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.


Radon gas exposure is the leading cause of lung cancer among nonsmokers in the U.S. People exposed to elevated levels of radon gas have a higher risk of developing lung cancer. Public health workers are change agents and their roles in protecting and improving the health of their communities are well documented. This study surveyed 386 public health educators, health officers, nurses, and registered environmental health specialists working in public health departments. We found significant differences (p < .01) in knowledge about radon gas exposure among public health workers. These findings suggest that the role of public health workers in disseminating information about environmental hazards to the communities they serve should be well-defined. Government agencies, including public health departments, will have to combine efforts to achieve the long-term goal of the 1988 Indoor Radon Abatement Act (IRAA). Training of public health workers about environmental hazards should be a priority to achieve the IRAA goal.


January 2020
January/February 2020
82.6 | 22-28
Paschal Nwako, MPH, PhD, REHS, DAAS, Camden County Department of Health and Human Services, Terrence Cahill, EdD, School of Health and Medical Sciences, Seton Hall University
Additional Topics A to Z: Radon

Risk communication on the health effects of radon encounters many challenges and requires a variety of risk communication strategies and approaches. The concern over radon exposure and its health effects may vary according to people’s level of knowledge and receptivity. Homeowners in radon-prone areas are usually more informed and have greater concern over those not living in radon-prone areas. The latter group is often found to be resistant to testing. In British Columbia as well as many other parts of the country, some homes have been lying outside of the radon-prone areas have radon levels above the Canadian guideline, which is the reason Health Canada recommends that all homes should be tested.

Over the last five years, the Environment Health Program (EHP) of Health Canada in the British Columbia region has been using a variety of different approaches in their radon risk communications through social media, workshops, webinars, public forums, poster contests, radon distribution maps, public inquiries, tradeshows and conference events, and partnership with different jurisdictions and nongovernmental organizations. The valuable lessons learned from these approaches are discussed in this special report.

January 2016
January/February 2016
78.6 | 102-106
Winnie Cheng, MET
Additional Topics A to Z: Radon

Article Abstract

In the study discussed in this article, 27 private drinking water wells located in a rural Colorado mountain community were sampled for radon contamination and compared against (a) the U.S. Environmental Protection Agency’s (U.S. EPA’s) proposed maximum contaminant level (MCL), (b) the U.S. EPA proposed alternate maximum contaminate level (AMCL), and (c) the average radon level measured in the local municipal drinking water system. The data from the authors’ study found that 100% of the wells within the study population had radon levels in excess of the U.S. EPA MCL, 37% were in excess of the U.S. EPA AMCL, and 100% of wells had radon levels greater than that found in the local municipal drinking water system. Radon contamination in one well was found to be 715 times greater than the U.S. EPA MCL, 54 times greater than the U.S. EPA AMLC, and 36,983 times greater than that found in the local municipal drinking water system. According to the research data and the reviewed literature, the results indicate that this population has a unique and elevated contamination profile and suggest that radon-contaminated drinking water from private wells can present a significant public health concern.  

August 2015
November 2013
76.4 | 18-24
Michael Anthony Cappello, MPH, PhD, REHS, Aimee Ferraro, MPH, PhD, Aaron B.Mendelsohn, MPH, PhD, Angela Witt Prehn, PhD
Additional Topics A to Z: Radon


On October 2, 2014, the Douglas County Health Department (DCHD) Lead Poisoning Prevention Program (LPPP) received a 61 μg/dL venous blood lead concentration (VBLC) report describing a 3-year-old female refugee. A VBLC above 45 µg/dL in a child less than 72 months requires an aggressive medical and lead hazard exposure intervention because encephalopathy risk is increased. To achieve these intervention objectives, LPPP managers must determine which LPPP stakeholders can respond, contact the parent/guardian and property owner, alert the LPPP stakeholder network, assess lead hazards in the victim’s environment, ensure the victim has a lead-safe dwelling, and monitor critical medical (e.g., treatment prognosis, VBLC reports, treatment discharge date, etc.) and environmental interventions (e.g., assure all lead-safe environment tasks are completed). This special report describes the DCHD protocol developed to ensure rapid environmental health responses to severe pediatric lead poisoning.


July 2018
July/August 2018
81.1 | 22-28
Larry W. Figgs, MPH, PhD, REHS/RS, Douglas County Health Department, Amy Bresel, DC, Douglas County Health Department, Khari Muhammad, Douglas County Health Department


We investigated an outbreak of eight Legionnaires’ disease cases among persons living in an urban residential community of 60,000 people. Possible environmental sources included two active cooling towers (air-conditioning units for large buildings) <1 km from patient residences, a market misting system, a community-wide water system used for heating and cooling, and potable water. To support a timely public health response, we used real-time polymerase chain reaction (PCR) to identify Legionella DNA in environmental samples within hours of specimen collection. We detected L. pneumophila serogroup 1 DNA only at a power plant cooling tower, supporting the decision to order remediation before culture results were available. An isolate from a power plant cooling tower sample was indistinguishable from a patient isolate by pulsed-field gel electrophoresis, suggesting the cooling tower was the outbreak source. PCR results were available <1 day after sample collection, and culture results were available as early as 5 days after plating. PCR is a valuable tool for identifying Legionella DNA in environmental samples in outbreak settings.

April 2018
April 2018
80.8 | 8-12
Isaac Benowitz, MD, Epidemic Intelligence Service, Centers for Disease Control and Prevention, Robert Fitzhenry, PhD, New York City Department of Health and Mental Hygiene, Christopher Boyd, New York City Department of Health and Mental Hygiene, Michelle Dickinson, MPH, New York State Department of Health


In the late 1980s it was discovered that the Pacific Northwest is sited in the Cascadia subduction zone, a fault capable of producing a magnitude 9.0 earthquake, which could result in significant destruction along the almost 700 miles of impact. One likely result of this earthquake would be a catastrophic impact to wastewater systems in the Portland metropolitan area, with anticipated loss of wastewater systems for 6 months–1 year. With approximately 2.3 million residents in the area, this loss poses a significant threat to the public’s health in the aftermath of an earthquake of this magnitude.

A group of multidisciplinary professionals from the five counties in the area was convened to develop recommendations to assist the public to safely handle their sanitation needs in the absence of a functional wastewater system for an extended period of time. Participants represented the disciplines of public health, emergency management, public works, wastewater treatment, waste hauling, and the Oregon Department of Environmental Quality. The group developed recommendations for the handling of human waste by residents of the Portland metropolitan region following a catastrophic earthquake. In this special report, we review the process, assumptions, and final recommendations for use by the public in a long-term wastewater system failure.


September 2019
September 2019
82.2 | 14-16
Susan Mohnkern, MPH, RN, Washington County Public Health, Ken Schlegel, Washington County Emergency Management, Erin O’Connell, REHS, Columbia County Environmental Services, Scott Johnson, MS, MEP, Clark Regional Emergency Services Agency
Additional Topics A to Z: Wastewater

Chuck Lichon, R.S., M.P.H., Deputy Health Officer at District Health Department #2 in Michigan, developed a Children’s Environmental Health Power Point Program with the financial assistance of the Dow Chemical Company, Midland, MI.  The Power Points are approximately 25-35 minutes in length, allowing for a presentation to be made during one classroom setting, or to be used for a community presentation, allowing time for Q & A.  Some of the topics include: Sunwise, Body Art, Household Hazardous Waste, Meth, Recreational Water, and more.  They are free to download and use for presentations in your school, health department community presentations, or for media use.  Changes in the presentations should not be made without consent from the author, and/or the NEHA Board of Directors.  

The Recreational Water PowerPoint is available via the link listed below:   

Chuck Lichon, R.S., M.P.H.
Additional Topics A to Z: Recreational Waters


Lead exposure causes an array of significant health problems in adults and especially in children. Therefore, reducing lead exposure is an important public health goal. Here, we analyzed data collected about the lead content in two product types, candy and purses. We show that following litigation, the prevalence of these products containing lead in California declined significantly. Results from products purchased online suggest that the decline was national, not just limited to California. Our results indicate that state consumer protection laws can be successful in reducing exposure to hazardous chemicals.


March 2019
March 2019
81.7 | 28-31
Caroline Cox, MS, Center for Environmental Health, Howard Hirsch, JD, Lexington Law Group
Additional Topics A to Z: Hazardous Materials


Repeated warnings by the scientific community on the dire consequences of climate change through global warming to the ecology and sustenance of our planet have not been give appropriate attention by the U.S. public. Research has shown that climate change is responsible for catastrophic weather occurrences--such as floods, tornadoes, hurricanes, and heat waves--resulting in environmental and public health issues. The purpose of this report is to examine factors influencing public views on climate change. Theoretical and political perspectives are examined to unpack opinions held by the public in the U.S. on climate change. The Health Belief Model is used as an example to showcase the efficacy of an individual behavior change program in providing the synergy to understand climate change at the microlevel. The concept of reframing is discussed as a strategy to alter how the public views climate change.

April 2017
April 2017
79.8 | 24-27
Caitlin Weems, MS, Department of Health Promotion and Physical Education, Ithaca College, Prithwi Raj Subramaniam, PhD, Department of Health Promotion and Physical Education, Ithaca College

A re-emergence of bedbugs and resultant impacts on community resources led to the convening of a “Bedbug Summit." Attendees represented professionals from a broad spectrum of affected sectors including housing providers, homeless-shelters, education, pest control services, public health, waste stream management, and social services. During the summit, this group worked together and identified collaborative approaches to address bedbugs in the region. The resulting Bed Bug Workgroup has made significant achievements including successful advocacy for additional funding, launching an information telephone hotline, developing a multi-lingual educational clearinghouse website, and identification of a collaborative surveillance system that protects pest control operators and the communities they serve. Attend this session to learn about how engaging nontraditional partners results in more robust environmental health outcomes and apply a community organizing model to emergent public health issues.

July 2015
Matt Davis, MPH, Christie  Sweitz, REHS
Potential CE Credits: 1.00