cph review session: environmental health review session: environmental health october 22, 2015...
TRANSCRIPT
CPH Review Session Environmental Health
October 22 2015
Gwendolyn Hudson MPH PhD CPH REHS LT US Public Health Service
bull The intent of this 75 minute review session is to assist PHS Officers from a wide range of agencies and disciplines with an opportunity to take the Certified Public Health (CPH) exam through the National Board of Public Health Examiners (NBPHE) As a ldquopilotrdquo program this test can be taken by PHS Officers at a reduced cost during the month of October 2015
bull In an effort to assist those PHS Officers interested in obtaining this certification a total of 8 weekly 75-minute review sessions will be led In addition these sessions will have additional review materials resources and ldquohomeworkrdquordquo in which the goal is to assist the officer in being prepared to test for this for the CPH exam
bull Please visit the following website if you are interested in the Certified in Public Health (CPH) Exam through the National Board of Public Health Examiners (NBPHE) under this pilot program for the month of October 2015 At this website you will also have access to information on the pilot project (ie target population) and resources to begin to prepare you for examination
wwwnbpheorg For questions please email LCDR Evelyn Seel at EvelynSeelhhsgov
or CDR Harvey Ball at HarveyBallhhsgov
Background
Certified in Public Health (CPH) Exam
DISCLAIMER All views and opinions expressed during this presentation do not represent the USPHS CC FDA EPA or any other agency or organization
Content Overview bull Air Quality ndash Ambient amp Indoor
ndash Primary and Secondary Chemical Contaminants
ndash Greenhouse Gases ndash Difference between Mobile and
Stationary Sources ndash Federal Regulation of Air Quality
bull Clean Air Act bull Criteria Air Pollutants
ndash Chemical Biological and Radiological Contaminants of Air
bull Major Contaminant Sources and Factors Affecting Indoor Air
bull Environmental Tobacco Smoke (PrimarySecond and Third-Hand)
bull Water Quality ndash Resources amp Portable Water ndash Ground Water and Surface
Waters ndash Water Scarcity (Climate Change
and Population Growth) ndash Major Biological and Chemical
Contaminants Associated with Water Quality and Waterborne Illness
ndash Waterborne Illness and Disease ndash Municipal (Potable) Water
Treatment Versus Waste Water Treatment
ndash Federal Regulation of Water bull Clean Water Act
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Content Overview bull Food Quality and Security
ndash Chemical and Biological Contaminants
ndash Foodborne illnesses ndash Causes of Foodborne Illnesses ndash Responses of Foodborne
Illnesses ndash Regulatory Responsibilities of
FDA USDA EPA with Respect to Food
bull Built Environment ndash Planning ndash Ecosystem ndash Sustainability and Planning
bull General Environmental Health ndash Chemical Physical and Biological
agents in the environment that affect human health
bull Occupational Health amp Safety ndash Workplaces and Hazardous Materials ndash Major Types Sources (Chemical
Physical Biological Agents) bull Toxicological Agents Principles
ndash Principles of Toxicology ndash Routes of Exposure ndash Concept of Dose-Response
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Content Overview
bull Infectious and Zoonotic Agents Principles ndash Zoonosis ndash Vectors and Vector Control
bull Global Environmental Health ndash Climate Change
bull Risk Assessment ndash Risk Assessment ndash Risk Communications ndash Risk Management
bull Solid and Hazardous Waste bull Environmental Justice bull Injury and Injury Control bull Disaster Preparedness
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Epidemiologic Triad
Agent
Host Environment
What is Environmental Health
ldquoEnvironmental health comprises those aspects of human health including quality of life that are determined by physical chemical biological social and psychosocial factors in the environment It also refers to the theory and practice of assessing correcting controlling and preventing those factors in the environment that can potentially affect adversely the health of present and future generations rdquo ndash WHO
General Environmental Health ndash Classification of Hazards
bull Chemical Agents ndash Ex Pesticides VOCs Lead Mercury
bull Physical Agents ndash Ex Radiation noise extreme temperatures
vibration pressure
bull Biological Agents ndash Ex Vectors pathogens other microorganisms
Chemical Agents bull Lead
ndash EPA banned in 1978 renal and neurological effects in children
ndash found in paint and gasoline ndash Present in some homes and soil
surrounding homes built prior to ban
bull Mercury ndash Inorganic organic elemental
metallic ndash Minamata Bay Japan - environmental
contamination of elemental mercury ndash Bioaccumulated in fish fish ingested
by residents causing congenital and severe neurological effects
bull Arsenic ndash Organic and inorganic known carcinogen ndash used in pesticides and fungicides
bull Chromium ndash Used in metal alloys ndash Chromium hexavalent is considered
carcinogen to certain animals
bull Manganese ndash mostly found in industry but can be found
in drinking water ndash causes neurological effects in children
bull Cadmium ndash By-product of Zinc production ndash Typically in industry environment ndash Bioaccumulates throughout life once
absorbed
Chemical Agents bull Volatile Organic Compounds
(VOCs) ndash Easily vaporizes (off-gassing) in
ambient temperatures ndash Found in building products
textiles fiberboard and paneling furniture etc
ndash Benzene TCE (trichloroethylene) fluorochlorocarbons
bull Nitrates and Nitrites ndash Affects water treatment systems ndash Creates algal growth (ldquoalgal
bloomrdquo) which increases biochemical oxygen demand and lowers dissolved oxygen
ndash Eutrophication leads to destruction of ecosystem
ndash Sources are runoff from agriculture (fertilizers)
ndash Can cause methemoglobinemia ldquoblue baby syndromerdquo ndash linked to nitrate levels in drinking water
Chemical Agents - Pesticides
bull Persistent Organic Pollutants (POPs) ndash General classification of
chemicals ndash Persist in the environment for
years and bioaccumulate in organisms
bull Endocrine disruptors ndash Interfere with hormone
production transport metabolism and elimination
ndash ldquohormone mimicsrdquo
bull Pesticides ndash Inorganic
bull toxic to humans lead arsenate bull used primarily before WWII)
ndash Organic bull organochlorine or chlorinated
hydrocarbons) bull most are POPs and EDCs DDT
Chlordane Lindane bull Silent Spring by Rachel Carson
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
bull The intent of this 75 minute review session is to assist PHS Officers from a wide range of agencies and disciplines with an opportunity to take the Certified Public Health (CPH) exam through the National Board of Public Health Examiners (NBPHE) As a ldquopilotrdquo program this test can be taken by PHS Officers at a reduced cost during the month of October 2015
bull In an effort to assist those PHS Officers interested in obtaining this certification a total of 8 weekly 75-minute review sessions will be led In addition these sessions will have additional review materials resources and ldquohomeworkrdquordquo in which the goal is to assist the officer in being prepared to test for this for the CPH exam
bull Please visit the following website if you are interested in the Certified in Public Health (CPH) Exam through the National Board of Public Health Examiners (NBPHE) under this pilot program for the month of October 2015 At this website you will also have access to information on the pilot project (ie target population) and resources to begin to prepare you for examination
wwwnbpheorg For questions please email LCDR Evelyn Seel at EvelynSeelhhsgov
or CDR Harvey Ball at HarveyBallhhsgov
Background
Certified in Public Health (CPH) Exam
DISCLAIMER All views and opinions expressed during this presentation do not represent the USPHS CC FDA EPA or any other agency or organization
Content Overview bull Air Quality ndash Ambient amp Indoor
ndash Primary and Secondary Chemical Contaminants
ndash Greenhouse Gases ndash Difference between Mobile and
Stationary Sources ndash Federal Regulation of Air Quality
bull Clean Air Act bull Criteria Air Pollutants
ndash Chemical Biological and Radiological Contaminants of Air
bull Major Contaminant Sources and Factors Affecting Indoor Air
bull Environmental Tobacco Smoke (PrimarySecond and Third-Hand)
bull Water Quality ndash Resources amp Portable Water ndash Ground Water and Surface
Waters ndash Water Scarcity (Climate Change
and Population Growth) ndash Major Biological and Chemical
Contaminants Associated with Water Quality and Waterborne Illness
ndash Waterborne Illness and Disease ndash Municipal (Potable) Water
Treatment Versus Waste Water Treatment
ndash Federal Regulation of Water bull Clean Water Act
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Content Overview bull Food Quality and Security
ndash Chemical and Biological Contaminants
ndash Foodborne illnesses ndash Causes of Foodborne Illnesses ndash Responses of Foodborne
Illnesses ndash Regulatory Responsibilities of
FDA USDA EPA with Respect to Food
bull Built Environment ndash Planning ndash Ecosystem ndash Sustainability and Planning
bull General Environmental Health ndash Chemical Physical and Biological
agents in the environment that affect human health
bull Occupational Health amp Safety ndash Workplaces and Hazardous Materials ndash Major Types Sources (Chemical
Physical Biological Agents) bull Toxicological Agents Principles
ndash Principles of Toxicology ndash Routes of Exposure ndash Concept of Dose-Response
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Content Overview
bull Infectious and Zoonotic Agents Principles ndash Zoonosis ndash Vectors and Vector Control
bull Global Environmental Health ndash Climate Change
bull Risk Assessment ndash Risk Assessment ndash Risk Communications ndash Risk Management
bull Solid and Hazardous Waste bull Environmental Justice bull Injury and Injury Control bull Disaster Preparedness
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Epidemiologic Triad
Agent
Host Environment
What is Environmental Health
ldquoEnvironmental health comprises those aspects of human health including quality of life that are determined by physical chemical biological social and psychosocial factors in the environment It also refers to the theory and practice of assessing correcting controlling and preventing those factors in the environment that can potentially affect adversely the health of present and future generations rdquo ndash WHO
General Environmental Health ndash Classification of Hazards
bull Chemical Agents ndash Ex Pesticides VOCs Lead Mercury
bull Physical Agents ndash Ex Radiation noise extreme temperatures
vibration pressure
bull Biological Agents ndash Ex Vectors pathogens other microorganisms
Chemical Agents bull Lead
ndash EPA banned in 1978 renal and neurological effects in children
ndash found in paint and gasoline ndash Present in some homes and soil
surrounding homes built prior to ban
bull Mercury ndash Inorganic organic elemental
metallic ndash Minamata Bay Japan - environmental
contamination of elemental mercury ndash Bioaccumulated in fish fish ingested
by residents causing congenital and severe neurological effects
bull Arsenic ndash Organic and inorganic known carcinogen ndash used in pesticides and fungicides
bull Chromium ndash Used in metal alloys ndash Chromium hexavalent is considered
carcinogen to certain animals
bull Manganese ndash mostly found in industry but can be found
in drinking water ndash causes neurological effects in children
bull Cadmium ndash By-product of Zinc production ndash Typically in industry environment ndash Bioaccumulates throughout life once
absorbed
Chemical Agents bull Volatile Organic Compounds
(VOCs) ndash Easily vaporizes (off-gassing) in
ambient temperatures ndash Found in building products
textiles fiberboard and paneling furniture etc
ndash Benzene TCE (trichloroethylene) fluorochlorocarbons
bull Nitrates and Nitrites ndash Affects water treatment systems ndash Creates algal growth (ldquoalgal
bloomrdquo) which increases biochemical oxygen demand and lowers dissolved oxygen
ndash Eutrophication leads to destruction of ecosystem
ndash Sources are runoff from agriculture (fertilizers)
ndash Can cause methemoglobinemia ldquoblue baby syndromerdquo ndash linked to nitrate levels in drinking water
Chemical Agents - Pesticides
bull Persistent Organic Pollutants (POPs) ndash General classification of
chemicals ndash Persist in the environment for
years and bioaccumulate in organisms
bull Endocrine disruptors ndash Interfere with hormone
production transport metabolism and elimination
ndash ldquohormone mimicsrdquo
bull Pesticides ndash Inorganic
bull toxic to humans lead arsenate bull used primarily before WWII)
ndash Organic bull organochlorine or chlorinated
hydrocarbons) bull most are POPs and EDCs DDT
Chlordane Lindane bull Silent Spring by Rachel Carson
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Content Overview bull Air Quality ndash Ambient amp Indoor
ndash Primary and Secondary Chemical Contaminants
ndash Greenhouse Gases ndash Difference between Mobile and
Stationary Sources ndash Federal Regulation of Air Quality
bull Clean Air Act bull Criteria Air Pollutants
ndash Chemical Biological and Radiological Contaminants of Air
bull Major Contaminant Sources and Factors Affecting Indoor Air
bull Environmental Tobacco Smoke (PrimarySecond and Third-Hand)
bull Water Quality ndash Resources amp Portable Water ndash Ground Water and Surface
Waters ndash Water Scarcity (Climate Change
and Population Growth) ndash Major Biological and Chemical
Contaminants Associated with Water Quality and Waterborne Illness
ndash Waterborne Illness and Disease ndash Municipal (Potable) Water
Treatment Versus Waste Water Treatment
ndash Federal Regulation of Water bull Clean Water Act
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Content Overview bull Food Quality and Security
ndash Chemical and Biological Contaminants
ndash Foodborne illnesses ndash Causes of Foodborne Illnesses ndash Responses of Foodborne
Illnesses ndash Regulatory Responsibilities of
FDA USDA EPA with Respect to Food
bull Built Environment ndash Planning ndash Ecosystem ndash Sustainability and Planning
bull General Environmental Health ndash Chemical Physical and Biological
agents in the environment that affect human health
bull Occupational Health amp Safety ndash Workplaces and Hazardous Materials ndash Major Types Sources (Chemical
Physical Biological Agents) bull Toxicological Agents Principles
ndash Principles of Toxicology ndash Routes of Exposure ndash Concept of Dose-Response
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Content Overview
bull Infectious and Zoonotic Agents Principles ndash Zoonosis ndash Vectors and Vector Control
bull Global Environmental Health ndash Climate Change
bull Risk Assessment ndash Risk Assessment ndash Risk Communications ndash Risk Management
bull Solid and Hazardous Waste bull Environmental Justice bull Injury and Injury Control bull Disaster Preparedness
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Epidemiologic Triad
Agent
Host Environment
What is Environmental Health
ldquoEnvironmental health comprises those aspects of human health including quality of life that are determined by physical chemical biological social and psychosocial factors in the environment It also refers to the theory and practice of assessing correcting controlling and preventing those factors in the environment that can potentially affect adversely the health of present and future generations rdquo ndash WHO
General Environmental Health ndash Classification of Hazards
bull Chemical Agents ndash Ex Pesticides VOCs Lead Mercury
bull Physical Agents ndash Ex Radiation noise extreme temperatures
vibration pressure
bull Biological Agents ndash Ex Vectors pathogens other microorganisms
Chemical Agents bull Lead
ndash EPA banned in 1978 renal and neurological effects in children
ndash found in paint and gasoline ndash Present in some homes and soil
surrounding homes built prior to ban
bull Mercury ndash Inorganic organic elemental
metallic ndash Minamata Bay Japan - environmental
contamination of elemental mercury ndash Bioaccumulated in fish fish ingested
by residents causing congenital and severe neurological effects
bull Arsenic ndash Organic and inorganic known carcinogen ndash used in pesticides and fungicides
bull Chromium ndash Used in metal alloys ndash Chromium hexavalent is considered
carcinogen to certain animals
bull Manganese ndash mostly found in industry but can be found
in drinking water ndash causes neurological effects in children
bull Cadmium ndash By-product of Zinc production ndash Typically in industry environment ndash Bioaccumulates throughout life once
absorbed
Chemical Agents bull Volatile Organic Compounds
(VOCs) ndash Easily vaporizes (off-gassing) in
ambient temperatures ndash Found in building products
textiles fiberboard and paneling furniture etc
ndash Benzene TCE (trichloroethylene) fluorochlorocarbons
bull Nitrates and Nitrites ndash Affects water treatment systems ndash Creates algal growth (ldquoalgal
bloomrdquo) which increases biochemical oxygen demand and lowers dissolved oxygen
ndash Eutrophication leads to destruction of ecosystem
ndash Sources are runoff from agriculture (fertilizers)
ndash Can cause methemoglobinemia ldquoblue baby syndromerdquo ndash linked to nitrate levels in drinking water
Chemical Agents - Pesticides
bull Persistent Organic Pollutants (POPs) ndash General classification of
chemicals ndash Persist in the environment for
years and bioaccumulate in organisms
bull Endocrine disruptors ndash Interfere with hormone
production transport metabolism and elimination
ndash ldquohormone mimicsrdquo
bull Pesticides ndash Inorganic
bull toxic to humans lead arsenate bull used primarily before WWII)
ndash Organic bull organochlorine or chlorinated
hydrocarbons) bull most are POPs and EDCs DDT
Chlordane Lindane bull Silent Spring by Rachel Carson
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Content Overview bull Food Quality and Security
ndash Chemical and Biological Contaminants
ndash Foodborne illnesses ndash Causes of Foodborne Illnesses ndash Responses of Foodborne
Illnesses ndash Regulatory Responsibilities of
FDA USDA EPA with Respect to Food
bull Built Environment ndash Planning ndash Ecosystem ndash Sustainability and Planning
bull General Environmental Health ndash Chemical Physical and Biological
agents in the environment that affect human health
bull Occupational Health amp Safety ndash Workplaces and Hazardous Materials ndash Major Types Sources (Chemical
Physical Biological Agents) bull Toxicological Agents Principles
ndash Principles of Toxicology ndash Routes of Exposure ndash Concept of Dose-Response
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Content Overview
bull Infectious and Zoonotic Agents Principles ndash Zoonosis ndash Vectors and Vector Control
bull Global Environmental Health ndash Climate Change
bull Risk Assessment ndash Risk Assessment ndash Risk Communications ndash Risk Management
bull Solid and Hazardous Waste bull Environmental Justice bull Injury and Injury Control bull Disaster Preparedness
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Epidemiologic Triad
Agent
Host Environment
What is Environmental Health
ldquoEnvironmental health comprises those aspects of human health including quality of life that are determined by physical chemical biological social and psychosocial factors in the environment It also refers to the theory and practice of assessing correcting controlling and preventing those factors in the environment that can potentially affect adversely the health of present and future generations rdquo ndash WHO
General Environmental Health ndash Classification of Hazards
bull Chemical Agents ndash Ex Pesticides VOCs Lead Mercury
bull Physical Agents ndash Ex Radiation noise extreme temperatures
vibration pressure
bull Biological Agents ndash Ex Vectors pathogens other microorganisms
Chemical Agents bull Lead
ndash EPA banned in 1978 renal and neurological effects in children
ndash found in paint and gasoline ndash Present in some homes and soil
surrounding homes built prior to ban
bull Mercury ndash Inorganic organic elemental
metallic ndash Minamata Bay Japan - environmental
contamination of elemental mercury ndash Bioaccumulated in fish fish ingested
by residents causing congenital and severe neurological effects
bull Arsenic ndash Organic and inorganic known carcinogen ndash used in pesticides and fungicides
bull Chromium ndash Used in metal alloys ndash Chromium hexavalent is considered
carcinogen to certain animals
bull Manganese ndash mostly found in industry but can be found
in drinking water ndash causes neurological effects in children
bull Cadmium ndash By-product of Zinc production ndash Typically in industry environment ndash Bioaccumulates throughout life once
absorbed
Chemical Agents bull Volatile Organic Compounds
(VOCs) ndash Easily vaporizes (off-gassing) in
ambient temperatures ndash Found in building products
textiles fiberboard and paneling furniture etc
ndash Benzene TCE (trichloroethylene) fluorochlorocarbons
bull Nitrates and Nitrites ndash Affects water treatment systems ndash Creates algal growth (ldquoalgal
bloomrdquo) which increases biochemical oxygen demand and lowers dissolved oxygen
ndash Eutrophication leads to destruction of ecosystem
ndash Sources are runoff from agriculture (fertilizers)
ndash Can cause methemoglobinemia ldquoblue baby syndromerdquo ndash linked to nitrate levels in drinking water
Chemical Agents - Pesticides
bull Persistent Organic Pollutants (POPs) ndash General classification of
chemicals ndash Persist in the environment for
years and bioaccumulate in organisms
bull Endocrine disruptors ndash Interfere with hormone
production transport metabolism and elimination
ndash ldquohormone mimicsrdquo
bull Pesticides ndash Inorganic
bull toxic to humans lead arsenate bull used primarily before WWII)
ndash Organic bull organochlorine or chlorinated
hydrocarbons) bull most are POPs and EDCs DDT
Chlordane Lindane bull Silent Spring by Rachel Carson
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Content Overview
bull Infectious and Zoonotic Agents Principles ndash Zoonosis ndash Vectors and Vector Control
bull Global Environmental Health ndash Climate Change
bull Risk Assessment ndash Risk Assessment ndash Risk Communications ndash Risk Management
bull Solid and Hazardous Waste bull Environmental Justice bull Injury and Injury Control bull Disaster Preparedness
Source Certified in Public Health Content Outline httpwwwnbpheorgdocumentsCPH_Content_Outline_April_2014pdf
Epidemiologic Triad
Agent
Host Environment
What is Environmental Health
ldquoEnvironmental health comprises those aspects of human health including quality of life that are determined by physical chemical biological social and psychosocial factors in the environment It also refers to the theory and practice of assessing correcting controlling and preventing those factors in the environment that can potentially affect adversely the health of present and future generations rdquo ndash WHO
General Environmental Health ndash Classification of Hazards
bull Chemical Agents ndash Ex Pesticides VOCs Lead Mercury
bull Physical Agents ndash Ex Radiation noise extreme temperatures
vibration pressure
bull Biological Agents ndash Ex Vectors pathogens other microorganisms
Chemical Agents bull Lead
ndash EPA banned in 1978 renal and neurological effects in children
ndash found in paint and gasoline ndash Present in some homes and soil
surrounding homes built prior to ban
bull Mercury ndash Inorganic organic elemental
metallic ndash Minamata Bay Japan - environmental
contamination of elemental mercury ndash Bioaccumulated in fish fish ingested
by residents causing congenital and severe neurological effects
bull Arsenic ndash Organic and inorganic known carcinogen ndash used in pesticides and fungicides
bull Chromium ndash Used in metal alloys ndash Chromium hexavalent is considered
carcinogen to certain animals
bull Manganese ndash mostly found in industry but can be found
in drinking water ndash causes neurological effects in children
bull Cadmium ndash By-product of Zinc production ndash Typically in industry environment ndash Bioaccumulates throughout life once
absorbed
Chemical Agents bull Volatile Organic Compounds
(VOCs) ndash Easily vaporizes (off-gassing) in
ambient temperatures ndash Found in building products
textiles fiberboard and paneling furniture etc
ndash Benzene TCE (trichloroethylene) fluorochlorocarbons
bull Nitrates and Nitrites ndash Affects water treatment systems ndash Creates algal growth (ldquoalgal
bloomrdquo) which increases biochemical oxygen demand and lowers dissolved oxygen
ndash Eutrophication leads to destruction of ecosystem
ndash Sources are runoff from agriculture (fertilizers)
ndash Can cause methemoglobinemia ldquoblue baby syndromerdquo ndash linked to nitrate levels in drinking water
Chemical Agents - Pesticides
bull Persistent Organic Pollutants (POPs) ndash General classification of
chemicals ndash Persist in the environment for
years and bioaccumulate in organisms
bull Endocrine disruptors ndash Interfere with hormone
production transport metabolism and elimination
ndash ldquohormone mimicsrdquo
bull Pesticides ndash Inorganic
bull toxic to humans lead arsenate bull used primarily before WWII)
ndash Organic bull organochlorine or chlorinated
hydrocarbons) bull most are POPs and EDCs DDT
Chlordane Lindane bull Silent Spring by Rachel Carson
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Epidemiologic Triad
Agent
Host Environment
What is Environmental Health
ldquoEnvironmental health comprises those aspects of human health including quality of life that are determined by physical chemical biological social and psychosocial factors in the environment It also refers to the theory and practice of assessing correcting controlling and preventing those factors in the environment that can potentially affect adversely the health of present and future generations rdquo ndash WHO
General Environmental Health ndash Classification of Hazards
bull Chemical Agents ndash Ex Pesticides VOCs Lead Mercury
bull Physical Agents ndash Ex Radiation noise extreme temperatures
vibration pressure
bull Biological Agents ndash Ex Vectors pathogens other microorganisms
Chemical Agents bull Lead
ndash EPA banned in 1978 renal and neurological effects in children
ndash found in paint and gasoline ndash Present in some homes and soil
surrounding homes built prior to ban
bull Mercury ndash Inorganic organic elemental
metallic ndash Minamata Bay Japan - environmental
contamination of elemental mercury ndash Bioaccumulated in fish fish ingested
by residents causing congenital and severe neurological effects
bull Arsenic ndash Organic and inorganic known carcinogen ndash used in pesticides and fungicides
bull Chromium ndash Used in metal alloys ndash Chromium hexavalent is considered
carcinogen to certain animals
bull Manganese ndash mostly found in industry but can be found
in drinking water ndash causes neurological effects in children
bull Cadmium ndash By-product of Zinc production ndash Typically in industry environment ndash Bioaccumulates throughout life once
absorbed
Chemical Agents bull Volatile Organic Compounds
(VOCs) ndash Easily vaporizes (off-gassing) in
ambient temperatures ndash Found in building products
textiles fiberboard and paneling furniture etc
ndash Benzene TCE (trichloroethylene) fluorochlorocarbons
bull Nitrates and Nitrites ndash Affects water treatment systems ndash Creates algal growth (ldquoalgal
bloomrdquo) which increases biochemical oxygen demand and lowers dissolved oxygen
ndash Eutrophication leads to destruction of ecosystem
ndash Sources are runoff from agriculture (fertilizers)
ndash Can cause methemoglobinemia ldquoblue baby syndromerdquo ndash linked to nitrate levels in drinking water
Chemical Agents - Pesticides
bull Persistent Organic Pollutants (POPs) ndash General classification of
chemicals ndash Persist in the environment for
years and bioaccumulate in organisms
bull Endocrine disruptors ndash Interfere with hormone
production transport metabolism and elimination
ndash ldquohormone mimicsrdquo
bull Pesticides ndash Inorganic
bull toxic to humans lead arsenate bull used primarily before WWII)
ndash Organic bull organochlorine or chlorinated
hydrocarbons) bull most are POPs and EDCs DDT
Chlordane Lindane bull Silent Spring by Rachel Carson
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
What is Environmental Health
ldquoEnvironmental health comprises those aspects of human health including quality of life that are determined by physical chemical biological social and psychosocial factors in the environment It also refers to the theory and practice of assessing correcting controlling and preventing those factors in the environment that can potentially affect adversely the health of present and future generations rdquo ndash WHO
General Environmental Health ndash Classification of Hazards
bull Chemical Agents ndash Ex Pesticides VOCs Lead Mercury
bull Physical Agents ndash Ex Radiation noise extreme temperatures
vibration pressure
bull Biological Agents ndash Ex Vectors pathogens other microorganisms
Chemical Agents bull Lead
ndash EPA banned in 1978 renal and neurological effects in children
ndash found in paint and gasoline ndash Present in some homes and soil
surrounding homes built prior to ban
bull Mercury ndash Inorganic organic elemental
metallic ndash Minamata Bay Japan - environmental
contamination of elemental mercury ndash Bioaccumulated in fish fish ingested
by residents causing congenital and severe neurological effects
bull Arsenic ndash Organic and inorganic known carcinogen ndash used in pesticides and fungicides
bull Chromium ndash Used in metal alloys ndash Chromium hexavalent is considered
carcinogen to certain animals
bull Manganese ndash mostly found in industry but can be found
in drinking water ndash causes neurological effects in children
bull Cadmium ndash By-product of Zinc production ndash Typically in industry environment ndash Bioaccumulates throughout life once
absorbed
Chemical Agents bull Volatile Organic Compounds
(VOCs) ndash Easily vaporizes (off-gassing) in
ambient temperatures ndash Found in building products
textiles fiberboard and paneling furniture etc
ndash Benzene TCE (trichloroethylene) fluorochlorocarbons
bull Nitrates and Nitrites ndash Affects water treatment systems ndash Creates algal growth (ldquoalgal
bloomrdquo) which increases biochemical oxygen demand and lowers dissolved oxygen
ndash Eutrophication leads to destruction of ecosystem
ndash Sources are runoff from agriculture (fertilizers)
ndash Can cause methemoglobinemia ldquoblue baby syndromerdquo ndash linked to nitrate levels in drinking water
Chemical Agents - Pesticides
bull Persistent Organic Pollutants (POPs) ndash General classification of
chemicals ndash Persist in the environment for
years and bioaccumulate in organisms
bull Endocrine disruptors ndash Interfere with hormone
production transport metabolism and elimination
ndash ldquohormone mimicsrdquo
bull Pesticides ndash Inorganic
bull toxic to humans lead arsenate bull used primarily before WWII)
ndash Organic bull organochlorine or chlorinated
hydrocarbons) bull most are POPs and EDCs DDT
Chlordane Lindane bull Silent Spring by Rachel Carson
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
General Environmental Health ndash Classification of Hazards
bull Chemical Agents ndash Ex Pesticides VOCs Lead Mercury
bull Physical Agents ndash Ex Radiation noise extreme temperatures
vibration pressure
bull Biological Agents ndash Ex Vectors pathogens other microorganisms
Chemical Agents bull Lead
ndash EPA banned in 1978 renal and neurological effects in children
ndash found in paint and gasoline ndash Present in some homes and soil
surrounding homes built prior to ban
bull Mercury ndash Inorganic organic elemental
metallic ndash Minamata Bay Japan - environmental
contamination of elemental mercury ndash Bioaccumulated in fish fish ingested
by residents causing congenital and severe neurological effects
bull Arsenic ndash Organic and inorganic known carcinogen ndash used in pesticides and fungicides
bull Chromium ndash Used in metal alloys ndash Chromium hexavalent is considered
carcinogen to certain animals
bull Manganese ndash mostly found in industry but can be found
in drinking water ndash causes neurological effects in children
bull Cadmium ndash By-product of Zinc production ndash Typically in industry environment ndash Bioaccumulates throughout life once
absorbed
Chemical Agents bull Volatile Organic Compounds
(VOCs) ndash Easily vaporizes (off-gassing) in
ambient temperatures ndash Found in building products
textiles fiberboard and paneling furniture etc
ndash Benzene TCE (trichloroethylene) fluorochlorocarbons
bull Nitrates and Nitrites ndash Affects water treatment systems ndash Creates algal growth (ldquoalgal
bloomrdquo) which increases biochemical oxygen demand and lowers dissolved oxygen
ndash Eutrophication leads to destruction of ecosystem
ndash Sources are runoff from agriculture (fertilizers)
ndash Can cause methemoglobinemia ldquoblue baby syndromerdquo ndash linked to nitrate levels in drinking water
Chemical Agents - Pesticides
bull Persistent Organic Pollutants (POPs) ndash General classification of
chemicals ndash Persist in the environment for
years and bioaccumulate in organisms
bull Endocrine disruptors ndash Interfere with hormone
production transport metabolism and elimination
ndash ldquohormone mimicsrdquo
bull Pesticides ndash Inorganic
bull toxic to humans lead arsenate bull used primarily before WWII)
ndash Organic bull organochlorine or chlorinated
hydrocarbons) bull most are POPs and EDCs DDT
Chlordane Lindane bull Silent Spring by Rachel Carson
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Chemical Agents bull Lead
ndash EPA banned in 1978 renal and neurological effects in children
ndash found in paint and gasoline ndash Present in some homes and soil
surrounding homes built prior to ban
bull Mercury ndash Inorganic organic elemental
metallic ndash Minamata Bay Japan - environmental
contamination of elemental mercury ndash Bioaccumulated in fish fish ingested
by residents causing congenital and severe neurological effects
bull Arsenic ndash Organic and inorganic known carcinogen ndash used in pesticides and fungicides
bull Chromium ndash Used in metal alloys ndash Chromium hexavalent is considered
carcinogen to certain animals
bull Manganese ndash mostly found in industry but can be found
in drinking water ndash causes neurological effects in children
bull Cadmium ndash By-product of Zinc production ndash Typically in industry environment ndash Bioaccumulates throughout life once
absorbed
Chemical Agents bull Volatile Organic Compounds
(VOCs) ndash Easily vaporizes (off-gassing) in
ambient temperatures ndash Found in building products
textiles fiberboard and paneling furniture etc
ndash Benzene TCE (trichloroethylene) fluorochlorocarbons
bull Nitrates and Nitrites ndash Affects water treatment systems ndash Creates algal growth (ldquoalgal
bloomrdquo) which increases biochemical oxygen demand and lowers dissolved oxygen
ndash Eutrophication leads to destruction of ecosystem
ndash Sources are runoff from agriculture (fertilizers)
ndash Can cause methemoglobinemia ldquoblue baby syndromerdquo ndash linked to nitrate levels in drinking water
Chemical Agents - Pesticides
bull Persistent Organic Pollutants (POPs) ndash General classification of
chemicals ndash Persist in the environment for
years and bioaccumulate in organisms
bull Endocrine disruptors ndash Interfere with hormone
production transport metabolism and elimination
ndash ldquohormone mimicsrdquo
bull Pesticides ndash Inorganic
bull toxic to humans lead arsenate bull used primarily before WWII)
ndash Organic bull organochlorine or chlorinated
hydrocarbons) bull most are POPs and EDCs DDT
Chlordane Lindane bull Silent Spring by Rachel Carson
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Chemical Agents bull Volatile Organic Compounds
(VOCs) ndash Easily vaporizes (off-gassing) in
ambient temperatures ndash Found in building products
textiles fiberboard and paneling furniture etc
ndash Benzene TCE (trichloroethylene) fluorochlorocarbons
bull Nitrates and Nitrites ndash Affects water treatment systems ndash Creates algal growth (ldquoalgal
bloomrdquo) which increases biochemical oxygen demand and lowers dissolved oxygen
ndash Eutrophication leads to destruction of ecosystem
ndash Sources are runoff from agriculture (fertilizers)
ndash Can cause methemoglobinemia ldquoblue baby syndromerdquo ndash linked to nitrate levels in drinking water
Chemical Agents - Pesticides
bull Persistent Organic Pollutants (POPs) ndash General classification of
chemicals ndash Persist in the environment for
years and bioaccumulate in organisms
bull Endocrine disruptors ndash Interfere with hormone
production transport metabolism and elimination
ndash ldquohormone mimicsrdquo
bull Pesticides ndash Inorganic
bull toxic to humans lead arsenate bull used primarily before WWII)
ndash Organic bull organochlorine or chlorinated
hydrocarbons) bull most are POPs and EDCs DDT
Chlordane Lindane bull Silent Spring by Rachel Carson
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Chemical Agents - Pesticides
bull Persistent Organic Pollutants (POPs) ndash General classification of
chemicals ndash Persist in the environment for
years and bioaccumulate in organisms
bull Endocrine disruptors ndash Interfere with hormone
production transport metabolism and elimination
ndash ldquohormone mimicsrdquo
bull Pesticides ndash Inorganic
bull toxic to humans lead arsenate bull used primarily before WWII)
ndash Organic bull organochlorine or chlorinated
hydrocarbons) bull most are POPs and EDCs DDT
Chlordane Lindane bull Silent Spring by Rachel Carson
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Chemical Agents - Pesticides bull Organophosphate
ndash First developed as wartime nerve gas agent Ex Sarin
ndash Nerve poisons inhibit cholinesterase enzyme breakdown buildup of acetylcholinesterase
ndash Range from weak to extremely toxic
ndash Broad-spectrum affects multiple species
ndash Break down in environment in weeks
ndash Ex Parathion malathion ndash Phosphates can also contribute
to eutrophication
bull Carbamate ndash Used in public health
applications agriculture ndash Mostly low toxicity to humans ndash Rapid knock-down ndash Ex Sevin (garden dust)
bull Pyrethroids ndash Extract from chrysanthemum
flowers common home amp garden
ndash Broad-spectrum ndash Low toxicity to humans and
animals ndash Can be used in dogcat flea
collars
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Physical Agents - Ionizing Radiation
bull Alpha particles ndash Low energy ndash Stopped by paper skin most clothing
bull Beta particles ndash More energy ndash Stopped by tinfoil most building materials
bull Gamma or X-rays ndash Requires concrete or lead to stop
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Physical Agents - Nonionizing Radiation
bull Ultraviolet light (UVA UVB) ndash Chronic exposure can cause skin cancers carcinomas melanomas
bull Visible light bull Infrared light (heat) bull Low frequency
ndash Radio radar microwaves electromagnetic fields (EMF) ndash Can cause anxiety psychological effects
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Sources of Radiation
bull Natural 50 ndash Cosmic radiation natural terrestrial minerals
radionuclides in body ndash Radon alone 37
bull Medical 48 bull Consumer products occupational and industrial 2
National Council on Radiation Protection amp Measurements 2015
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Radiation bull High level
ndash Causes cell death ndash Radiation sickness
(accidental exposure) bull Low level
ndash Causes cell damage ndash Genetic effects congenital
abnormalities cancer (mutagen teratogen carcinogen)
bull Higher altitudes lead to greater exposure to cosmic radiation
bull Half-Life Decay ndash A half-life is the period
of time necessary to reduce the amount of the substance by one-half
ndash Many radioactive substances have an extremely long half-life on the order of hundreds to thousands of years
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Physical Agents ndash Sound and Effects of Noise
bull Frequency (pitch) ndash Measured in Hertz (Hz)
bull Amplitude (volume loudness) ndash Measured in decibels (dB)
bull Decibels are measured on a logarithmic scale
bull Threshold of hearing ndash 0 dB bull Threshold of pain ndash 140 dB bull Hearing damage begins at
sustained volume of 85 decibels
bull Workplace exposure regulated by OSHA
bull Sleep deprivation stress learning ability safety
bull Sensorineural ndash Irreversible hearing aid will not
help bull Conductive
ndash Often treatable with surgery or medication
bull Presbycusis ndash Age related hearing loss
bull Temporary Threshold Shift bull Tinnitis
ndash Persistent ringing or buzzing Usually accompanies sensorineural
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Biological Agents ndash Zoonoses and Communicable Diseases
bull Zoonoses ndash any disease or infection that is transmitted by vertebrate animals to humans ndash Can occur via bacteria viruses parasites fungus prions ndash Can be transmitted as vectorborne waterborne soil foodborne airborne
bull Examples of Zoonoses include (See ldquoAdditional Resourcesrdquo slide) ndash Lyme disease and Rocky Mountain spotted fever ndash West Nile Virus ndash Dengue fever and malaria ndash Salmonella from handling live poultry and reptiles ndash Escherichia coli (E coli)
bull Antibiotic resistance super bugs (Ex Methicillin-Resistant Staphylococcus aureus (MRSA) ndash Incomplete treatment ndash Incorrect usage of antibiotics ndash Plasmid can transfer resistance
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Vectors of Infectious Diseases and Pest Management
bull Vector is an organism (typically insect or rodents) which carries disease plasmids viruses and bacteria can also be vectors
bull Pests can contaminate food cause discomfort allergic reactions and may poison humans and animals
bull Insects ndash Mosquitos flies fleas ticks bed
bugs roaches lice etc
bull Rodents ndash Hantavirus plague (fleas on rodents)
bull Other large mammals (primates dogs cats horses etc) reptiles and amphibians
bull Integrated Pest Management (IPM) ndash An approach that combines
information and strategies to effectively address pest control issues
ndash Catered to specific and individual pest prevention goals and eradication needs
ndash Typically uses environmentally sensitive approach that uses a variety of tools
bull Knowledge of pest life cycle to inhibit growth and development of pests
bull Use of other organisms to naturally reduce pest population
bull May involve the use of pesticides when necessary
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Routes of Entry bull Inhalation ndash exposure through the respiratory system occurs
from breathing ambient air indoor air or contaminated air in the work environment most common route for occupational
bull Dermal (parenteral) ndash exposure due to absorption on through the skin also includes the eye exposure potential is determined by the concentration of the toxicant surface area involved and duration of contact
bull Ingestion - exposure based on consumption foods (solids and liquids) and non-food items consumed by accident (dust particulates etc)
bull Injection ndash exposure due to the penetration or puncture of the skin
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Toxicology bull The study of how specific
chemicals cause injury to living cells and whole organisms
bull Dose vs Exposure ndash Dose is amount in body
bull Dose-Response Curve ndash Threshold ndash Toxic Dose TD50 and TD100 ndash Effective Dose ED50 and ED100 ndash Lowest observable adverse effect
level (LOAEL) ndash No observable adverse effect
level (NOAEL) bull Risk = Toxicity x Exposure
Sources httpwwweoearthorgviewarticle151784 httpstoxlearnnlmnihgovhtmlversionmodule1html
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Dose-Response
bull For regulatory purposes we assume that radiation has a dose-response relationship
bull The higher the dose the greater the effects observed
bull Exception to the carcinogen rule ndash For carcinogens there is no safe threshold level
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Bioaccumulation and Biomagnification of Chemicals
bull ldquoThe accumulation of chemicals in the tissue of organism either directly from exposure to a contaminated medium or by consumption of food containing the chemicalrdquo EPA 2010
ndash Bioaccumulation occurs within the organism usually refers to the first organism
ndash Bioconcentration is used to describe absorption directly from medium
bull Biomagnification occurs across levels of the food chain
bull Resulting in animals higher in the food chain receiving greater burden
ndash DDT Mercury PCBs etc
bull Example Minamata Bay Japan
Source httpmercurypolicyscriptsmitedu
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Toxicology Terminology bull Toxicant is any substance that can
potentially produce toxicity or an adverse biological effect typically introduced by man
bull Toxin naturally occurring any various poisonous substance produced by organisms (bacterial mycotoxin zootoxin etc)
bull Xenobiotic is any chemical which is ldquoforeignrdquo to the body
bull Poison any substance that cause harm to organisms when sufficient quantities are inhaled absorbed or ingested effect can be illness to death
bull The amount of a substance is of crucial importance
All substances are poisons there is none which is not a poison The right dose differentiates a poison and a remedyldquo - Paracelsus Father of Toxicology
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Selection of Species for Toxicity Testing
bull Varies with toxicity test performed and no single species for all types of tests ndash Rodents and rabbits most common ndash Low costs and historically reliably results
bull Route of exposure should simulate human exposure ndash Inhalation oral dermal
bull Age of test animals (typically young adults pregnant newborn) bull Both sexes are used bull Assays and tests vary based on proven methods accepted by scientific
bodies ndash Number of animals for statistical significance dosage requirements and
observation bull Types of Toxicity Tests include acute sub chronic chronic carcinogenicity
reproductive developmental dermal ocular neurotoxicity genetic
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Risk Assessment
bull The process of characterizing the risk or adverse effects either to human health or to the environment that may result from exposures to specific pollutants or other toxic agents
bull Types of Risk Assessments ndash Public Health Hazard Assessments - NIOSH Health Hazard
Evaluations in workplaces (popcorn lung) ndash Health Impact Assessments ndash EPA IRIS (Integrated Risk Information System) evaluates
information on health effects that may result from exposure to environmental contaminants
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Risk Assessment
bull Four Components ndash Hazard Identification ndash Qualification step serves to identify the
contaminants and exposure for further evaluation ndash Toxicity (Dose-Response) Assessment ndash Characterization of the
inherent toxicity of a chemical ndash Exposure Assessment
bull Route of exposure (ex dermal) distribution (ex Blood) biotransformation or metabolism and target organ and excretion or elimination (ex Urine)
bull 4 major routes of elimination urine feces respiratory body fluids (breast milk)
ndash Risk Characterization ndash this step serves to estimate the risk based on the information collected during hazard ID toxicity assessment and exposure assessment
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Risk Communication and Management
bull Risk Communication ndash ldquoinformation exchangerdquo ndash Ex Federal Register Notice
Public Notices etc ndash 7 Rules for Risk Communication
bull Accept and involve the public bull Plan and evaluate bull Listen to public concerns bull Honest frank open bull Coordinate with credible
sources bull Media involvement bull Speak clearly with compassion
bull Risk Management ndash ldquoDecision makingrdquo ndash Considers risk assessment
technology feasibility economic impact statutory requirements public concerns and etc
ndash Risk Assessment supports risk management
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Environmental Health Services
bull Air bull WaterWastewater bull Food bull Solid Waste bull Hazardous Waste
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Air Quality - Ambient
bull Composition ndash 781 Nitrogen ndash 209 Oxygen ndash 09 Argon ndash 01 Other
bull Carbon dioxide neon helium methane ndash Water dropletsice crystals dust
bull Atmospheric Conditions ndash Prevailing Winds ndash Air Temperature ndash Inversion - a thin layer of the atmosphere where the normal decrease
in temperature with height switches to the temperature increasing with height An inversion acts like a lid
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Criteria Air Pollutants bull National Ambient Air Quality Standards (NAAQS) sets limits for the six primary air pollutants
revised every 5 years ndash Sulfur dioxide (acid rain) ndash causes respiratory effects particularly in asthmatics and other susceptible
populations ndash Nitrogen oxides (smog acid rain) ndash linked to respiratory effects can affect asthmatics ndash Carbon monoxide ndash reduces oxygen to body tissues can affect those with cardiovascular conditions ndash Ozone ndash airway irritation coughing difficulty breathing can affect COPD asthmatic ndash Lead ndash Metal that occurs naturally can cause neurological effects in children can also affect kidney
immune development and reproductive systems ndash Particulate Matter ndash particulates measuring below 10 micrometers includes both PM10 and PM25
can cause respiratory effects
bull State Implementation Plans ndash specific obligations to ensure that new NAAQS are met developed using public input
ndash Within 2 years ndash designates areas that meet (attainment) or do not meet (nonattainment) standards ndash Within 3 years ndash all states must submit plans showing basic air quality management program
components are in place ndash Within 18-36 months after designations ndash Nonattainment states (ldquoGreen Bookrdquo) due dates for
outlining strategies and emissions control measures to ensure states meet new NAAQS
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Air Quality ndash Primary and Secondary Standards
Source httpwww3epagovttnnaaqscriteriahtml
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Climate Change
bull Increase in Earthrsquos average temperature ndash Increased by 15 degrees F in the past 100 years ndash 05 to 86 degrees over the next 100 years
bull Climate change indicators include ndash weather and rising global temperatures ndash oceans absorbing more heat resulting in increased surface temperatures ndash trends regarding snow and glaciers ndash health and society including heat-related deaths tick populations and Lyme
disease ndash ecosystems (wildfires longer seasons and bloom dates bird migration pattern
changes and ndash Greenhouse gases
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Greenhouse Gases
bull Greenhouse gases created by human activities are the largest driver of climate change (increased by 6 from 1990 to 2013) ndash Carbon dioxide ndash primarily emitted through fossil fuels solid waste trees and
wood products deforestation and soil degradation play a role ndash Nitrous oxide ndash sources are primarily agricultural and industrial activities
combustion of fossil fuels and solid waste ndash Methane ndash production and transport of coal natural gas and oil livestock and
agricultural practices decay from municipal solid waste landfills ndash Fluorinated gasesChlorofluorocarbons (CFCs) ndash variety of industrial processes
and commercial and household uses (new labels on spray aerosol cans) can destroy the stratospheric ozone layer
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Ambient Air ndash Sources and Effects
bull Anthropogenic ndash Man-made ndash Mobile
bull Cars airplanes trains etc ndash Stationary
bull Industrial processes (coalwood burning)
bull Urban Municipalities (energy use and production)
bull Natural ndash forest fires ndash dust storms ndash volcanic eruptions
bull Health Effects ndash Asthma ndash Chronic Bronchitis ndash Pulmonary emphysema ndash Lung Cancer
bull Environmental Effects ndash Acid rain and damage to
vegetation ndash Smog ndash Global warming ndash Ozone depletion
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Air Quality - Indoor
Source httpwwwcdcgovncehpublicationsbookshousingfigure_cha07htm
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Indoor Air Quality (IAQ) Contaminants
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Environmental Tobacco Smoke and Other IAQ
bull ETS contains over 4000 chemical compounds universal asthma trigger and known human carcinogen
bull First hand ndash exposure to the smoker resulting from inhaled cigarette or tobacco smoke
bull Secondhand ndashtraditionally ETS also known as passive smoke mixture of 2 forms ndash Sidestream smoke from lighted end of cigarette pipe or cigar ndash Mainstream smoke exhaled by smoker
bull Third hand ndash exposure to smoke particulate and gas residues that exist on surfaces and dust includes clothing furniture cars homes etc
bull Indoor Air Quality can also be affected by mold fungi allergens (pet dander) and insects
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Air Legislation - CAA
bull Clean Air Act 1970 ndash Established ambient air standards for the six criteria air
pollutants ndash Regulates both mobile and stationary sources ndash Hazardous air pollutants (HAPs) ndash criteria pollutants that
are human carcinogens asbestos benzene beryllium mercury radionuclides vinyl chloride
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Water Quality- Sources amp Distribution
bull Earthrsquos Water Distribution ndash 975 Saltwater (Oceans and other saline sources) ndash 25 Freshwater
bull 687 Frozen bull 301 Groundwater bull 12 Surface water
bull Two primary sources ndash Groundwater (aquifers underground lakes streams)
bull Excessive droughts can lower the water table bull Excessive flooding or pumping groundwater can create sinkholes
ndash Surface Water (lakes rivers reservoirs)
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Water Quality ndash Hydrologic Cycle
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Sources of Water Pollution
bull Point Sources ndash Pollution that comes from a discrete source ndash Factory wastes dumps into body of water ndash Requires National Pollutant Discharge Elimination System (NPDES)
Permit ndash control program to regulate the amount and type of discharge eliminated in public water systems
bull Nonpoint Sources ndash Pollution that comes from more diffuse sources particularly runoff ndash Agriculture construction urban street mining airborne pollutant
fallout
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Waterborne Pathogens and National Primary Drinking Water Standards
bull National Primary Drinking Water Standards are regulated by EPA and are legally enforceable standards which apply only to public water systems
bull They consist of microorganisms disinfectants and disinfection byproducts inorganic and organic chemicals and radionuclides
bull EPA Regulates the following pathogens in drinking water For other contaminants See ldquoAdditional Resourcesrdquo slide
ndash Cryptosporidium bull Single cell protozoa found in surface waters contaminated by sewage and animal waste bull GI illnesses (diarrhea vomiting cramps)
ndash Giardia lamblia bull Single cell protozoa found in soil food or water contaminated with feces of infected humans or animals bull Symptoms include cramps diarrhea and headaches
ndash Legionella bull Bacteria found naturally in environment usually water bull Legionella are health risk if bacteria is aerosolized (shower) and inhaled bull Can result in Legionnaires disease a type of pneumonia
ndash Enteric viruses bull Includes polioviruses and non-polio enteroviruses bull Illnesses include norovirus rotavirus and meningitis
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Water Treatment Process bull Maximum Contaminant Level Goal (MCLG) - The level of a contaminant in
drinking water below which there is no known or expected risk to health MCLGs allow for a margin of safety and are non-enforceable public health goals (MCLG for microorganisms is zero)
bull Maximum Contaminant Level (MCL) - The highest level of a contaminant that is allowed in drinking water MCLs are set as close to MCLGs as feasible using the best available treatment technology and taking cost into consideration MCLs are enforceable standards
bull Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Water Treatment bull Potable vs Palatable ndash Tertiary treatment processes are more aesthetic
(taste clarity etc) bull Physical properties
ndash Color temperature sediment suspended (floating) solids ndash Turbidity (measure of water clarity) includes suspended solids particles and
can affect color high turbidity higher water temperatures lowering concentration of dissolved oxygen
ndash Suspended solids removed via sedimentation and filtration bull Chemical properties
ndash Dissolved solids phosphates pesticides petrochemicals heavy metals ndash DS are in solution and are removed by extraction precipitation distillation
bull Biological ndash Bacteria viruses parasites fungi
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Steps for Water Treatment bull Preliminary Treatment amp Sedimentation involves physical chemical and
mechanical processes to remove large solids bull CoagulationFlocculation mixes alum with turbid water to produce large flocs that
settle out bull Clarification
ndash Filtration to remove suspended solids
bull Disinfection ndash destroys pathogenic bacteria and harmful organisms ndash Pre-Chlorination ndash Post-Chlorination leaves residual chlorine for continued disinfection throughout distribution
bull Conditioning ndash removal of undesirable material add desirable material bull Softening and Stabilization ndash Removal of Calcium and Magnesium to reduce scale bull Fluoridation to prevent dental caries bull Removal of tastesodors using activated carboncharcoal
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Water Quality ndash Water Treatment Process
Source httpcof-cofcasurface-water-treatment-plant-flow-diagram
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Wastewater Treatment bull Primary Treatment
ndash Solids removed by physical processes includes primary clarification step ndash BOD (biochemical oxygen demand) - the amount of oxygen microorganisms must consume to
breakdown the organic material present in the wastewater ndash Primary treatment can reduce BOD by 20 to 30 percent and suspended solids by up to 60 percent
bull Secondary Treatment ndash Biological processes remove organic waste microbes consume the organic matter as food
converting it to carbon dioxide water and energy ndash May use activated sludge or construct wetlands ndash Final phase involves a settling process to remove more SS Secondary treatment can remove up to 85
percent of BOD and total suspended solids
bull Tertiary Treatment ndash Removes remaining solids and BOD ndash Rapid sand filters micro straining and fluidized bed systems are commonly used in tertiary treatment ndash Activated carbon and sand are typically used
bull Disinfection step may be added
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Water Quality ndash Wastewater Treatment Process
Source httpwatertreatmentprocessnetwaste-water-treatment-processwaste-water-treatment-process
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Water Legislation - SDWA
bull Safe Drinking Water Act (1974) ndash Principal federal law in the US intended to ensure safe
drinking water for the public ndash Amended in 1996 ndash Primarily involves public water systems does not apply to
private wells ndash Required to set standards for drinking water quality and
oversee states localities and water suppliers who implement standards
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Water Legislation - CWA
bull Clean Water Act (1972) ndash Primary federal law in the US governing water pollution
based on the Federal Water Pollution Control Amendments of 1972
ndash Thrust of legislation is toward chemical physical and biological integrity of waters for recreation and wildlife
ndash Name changed in 1977 with amendments
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Food Safety
bull Involves active managerial controls ndash Time and Temperature are biggest sources of problems
bull Cooking temperatures (initial cooking temperature and times) bull Cold and Hot holding (the amount of time and temperature requirements cooked
food must be held to ensure reasonably safe)
ndash Handwashing and worker hygiene a close second ndash Cross-contamination ndash separate raw meats from cooked foods or foods
that have no additional kill step ndash Safe and reputable food sources chain of custody ndash Adequate labeling to identify food allergens
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Food Storage bull Factors that promote the growth of bacterial life
ndash FAT TOM bull Food - nutrients especially protein rich bull Acidity (pH) - thrive in pH 66 to 75 bull Time ndash 2 hours is danger zone bull Temperature ndash between 41 to 135 is danger zone (thrive between 70 and
120) bull Oxygen - most are aerobic bull Moisture ndash Water activity between 10 and 086
bull Food storage techniques aim to deny these requirements
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Food Safety ndash Foodborne Illnesses bull Sickness that occurs when people eat or drink harmful microorganisms or
chemical contaminants present in food and or water ndash Symptoms and incubation will vary by pathogen but typical symptoms include
stomach cramping or pain vomiting diarrhea fever headaches chills body aches
ndash Typical foodborne pathogens resource document (See Resources slide) bull Foodborne Illness Response Efforts
ndash State and Local health agencies are typically the first to detect an outbreak required to report cases of foodborne illness to the CDC
ndash CDC determines extent of outbreak by linking clusters of foodborne illnesses to different areas using FoodNet and PulseNet
ndash FDA becomes involved when the outbreak involves an FDA-regulated product suspected as the cause
ndash Coordinated Outbreak Response and Evaluation (CORE) Network manages outbreak response surveillance and post-response activities
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Hazard Analysis and Critical Control Points (HACCP)
bull A systematic (preventive) approach to the identification evaluation and control of food safety hazards
bull Management system for food safety which covers control of biological chemical and physical hazards that may be introduced in all steps of food production
bull Prerequisites include ndash Protection from hazards ndash Control of bacterial growth from
temperature abuse ndash Maintenance of equipment
bull HACCP plan is a written document bull HACCP system involves implementation of
the plan
bull 7 HACCP Principles ndash Conduct hazard analysis ndash Determine critical control points (point at
which a measure of control can be applied preventing eliminating or reducing hazard to acceptable level)
ndash Establish critical limits (the value to which a parameter must be controlled including time temperature physical dimensions humidity moisture pH etc)
ndash Establish monitoring procedures allows the opportunity to take corrective action
ndash Establish verification procedures (confirms CCPs)
ndash Establish recordkeeping and documentation procedures written evidence reviewed during inspections
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Food Legislation bull Federal Food Drug and Cosmetic Act (1938)
ndash Replaced by Pure Food and Drug Act (1906) ndash Food Quality Protection Act (1976) amended FDCA and FIFRA
bull Single Safety Standard for raw and processed foods and the impact and exposure to pesticides
bull Food Modernization Act of 1997 eliminated premarket FDA approval of packaging and other substances in contact with food FDA has 120 days to object
bull Food Code of 1997 added HACCP plans allowed FDA EPA and USDA input bull New Food Safety Modernization Act (FSMA 2011)
ndash Multiple rollout periods ndash Preventive Controls Final Rule published Federal Register Notice 092015 ndash Also consists of Produce Safety Standard ndash Promotes inspection and compliance frequency (HRNHR) response (improved
enforceable actions) Imports and Partnership building (industry involvement)
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Solid Waste bull Conventional Solid Waste (39 paper and 14 yard waste) bull Requires groundwater monitoring (due to leachate from landfills) and
operating conditions to reduce odor control litter insects and rodents ndash Location restrictions ndash built in suitable geological areas away from faults wetlands flood
zones etc ndash Composite liner requirements ndash flexible membrane overlaying 2 feet of clay soil to
protect groundwater and underlying soil
bull Solid waste reduction ndash Source reduction ndash use of cloth materials (grocery bags napkins diapers)
returnable containers reduceeliminate packaging bulk ndash Recycling ndash resource recovery collection processing remanufacturing of
materials for reuse ndash Composting ndash natural biochemical decay process to convert organic wastes to
soil involves preparation sorting separation curing (nitrogen offset) ndash Waste Combustion ndash incineration of waste products can be used as energy for
mass burns ndash Sanitary Landfilling- most waste is disposed in landfills
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Hazardous Waste bull Specific characteristics of hazardous waste
ndash Toxic ndash Ignitable ndash Corrosive ndash Reactive ndash Includes solvents paints industrial liquids heavy metals
bull Hazardous Materials Transportation Act ndash Authorizes DOT to regulate movement of substances that may pose a threat to health safety and property or the environment when transported by air highway rail or water
bull Does not include ndash Nuclear (high-level) or low-level radioactive waste Nuclear Waste Policy Act ndash Biomedical Waste Medical Waste Tracking Act
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Solid and Hazardous Waste Legislation
bull Resource Conservation and Recovery Act (RCRA) 1976 ndash Most states have enacted laws and created regulations that are at
least as stringent as federal regulations ndash Requires tracking and permitting principal law governing the
disposal of solid waste and hazardous waste ndash ldquocradle to graverdquo bull Comprehensive Environmental Response Compensation
and Liability Act (CERCLA) 1980 ndash Funds for cleanup of sites contaminated with hazardous substances ndash Love Canal (1978) prompted the creation of the Superfund program
to help pay for cleanup of toxic sites ndash ldquoSuperfundrdquo Superfund Amendments and Reauthorization Act
(SARA) (1986) created due to Urban Carbide release of methyl isocyanate pesticide in Bhopal India killing nearly 8000
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Other Federal Legislation bull National Environmental Policy Act (NEPA) enacted 1970
ndash National framework for protecting the environment to assure that all branches of government give proper consideration to the environment prior to undertaking federal action that may affect the environment
ndash Required for airports buildings military installations highways etc ndash May require assessments of the likelihood of impacts from alternative courses
of action Environmental Assessments and Environmental Impact Statements bull Toxic Substances Control Act (TSCA) 1976
ndash Provides EPA with authority to require reporting recording and testing requirements and restrictions relating to chemical substances andor mixtures Excludes ndash food drugs cosmetics (FFDCA) and pesticides (FIFRA)
ndash Addresses production importation use and disposal of specific chemicals including Polychlorinated biphenyls (PCBs) asbestos radon and lead-based paint
ndash TSCA reform ndash Unlike other laws has never been amended TSCA Modernization Act of 2015 both Senate and House have separate versions and will need to work together to unify the Bills
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Other Federal Legislation bull Federal Insecticide Fungicide and Rodenticide Act (FIFRA) 1947
ndash Established procedures for registering pesticides ndash Originally included USDA but amended in 1972 to include EPA ndash Mandates EPA Regulate use and sale of pesticides to protect human health
and preserve the environment ndash 1988 Amendments including labeling storage transportation and disposal
requirements gave EPA the authority to suspend or cancel registration ndash Also provides the authority to set tolerances or maximum residue limits for
pesticide residues on food according to section 408 of FFDCA
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Occupational Health
bull Occupational Health ndash ldquoThe identification and control of risks arising from
physical chemical and other workplace hazards in order to establish and maintain a safe and healthy working environmentrdquo ndash NIEHS 2015
bull Industrial Hygiene ndash Anticipation recognition evaluation and control of
workplace factors that may cause illness and injury impaired health and well-being or significant discomfort
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
OSHA Standards Regulate Common Workplace Hazards
bull Carcinogens ndash Acute myelogenous leukemia (AML) resulting from exposure to benzene ndash Liver cancer exposure to vinyl chloride ndash Bladder cancer from exposure to aniline dyes
bull Coke oven emissions and mixed dust exposure to coal miners ndash Black lung or chronic obstructive lung disease among miners sandblasters
stoneworkers due to exposure to fine particulates ndash Particulates easily travel to lower respiratory system
bull Lead ndash may continue to exist in certain industries (batteries) bull Noise and hearing conservation bull Asbestos
ndash Shipyard workers also used extensively as a fire retardant in home building materials ndash Two forms of cancer Mesothelioma and bronchogenic carcinoma
bull Silicosis ndash Inflammatory lung disease caused by inhalation of silica ndash Common among miners quarry and stoneworkers ndash Higher risk for developing tuberculosis
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Ergonomics
bull Design of workplace and implements so as to use the human body to its advantage and not to require undue stresses
bull Biggest workplace problems in back neck and shoulder hand and wrist ndash Repetition force posture vibration ndash Typically a combination of more than one
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
General Controls for Occupational Environments
bull Training is the mechanism used to inform workers of the hazards in the workplace and the means to control them
bull Hygiene Practices ndash Actions taken by individuals to reduce risk of
exposure
bull Medical Surveillances ndash Sampling of blood breath urine etc ndash Scheduled monitoring such as x-rays etc
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Specific Controls for Occupational Environments
bull Primary methods to control hazards bull The following specific controls are selected and
implemented based on the manifestation of the hazards and local constraints ndash Engineer Controls
bull Eliminate or isolate the hazard
ndash Administrative Controls bull Manage the risk of exposure by controlling the way work is
performed
ndash Personal Protection Equipment (PPE) bull Individual barrier to individual exposure
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Exposure Limits bull Established by a variety of national organizations and governmental agencies bull Used as guides in control of environmental and workplace health hazards bull Derived for industrial settings only and should not be used to evaluate indoor air
Organization or Agency Exposure Limits Enforcement Level
Occupational Health and Safety Administration (OHSA)
Permissible Exposure Limit (PEL) Units
Enforceable regulatory exposure levels
National Institute of Occupational Safety and Health (NIOSH)
Recommended Exposure Limit amp Immediately Dangerous to Life or Health (IDLH)
Non-regulatory recommended
American Conference of Governmental Industrial Hygienists (ACGIH)
Threshold Limit Value (TLV) and Biological Exposure Indices (BEI)
Guidelines Non-enforceable
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Occupational Safety and Health Legislation
bull Occupational Safety and Health Act (OSHA) 1970 ndash Assures safe and healthful working conditions for working
men and women by authorizing enforcement of the standards developed under the act
ndash Assist and encourage States in efforts to assure safe and healthful working conditions
ndash Provides research information education and training in the field of occupational safety and health
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Built Environment
bull Physical structure and socio-cultural characteristics ndash Home neighborhood community school etc ndash Recreation facilities shopping malls grocery stores
bull Built environment and Physical activity ndash Commuting to work and school ndash Safety Factor ndash Walkability factor ndash Some may impact or enhance physical activity increasing or
decreasing risk of obesity and cardiovascular disease
bull Sustainability ndash Field of urban planning ndash Increasing social capacity
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Disaster Preparedness Cycle
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Disaster Preparedness ndash Types of Events and Incidents
bull Natural Disasters ndash Ex Hurricanes Extreme weather events Tornadoes Tsunami Earthquake Forest Fires
bull SocietalHuman-Caused Incidents ndash Riots and mass shootings bull Communicable Diseases ndash Ebola Pandemic influenza SARS bull Chemical Biological Radiological Nuclear Events (CBRNE)
ndash Biological ndashAnthrax smallpox plague botulinum toxin ndash Chemical ndash Nerve agents Ex Sarin gas ndash Radiological ndash dispersal devices (RDD) ldquodirty bombrdquo exposure devices
(RED) colorless odorless tasteless ndash NuclearRadioactive Ex Hiroshima and Nagasaki Japan WWII black
market selling of nuclear material
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Highly Susceptible and At-Risk Populations
bull ldquoCondition of having one of 2 or more interacting causes (or risk factors) and therefore makes one predisposed to or experience enhanced vulnerability to the effects of anotherrdquo ndash AAP 2012
bull Due to unique social and demographic characteristics various segments of the population may experience exposures different from those of the general population which in many cases may be greater
bull If highly susceptible or at-risk populations are not identified prior to preparing any risk assessments or exposure assessments then the resulting risk management decisions may not adequately protect these populations
bull Immunocompromised infants and young children older adults expectant mothers genetic influences nutritional economically disadvantaged race and gender etc
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Childrenrsquos Environmental Health bull Executive Order 13045 ndash Protection of Children from Environmental Health Risks and Safety
Risks (April 1997) EPA must evaluate the effects of the planned regulation on children and explain why the regulation is preferable to potentially effective and reasonably feasible alternatives
bull Children particularly infants and young children under five years of age have unique vulnerabilities to environmental hazards
bull Children experience different life stages and eat drink and breathe more as compared to adults on a per body weight basis
bull Diet ndash less diverse than adults and may consume greater proportions of certain foods and chemicals
ndash Children between birth and 5 months consume ~19 gkgday of apples compared to adults who consume ~2gkgday ndash If drinking water supply contains contaminants an infantrsquos exposure could be almost 10x greater due to higher
consumption of water and reconstituted formula ndash Could lead to excessive consumption of manganese causing affecting neurological development and fluoride causing
tooth pitting
bull Behavioral differences - crawling mouthing hands and objects bull Physical - lower breathing zone and breathing rates due to structural differences in the lower
respiratory tract bull Childrenrsquos Physiology - Rapidly growing and developing in a relatively short time frame bull Uniquely vulnerable to certain environmental contaminants ndash Lead mercury arsenic radon
carbon monoxide ETS pesticides
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Environmental Justice bull ldquoThe fair treatment and meaningful involvement of all people regardless
of race color national origin or income with respect to the development implementation and enforcement of environmental laws regulations and policiesrdquo Executive Order 12898 EPA 2015
bull EO 12898 directed federal agencies to identify and address the disproportionate impacts specifically on minority and low income communities
bull Fair Treatment - No group of people should bear a disproportionate share of negative environmental consequences resulting from industrial governmental and commercial operations or policies
bull Meaningful Involvement ndash People have the opportunity to participate in decisions ndash Public contribution can influence regulatory decision ndash Concerns will be considered in the decision making process ndash Decision makers seek out and facilitate the involvement of those potentially
affected
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
QUESTIONS
Email GwendolynHudsonfdahhsgov
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Additional Resources bull NBPHE CPH Study Resources httpwwwnbpheorgCPHstudyResourcescfm
bull CPH Study Session Webinars httpwwwnbpheorgCPHwebinarscfm
bull ASPPH Study Guide (Discount for PHS CC) httpscphstudyguideaspphorg
bull FDA Food Safety ndash Foodborne Pathogens httpwwwfdagovfoodresourcesforyouhealtheducatorsucm091681htm bull EPA National Primary Drinking Water Standards httpwaterepagovdrinkcontaminantsList bull APHA Control of Communicable Diseases Manual 20th Edition Mobile and Web
Versions Available httpwwwunboundmedicinecomproductscommunicable_diseasessvar=a|aphaampsvar=c|ccdm bull Books and Manuals (See References Slide)
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Additional Resources bull South Central Center for Public
Health Preparedness httpwwwsouthcentralpartnershiporgephoc
ndash Registration is FREE ndash 15 courses on environmental
health topics ndash Courses can be used to obtain
CEUs
01- General Environmental Health 02- Statutes and Regulations 03- Food Protection 04- Potable Water 05- Wastewater 06- Solid and Hazardous Waste 07- Hazardous Materials 08- Zoonoses Vectors Pests and Weeds 09- Radiation Protection 10- Occupational Safety and Health 11- Air Quality and Environmental Noise 12- Housing Sanitation and Safety 13- Institutions and Licensed Establishments 14- Swimming Pools and Recreational Facilities 15- Disaster Sanitation
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-
Additional References American Academy of Pediatrics Council on Environmental Health Pediatric Environmental
Health 3rd Edition Elk Grove Village IL American Academy of Pediatrics 2012 934 pages
Burke G Singh B and Theodore L Handbook of Environmental Management and Technology 2nd Edition Hoboken NJ Wiley Interscience 2005 806 pages
Environmental Protection Agency Six Common Air Pollutants Accessed October 19 2015 Online httpwww3epagovairqualityurbanairindexhtml
Koren A and Bisesi M Handbook of Environmental Health Volumes 1 Biological Chemical and Physical Agents of Environmentally Related Disease 4th Edition Boca Raton FL CRC Press and NEHA 2003 794 pages
Koren A and Bisesi M Handbook of Environmental Health Volumes 2 Pollutant Interactions in Air Water and Soil 4th Edition Boca Raton FL CRC Press and NEHA 2003 876 pages
Nadakavukaren A Our Global Environment A Health Perspective Prospect Hills IL Waveland Press 2005 616 pages
National Environmental Health Association REHSRS Study Guide A Guide for Environmental Health Responsibilities and Competencies 4th Edition USA NEHA 2015 250 pages
- CPH Review Session Environmental Health
- BackgroundCertified in Public Health (CPH) Exam
- Content Overview
- Content Overview
- Content Overview
- Epidemiologic Triad
- What is Environmental Health
- General Environmental Health ndash Classification of Hazards
- Chemical Agents
- Chemical Agents
- Chemical Agents - Pesticides
- Chemical Agents - Pesticides
- Physical Agents - Ionizing Radiation
- Physical Agents - Nonionizing Radiation
- Sources of Radiation
- Radiation
- Physical Agents ndash Sound and Effects of Noise
- Biological Agents ndash Zoonoses and Communicable Diseases
- Vectors of Infectious Diseases and Pest Management
- Routes of Entry
- Toxicology
- Dose-Response
- Bioaccumulation and Biomagnification of Chemicals
- Toxicology Terminology
- Selection of Species for Toxicity Testing
- Risk Assessment
- Risk Assessment
- Risk Communication and Management
- Environmental Health Services
- Air Quality - Ambient
- Criteria Air Pollutants
- Air Quality ndash Primary and Secondary Standards
- Climate Change
- Greenhouse Gases
- Ambient Air ndash Sources and Effects
- Air Quality - Indoor
- Indoor Air Quality (IAQ) Contaminants
- Environmental Tobacco Smoke and Other IAQ
- Air Legislation - CAA
- Water Quality- Sources amp Distribution
- Water Quality ndash Hydrologic Cycle
- Sources of Water Pollution
- Waterborne Pathogens and National Primary Drinking Water Standards
- Water Treatment Process
- Water Treatment
- Steps for Water Treatment
- Water Quality ndash Water Treatment Process
- Wastewater Treatment
- Water Quality ndash Wastewater Treatment Process
- Water Legislation - SDWA
- Water Legislation - CWA
- Food Safety
- Food Storage
- Food Safety ndash Foodborne Illnesses
- Hazard Analysis and Critical Control Points (HACCP)
- Food Legislation
- Solid Waste
- Hazardous Waste
- Solid and Hazardous Waste Legislation
- Other Federal Legislation
- Other Federal Legislation
- Occupational Health
- OSHA Standards Regulate Common Workplace Hazards
- Ergonomics
- General Controls for Occupational Environments
- Specific Controls for Occupational Environments
- Exposure Limits
- Occupational Safety and Health Legislation
- Built Environment
- Disaster Preparedness Cycle
- Disaster Preparedness ndash Types of Events and Incidents
- Highly Susceptible and At-Risk Populations
- Childrenrsquos Environmental Health
- Environmental Justice
- Questions
- Additional Resources
- Additional Resources
- Additional References
-