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.


Restaurant food safety is monitored by local health departments through routine inspections. Given the historical use of different inspection formats, the purpose of this study was to assess how word choices used to categorize violations could influence restaurant manager interpretation of inspection results. This study used a scenario-based questionnaire to examine manager perceptions and preferences among inspection formats, including the three-tier system currently recommended by the Food and Drug Administration. Results suggest that managers were able to determine the relative seriousness of violations, but perceptions of risk were influenced by the words used to classify the violation. In particular, use of the words "priority foundation" and "core" as part of the three-tier violation format were confusing. Managers preferred the letter grade and numeric score systems because they were perceived to be easy to understand, easy to use, accurate, and require the least amount of time. Managers had some concerns about the new three-tier system in the area of accuracy. Results suggest the need for additional training for restaurant managers, especially on the meaning of different classifying terms when changing to a new inspection format, as well as the rationale and benefits of changing to a new system such as the three-tier format.


June 2019
June 2019
81.10 | 8-14
Jing Ma, PhD, University of Delaware, Jooho Kim, PhD, James Madison University, Barbara Almanza, PhD, RD, Purdue University


Marion County Public Health Department (MCPHD) in Indianapolis, Indiana, was awarded funding in 2009 from the U.S. Department of Housing and Urban Development through the Healthy Homes Demonstration Grant Program as a part of the American Recovery and Reinvestment Act. This funding is currently supporting activities addressing health and safety hazards in homes of low- and very low-income residents living in an urban community within Marion County with an extensive history of heavy industry and lead smelting. One portion of this grant is being used to fund IRB-approved research conducted by MCPHD for the period of the grant. Development and implementation of this study has provided both unique challenges and positive opportunities for study participants, MCPHD, and community stakeholders. The following commentary provides insight into the benefits and rewards of implementing a successful study process, as well as challenges in implementing a community-based research study for the first time in a preexisting Healthy Homes Demonstration Grant Program health department.

July 2016
July/August 2016
79.1 | 20-23
Juanita Ebert Brand, MSN, EdD, RN, WHNP-BC, Virginia A. Caine, MD, Jo Rhodes, MSG, HHS, CRT, Jason Ravenscroft, MPH, REHS, CHMM

Article Abstract

Water quality of rooftop-collected rainwater is an issue of increased interest particularly in developing countries where the collected water is used as a source of drinking water. Bacteriological and chemical parameters of 25 samples of rooftop-harvested rainwater stored in ferrocement tanks were analyzed in the study described in this article. Except for the pH and lower dissolved oxygen levels, all other physicochemical parameters were within World Health Organization guidelines. Bacteriological results revealed that the rooftop-harvested rainwater stored in tanks does not often meet the bacteriological quality standards prescribed for drinking water. Fifty percent of samples of harvested rainwater for rural and urban community use and 20% of the samples for individual household use showed the presence of E. coli. Fecal coliform/fecal streptococci ratios revealed nonhuman animal sources of fecal pollution. Risk assessment of bacterial isolates from the harvested rainwater showed high resistance to ampicillin, erythromycin, penicillin, and vancomycin. Multiple antibiotic resistance (MAR) indexing of the isolates and elucidation of the resistance patterns revealed that 73% of the isolates exhibited MAR.


Jan/Feb 2014
76.6 | 114-121
A.A. Mohamed Hatha, PhD, Y. Jesmi, MPhil, K.M. Mujeeb Rahiman, PhD, Lal Deepu, MSc
Additional Topics A to Z: Drinking Water

In the study described in this article, the concentrations of metals (cadmium, copper, chromium, aluminum, lead, nickel, zinc, cobalt, manganese, and iron) in samples of some commonly used hair dyes and tattoo inks were determined with a view to providing information on the hazards associated with the use of these products. The concentrations of metals were measured after nitric acid/perchloric acid/hydrogen peroxide digestion by atomic absorption spectrometry. Results indicated that the tattoo ink samples contained allergenic metals such as nickel, chromium, and cobalt at concentrations above the suggested  limit of 1 µg/g for greater skin protection, and the toxic metals were below their respective prescribed limits, as impurities in ingredients for use for cosmetics, in the majority of the samples.

January 2016
January/February 2016
78.6 | 26-30
Chukwujindu M.A. Iwegbue, Sunday O. Onyeloni, Francisca I. Bassey, Godswill O. Tesi
Additional Topics A to Z: Hazardous Materials


Arsenic and boron can naturally occur in well water and chronic exposure to both is associated with a wide variety of health effects. In 2016, two New Jersey townships were targeted for a school-based outreach and testing event because the population relies on private well water for potable use, the aquifer is known to be at risk for arsenic and boron contamination, and young children are particularly vulnerable. Within 1 week, 376 homes submitted water samples. The results showed 94 homes (25%) exceeded the New Jersey arsenic maximum contaminant level and 18 homes (5%) exceeded the U.S. Environmental Protection Agency boron health advisory for children. A short survey attached to sample bottles provided information about reasons for testing and asked if a treatment method was installed. School-based recruitment for private well testing was an efficient public health outreach method to quickly obtain many private well samples and is a promising model for future private well outreach.


September 2020
September 2020
83.2 | 26-32
Megan Rockafellow-Baldoni, MPH, PhD, New Jersey Department of Environmental Protection; Rutgers University, Brady L. Lubenow, MS, New Jersey Geological and Water Survey, New Jersey Department of Environmental Protection, Nicholas A. Procopio, MS, PhD, Division of Science and Research, New Jersey Department of Environmental Protection, Jessie A. Gleason, MSPH, Environmental and Occupational Health Surveillance Program, New Jersey Department of Health

Motor vehicle crashes (MVC) are the leading cause of death from severe injuries on the Pine Ridge Indian Reservation (PRIR), averaging 16 MVC deaths per year from 2002 to 2011. The Sacred Cargo Coalition was established in PRIR in 2007 to implement intervention strategies to increase seat belt usage and reduce MVC fatalities, including seat belt law enforcement, creating a traffic court system, and educational campaigns on MVC prevention. The study described in this article examined the effectiveness of the interventions on increasing the seat belt usage rates and reducing MVC deaths. Secondary data were collected from the National Highway Traffic Safety Administration and other federal and local agencies. Seat belt usage rates increased an average of 6.8 percentage points from 2007 (10%) to 2012 (44%). MVC fatalities decreased by 46.7% from the preintervention to the intervention period. Maintenance and improvement of the intervention strategies may be achieved by seeking additional funding and including appropriate engineering activities in PRIR.

January 2016
January/February 2016
78.6 | 46-52
Joseph Amiotte, MSEH, REHS, Jo Anne Balanay, PhD, CIH, Charles Humphrey, PhD
Additional Topics A to Z: Injury Prevention

Article Abstract

Handheld temperature and relative humidity (T/RH) meters are commonly used in residential indoor air surveys. Although popular, T/RH meters are prone to sensor drift and consequent loss of accuracy, and thus instrument manufacturers often recommend annual calibration and adjustment. Field-use conditions, however, have been shown to accelerate electronic sensor drift in outdoor applications, resulting in out-of-tolerance measurements in less than one year. In the study described in this article, sensor drift was evaluated under residential field use for 30 handheld T/RH meters to predict needed calibration intervals based on hierarchical linear modeling. Instruments were used in 43 home visits over a 93-day period and were calibrated (without adjustment) 49 times over the study period with a laboratory standard. Analysis of covariance showed significant drift among temperature sensors for all three instrument types (p < .0001) and among humidity sensors in two instruments. The authors’ study suggests calibration frequency should be based on instrument performance under specific sampling conditions rather than on predetermined time intervals.

October 2014
77.3 |
Scott A. Bernhardt, Scott C. Collingwood, Kyle Mumford, Dennis Eggett
Additional Topics A to Z: Ambient Air