raising awareness of this growing environmental health issue among the public.
79.3 | 8-16
Insufficient cleaning can create reservoirs of microorganisms, resulting in the spread of infection in the workplace. In this study, we examined the effects of increased cleaning of high-frequency touch sites on bioburden and absence rates at an office building. Daily cleaning of computer keyboards, mice, and telephones was performed on one floor and compared with a control floor. Contact plate samples were taken weekly from keyboards and bacterial contamination was assessed over a 3-month period. Increased cleaning and bioburden were compared to employee absence rates. Increased cleaning reduced overall bioburden on keyboards from 27–44 CFU/25 cm2 to 7–11 CFU/25 cm2 (n = 550), when compared with standard practice. Keyboards were found, however, to be recontaminated once used. Levels of bacteria from control floors decreased over the intervention period. Skin flora was most commonly isolated. Isolation of Enterococcus spp., suggesting fecal contamination, was reduced after increased cleaning. Regular cleaning reduces bioburden and has a lasting effect. Despite efficacy of increased cleaning, there was no significant effect on absences due to the wide variability of absence rates over time.
82.10 | 16-19
Recruitment of participants into any community-based project can be a significant challenge, particularly for Lead Hazard Control and Healthy Homes grantees funded by the U.S. Department of Housing and Urban Development. One of these grantees, the 2013–2016 Henderson Lead Hazard Control and Healthy Homes Program, implemented six recruitment strategies: 1) person-to-person referrals, 2) direct mail, 3) door-to-door neighborhood canvassing, 4) child-oriented community event outreach, 5) passive program information, and 6) general event outreach. Program staff reached more than 10,000 individuals via these methods, and 136 participants ultimately were enrolled. The success of each method was determined by its percentage yield of enrolled participants. Community event outreach resulted in the greatest number of contacts, while person-to-person referrals and direct mailings yielded the most enrolled participants with minimal staff time required. Landlords were essential to the enrollment of rental units. These results might help provide insight to some of the most effective strategies for recruitment into Lead Hazard Control and Healthy Homes programs.
80.7 | 20-26