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.


Characteristics of an urban setting such as New York City (NYC), including readily available putrescible waste and ample underground infrastructure, make it highly attractive to the Norway rat (Rattus norvegicus). To identify property and neighborhood characteristics associated with rat presence, recent inspectional results were analyzed from over 77,000 properties in the Bronx and Manhattan. Variables capturing the location and density of factors believed to promote rat populations were tested individually and in combination in models predicting rat activity. We found that property-specific characteristics typically associated with high garbage volume, including large numbers of residential units, public ownership, and open-space designation (parks, outdoor recreation, or vacant land) were the most important factors in explaining increased rat presence across neighborhoods in NYC. Interventions that involved improved garbage management and street sanitation within a designated area reduced the likelihood of finding rats, especially in medium- and high-poverty neighborhoods. Neighborhood characteristics, such as being near a railroad or subway line, having a school nearby, the presence of numerous restaurants, or having older infrastructure, also contributed to the increased likelihood of rats. Our results support the use of built environment data to target community-level interventions and capture emerging rat infestations.

June 2016
June 2016
78.10 | 22-29
Sarah Johnson, MS, MPH, Caroline Bragdon, MPH, Carolyn Olson, MPH, Mario Merlino, MS, MPH


In King County, Washington, the most frequently used alternative solvent to perchloroethylene is a hydrotreated petroleum hydrocarbon. The objectives of the authors’ study were to 1) determine the frequency of use of process chemicals used in “hydrocarbon” dry cleaning and gather other operational information; 2) chemically characterize the process chemicals; 3) characterize the still bottoms and separator water wastes according to dangerous waste and wastewater discharge regulations; 4) identify linkages between work practices, process chemicals, and the chemical composition of the waste streams; and 5) evaluate the aquatic toxicity of the hydrocarbon solvent and detergent. Many hydrocarbon dry cleaners are using process chemicals that contain hazardous substances, including trichloroethylene. One sample of separator water contained 13,000 µg/L trichloroethylene. This sample was determined to be federal hazardous waste, state-only dangerous waste (i.e., according to Washington state-specific regulations), and failed wastewater discharge thresholds. All still bottoms were determined to be state-only dangerous wastes. Efforts should be directed towards replacing hazardous spot cleaning chemicals with safer alternatives and ensuring that wastes are disposed of appropriately.

September 2015
78.2 | 8-13
Stephen G. Whittaker, PhD, Jessie Taylor, MS, Linda M. Van Hooser, MS
Additional Topics A to Z: Hazardous Materials


Efforts to characterize environmental health workers (EHWs) are needed in order to strengthen the field. Data from the 2014 Public Health Workforce Interests and Needs Survey were used to describe the self-reported roles, important daily work tasks, and skill gaps of EHWs and to compare and contrast these characteristics between state health agencies (SHAs) and local health departments (LHDs). While EHWs at SHAs and LHDs share overall similarities in terms of important daily work tasks and skill gaps, the differences could reflect that the strengths of local-level environmental work fall within communicating and community interaction, whereas state-level strengths reside in administrative, policy, and scientific functions. Our findings also highlight a need for EHWs to strengthen their skills in budget- and policy-related competencies, especially at the local level. We found that number of years in current position was a significant predictor of the number of skill gaps, suggesting the utility of a peer-learning network.

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January 2019
January/February 2019
81.6 | 22-31
Leila Heidari, MPH, de Beaumont Foundation, Theresa Chapple-McGruder, MPH, PhD, de Beaumont Foundation, Sandra Whitehead, PhD, National Environmental Health Association, Brian C. Castrucci, MA, de Beaumont Foundation
Additional Topics A to Z: Workforce Development

The movement and requirements for Green cleaning has sparked innovation in retail food sanitation. New chemical-free cleaning and sanitizing systems are being used in selected food establishments with surprising results. Several of these innovative systems are listed with NSF under new and rigorous Protocols and meet current standards. Several of these extreme Green technologies will be highlighted and contrasted. Attendees will evaluate these solutions against standards and leave with a knowledge of current cleaning innovations.


Presented at NEHA 2015 AEC

July 2015


Restroom internal door handles have the potential to become contaminated by pathogenic bacteria, particularly because frequent breakdowns occur in hand hygiene. Cleaning these door handles periodically could reduce this cross-contamination risk. The sustained effect following cleaning with chlorhexidine could be beneficial in restroom facilities as cleaning episodes are of necessity at time intervals. The cleaning efficacies and residual effects of Sani Cloth CHG 2% wipes were investigated in a double-blinded randomized crossover controlled trial in a school setting. No significant difference occurred in initial cleaning efficacy; however, following a six-hour period of use by pupils of the restroom facilities, the internal door handles wiped with Sani-Cloth CHG 2% wipes were significantly less contaminated than those with the control wipe (14% v. 32%, p = .02). Cleaning with Sani-Cloth CHG 2% wipes demonstrated significant improvements in the continuous cleanliness of restroom door handles during use with this simple and inexpensive technique.

November 2015
November 2015
78.4 | 14-17
Holly Young, Zara Plumb, James Stevenson, Annabelle Tibbett
Additional Topics A to Z: General Environmental Health

October 2021 issue of the Journal of Environmental HealthAbstract

The impact of dust storms on human health has been well described in Asian and European countries. Several research studies have examined adverse health outcomes attributable to dust and dust storm events, including respiratory and cardiovascular diseases, across these and other developed countries. Despite an increasing number of dust storm events plaguing the Middle East attributable to climate change, little is presently understood about the effects of dust storms on the health of human populations residing in this region. This review sought to identify and assess what is currently understood about the health impacts of dust storms in the Middle East. A systematic review was designed and conducted using MEDLINE/PubMed and Google Scholar. Out of 534 articles identified, 16 met predetermined eligibility criteria and were included in our analysis. Our review identified a number of health consequences associated with dust events in the region of interest, existing gaps in available literature, vulnerable populations, and directions for future research.


October 2021
October 2021
84.3 | 8-15
Muge Akpinar-Elci, MPH, MD, Old Dominion University, Brenda Berumen-Flucker, MPH, Old Dominion University, Hasan Bayram, MD, PhD, Old Dominion University, Abdullah Al-Taiar, MD, PhD, Old Dominion University


We describe a 2016 community-wide recreational water-associated cryptosporidiosis outbreak investigation and response in Maricopa County, Arizona. Persons with a laboratory-confirmed illness were interviewed using a standardized questionnaire that assessed exposures 2 weeks before symptom onset. A convenience sample of managers and operators of chlorine-treated public aquatic facilities was surveyed regarding permanent supplemental treatment systems for Cryptosporidium. Among 437 cases identified (median age 12, range <1–75 years), 260 persons were interviewed. Public-treated recreational water was the most frequently reported exposure (177, 68%) of interviewed persons; almost 1 in 5 (43, 17%) swam when diarrhea was ongoing.

After the 2016 outbreak, managers of some facilities expressed intentions to install supplementary water treatment systems, and by May 2017, at least one large facility installed an ultraviolet light system. Strategies to prevent additional illness included community messaging, education, and targeted remediation of affected facilities on the basis of interviews. Challenges to remediation during a cryptosporidiosis outbreak in a large jurisdiction with primarily outdoor pools underscore the importance of promoting healthy swimming practices that help prevent contamination from occurring.


November 2018
November 2018
81.4 | 14-21
Sally Ann Iverson, MPH, DVM, Centers for Disease Control and Prevention, Maricopa County Department of Public Health, Nicole Fowle, MPH, LPN, Maricopa County Department of Public Health, Gregory Epperson, RS, Maricopa County Environmental Services Department, Jennifer Collins, MPH, Maricopa County Department of Public Health
Additional Topics A to Z: Recreational Waters


Most occupational research on firefighter exposure in the U.S. has been conducted in large urban cities with career firefighters. Over 70% of U.S. firefighters, however, are volunteers, a population overrepresented in small rural fire departments and thus under studied. We conducted three focus groups with individuals from eight fire departments in the Green River Firefighters Association fire protection district in northwestern Kentucky. Based on these focus groups, we developed a survey and administered it to 43 career and 187 volunteer firefighters at their annual fire training school. Based on their responses, we identified significant variables related to existing personal protective equipment (PPE) use, storage, and cleaning practices of firefighters. Except for storage, work practices related to the use of turnout gear (coats and pants) showed no significant difference between the two groups of firefighters. A majority of both career firefighters (85%, n = 16) and volunteer firefighters (59%, n = 57) stored their gear at the fire department (p < .05). Although turnout gear is the core component of PPE, 11% of the volunteer firefighters did not own turnout gear Both firefighter groups have a substantial challenge with respect to PPE practices. Career firefighters deal with more frequent exposures to fire-related contaminants during training and while on duty. In contrast, volunteer firefighters lack the resources needed to properly maintain, clean, and store their PPE, concerns that are not addressed by National Fire Protection Association recommendations.


December 2019
December 2019
82.5 | 8-14
Jooyeon Hwang, PhD, Department of Occupational and Environmental Health, Hudson College of Public Health University of Oklahoma Health Sciences Center, Ritchie Taylor, PhD, Department of Public Health, College of Health and Human Services, Western Kentucky University, Gretchen Macy, EdD, Department of Public Health, College of Health and Human Services, Western Kentucky University, Charles “Mac” Cann, MPH, Department of Public Health, College of Health and Human Services, Western Kentucky University
Additional Topics A to Z: Injury Prevention


Preventing lead exposure from all sources is critical for children’s optimal health and development. The crisis in Flint, Michigan, drew attention to the role of drinking water in lead exposure. School drinking water might pose significant risks due to aging infrastructure and the particular conditions of water use in schools. In 2016, New Jersey mandated that school districts test all drinking water outlets for lead and specified procedures that districts must follow. This study assessed compliance with this mandate. Districts were required to report results on their websites, so we used district websites as the unit of analysis to assess compliance with testing and reporting procedures and to identify schools that had reported maximum concentrations of lead in water. Most districts complied with the mandate to test their drinking water (90%) and the majority complied with online reporting requirements to some extent (87%). Most districts (79%) had one or more outlets in their district that exceeded the U.S. Environmental Protection Agency’s action level of 15 ppb. Mandated testing for lead in drinking water in schools is an important policy that can prevent childhood lead exposure. New Jersey should consider lowering the action level at which lead in drinking water should be remediated.


July 2019
July/August 2019
82.1 | 14-19
Marianne Sullivan, MPH, DrPH, William Paterson University of New Jersey, Marcos Lopez, William Paterson University of New Jersey
Additional Topics A to Z: Institutions / Schools