Topics A to Z

As part of NEHA's continuos effort to provide convenient access to information and resources, we have gathered together for you the links in this section. Our mission is "to advance the environmental health and protection professional for the purpose of providing a healthful environment for all,” as well as to educate and inform those outside the profession.


Various methodologies have been utilized in hand-hygiene (HH) research to measure the quality and compliance rates of hand washing. Some notable examples are direct observation, self-report, image quantification of fluorescence, microbial sampling, automated systems, and electronically assisted devices. While direct observation is considered the gold standard of HH monitoring systems, its methodological limitations (e.g., high staffing demands, participant reactivity, and undersampling) have yet to be overcome. As a result, there is renewed interest in developing technologies or methods of assessment that are cost-effective, accurate, and not intrusive. This article provides a brief review of HH monitoring systems while presenting a less resource-intensive methodology utilizing image analysis of fluorescence to assess hand washing. Results indicate that the proposed HH protocol could be used to replace human visual analysis of fluorescence, as well as provide a less resource-intensive option to assess HH under controlled conditions. Future implications and the need for additional research, such as cross-validating the results in a real-world clinical setting, are discussed.

June 2016
June 2016
78.10 | 14-20
Neil Deochand, MS, MA, Michelle E. Deochand, MS


We surveyed public health and vector control agencies in the U.S. to identify barriers restricting the implementation of geospatial modeling for West Nile virus (WNV) control. We conducted 18 standardized interviews with public health and vector control agencies in states with the highest cumulative human WNV cases. Agencies were organized by their implementation of geospatial modeling (Initial: Implementation and Support; Internal: Surveillance and Mitigation, and External: Outreach and Communication) and thematic analysis was used to identify barriers and best practices. Initial: Implementation and Support agencies reported funding and educational barriers, while Internal: Surveillance and Mitigation agencies reported surveillance data challenges and mistrust of geospatial modeling as limiting geospatial modeling usage. Agencies involved in External: Outreach and Communication reported policy guidelines and lack of public interest as barriers to using geospatial modeling for WNV control. To overcome these challenges, we identified the use of unified resource programs, local data repositories, and multi-stakeholder taskforces for addressing these challenges to WNV control. The findings from this study can be used to help improve WNV control within the U.S. and might be equally valuable for preemptively mitigating the impacts of emerging and reemerging mosquito-borne diseases.


June 2018
June 2018
80.10 | 24-31
Bryan Moy, MPH, PhD, University of California, Los Angeles, Ryan Harrigan, PhD, University of California, Los Angeles, Hilary Godwin, PhD, University of California, Los Angeles
Additional Topics A to Z: Technology

The use of letter grades, colored placards, or a numbered score is seen across the country to convey to restaurant patrons information on how safe and clean a restaurant is (i.e., the findings of the local health department's inspection of the facility). This column goes beyond exploring this practice or its efficacy—it explores how local health departments go about developing such programs and if unnecessary staff and resources are being consumed by such projects. The column poses an interesting question on the creation of a unified brand to support capacity and calls upon the environmental health leadership to develop and present a standard by which a local health department can quickly and efficiently launch a grading or placarding program.

Read the full column.

September 2015
78.2 | 34-35
Darryl Booth, MBA


Since 2002, the national Environmental Health Tracking Program of the Centers for Disease Control and Prevention (CDC) has provided vital support to state environmental public health efforts while simultaneously building a nationwide network of state, local, and academic partners to improve our nation’s capacity to understand and respond to environmental threats to public health. As part of program review and strategic planning, national thought leaders in environmental public health were convened to assess progress, identify gaps and challenges, and provide recommendations for enhancing the utility and impact of the Tracking Program. Several opportunities were identified. Chief among these was the need for continued and expanded CDC leadership to develop a coordinated Tracking Program agenda identifying specific scientific goals, data needs, and initiatives. Recommendations for future growth included expanded data availability and program coverage: i.e., making data available at the community scale and establishing tracking programs in all 50 states. Finally, a set of recommendations emphasizing communication to decision makers and the public was made that will be integral to the future utility and success of the Tracking Program.

June 2017
June 2017
79.10 | 14-19
Mary A. Fox, MPH, PhD, Sheriza Baksh, MPH, Juleen Lam, MHS, PhD, Beth Resnick, MPH, DrPH


Characterizing built or physical environment risk factors for gun violence in and around K-12 schools is an emerging, complex childrens environmental health need. We used data on New Jersey high schools on gun violence-related preventive practices and school (building and facility) environmental controls in place in fall 2019. We assimilated publicly available secondary data from state education agencies, school websites, and Google Maps to identify aspects of high school indoor and outdoor built environments, including fields, gymnasiums, auditoriums, and athletic fields and types of seating. We analyzed statewide data and stratified by county, region, and urban/nonurban locale. Results identified deficient environmental aspects of schools; however, if addressed, then more effective responses to active shooter scenarios could occur. These deficits included unmonitored entrances, security systems with missing cameras, hidden stairwells, and dense foliage around school buildings. Our research was also relevant to the scope of practice and services highlighted by the recent Understanding the Needs, Challenges, Opportunities, Vision, and Emerging Roles in Environmental Health (UNCOVER EH) initiative. Future research can help inform local emergency preparedness, response efforts, and school priorities for design, operations, and maintenance.

November 2021
November 2021
84.4 | 8-16
Juhi Aggarwal, MPH, Rutgers School of Public Health, Erika S. Eitland, MPH, ScD, Harvard T.H. Chan School of Public Health, Lauren N. Gonzalez, MA, Rutgers School of Public Health, Maryanne L. Fakeh Campbell, Rutgers School of Public Health

Article Abstract

Lead is known for its devastating effects on people, particularly children under the age of six. Disturbed lead paint in homes is the most common source of lead poisoning of children. Preventive approaches including consumer education on the demand side of the housing market (purchasers and renters of housing units) and disclosure regulations on supply side of the housing market (landlords, homeowners, developers, and licensed realtors) have had mixed outcomes. The study described in this article considered whether a novel supply-side intervention that educates licensed real estate agents about the specific dangers of lead poisoning would result in better knowledge of lead hazards and improved behavior with respect to the information they convey to potential home buyers. Ninety-one licensed realtors were trained for four hours on lead hazards and their health impacts. Pre- and postsurveys and a six-month follow-up interview were conducted to assess the impact of the intervention on their knowledge and self-reported behaviors with clients. The findings suggest that supply-side education could have a salutary impact on realtor knowledge and behavior.

July/August 2013
76.1 | 28-36
Rodney D. Green, PhD, Janet A. Phoenix, MPH, MD, Aisha M. Thompson, MBA
Additional Topics A to Z: Hazardous Materials


High carbon monoxide (CO) concentrations can elicit adverse health effects. We assessed CO concentrations at filling stations and determined carboxyhemoglobin (%COHb) levels and health problems reported by filling station attendants (FSAs) via questionnaires. This cross-sectional design studied 20 filling stations from Ibadan North Local Government, Nigeria. Outdoor CO concentrations (ppm) were measured for 8 weeks in August–September 2015 from 8:00–10:00 a.m. and 12:00–2:00 p.m., and %COHb levels were measured among 100 FSAs. Data collected were analyzed using Student’s t-test and analysis of variation (p = .05) and compared with relevant guideline limits. Mean CO concentrations in morning (15.4 ± 2.1 ppm) and afternoon (11.6 ± 1.4 ppm) were higher (p < .01) than the World Health Organization (WHO) guideline of 9.0 ppm. Mean %COHb for FSAs (11.1 ± 2.6) was significantly higher (p < .01) than the WHO guideline of 2.5%. Among respondents, 13.4% of FSAs vomited and 14.9% of FSAs experienced nausea. FSAs need personal protective equipment and filling stations should modernize pump delivery systems to minimize exposures.


July 2020
July/August 2020
83.1 | 26-31
Godson R.E.E. Ana, MEng, MPH, PhD, Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Toluwanimi M. Oni, MPH, Department of Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of Ibadan, Derek G. Shendell, MPH, DEnv, Department of Environmental and Occupational Health, New Jersey Safe Schools Program, Rutgers School of Public Health

July/August 2021 issue of the Journal of Environmental HealthAbstract

Carbon monoxide (CO) is a colorless and odorless gas generated from incomplete combustion of hydrocarbon-based fuels. Exposure to elevated CO concentrations can cause an array of health problems or even death. Of increasing concern are CO-related poisonings and fatalities associated with recreational watercraft. From 2005–2018, there were 78 known deaths of people due to CO associated with the use of recreational watercraft in the U.S. The incidence, however, is likely higher due to many CO poisoning-related deaths being inaccurately attributed to drowning instead of CO poisoning.

To examine the significance of this public health hazard, a range of plausible exposures were characterized by measuring instantaneous CO concentrations at 17 sampling locations on or near the stern of four recreational boats. Observed CO concentrations were highest in samples proximal to the engine exhaust manifold, with maximum concentrations for the four boats being 42,600 ppm, 2,550 ppm, 6,100 ppm, and 3,700 ppm, respectively. Continuous CO monitoring was performed at a fixed location near the passenger seat in the back of each boat. Comparing our monitoring results with thresholds set by the U.S. Environmental Protection Agency, National Institute for Occupational Safety and Health, and World Health Organization demonstrates that many CO concentrations exceed or nearly exceed established exposure thresholds. Thus, environmental health and public safety professionals must remain aware of this hazard and examine administrative and engineering controls that reduce watercraft-related CO exposures and prevent injuries and drowning related to CO.


July 2021
July/August 2021
84.1 | 8-14
Thomas Gerding, MPH, Department of Environmental Health, University of Cincinnati, Jason W. Marion, MS, PhD, Department of Environmental Health Science, Eastern Kentucky University, Dale Stephenson, PhD, CIH, College of Health and Human Services, Northern Kentucky University
Additional Topics A to Z: Recreational Waters