Revitalizing EPA’s Integrated Risk Information System Program: Improving Assessment Products, Enhancing Transparency, and Meeting Stakeholder Needs

EPA’s Integrated Risk Information System (IRIS) Program provides information on potential human health effects from long term exposure to chemicals present in air, water, or land. IRIS assessments are a critical part of the scientific foundation for decisions to protect public health. IRIS assessments include information on the hazard of the chemical (hazard identification) as well as information about the relationship between the dose of the chemical and the effect or response (dose-response assessment). IRIS includes toxicity values (e.g., oral reference dose, inhalation reference concentration, oral cancer slope factor, inhalation unit risk) that, when combined with information about exposure, can be used to characterize the health risk of exposure to environmental chemicals. Because of the importance of IRIS to state and local health agencies that must make decisions about chemicals in the environment, EPA has been making improvements to the Program to better meet stakeholder needs and improve transparency.

This session will provide a brief overview of the IRIS Program and IRIS database, with information about how IRIS can be used to inform decision-making. It will highlight changes that are being made to make critical information more accessible to users. The session will also highlight efforts by the IRIS Program to aggressively engage a broad spectrum of stakeholders, including the public health community, throughout the IRIS assessment development process. This will be followed by a Q&A/discussion period during which participants may ask questions, offer their opinions on the changes the IRIS Program is making, and provide suggestions for changes the public health community would like to see in IRIS. Robust stakeholder engagement will help the IRIS Program better understand what chemicals are priorities for assessment; get feedback about the changes that are being made in the Program; and understand how IRIS can better meet decision-making needs.

Tricks to Make Training Stick

Do your participants fall asleep in your training sessions?  Do you wonder if your material is sinking in?  In this session participants will learn new ways to open and close training sessions as well as keep learners engaged. Participants will practice the techniques as a part of the learning lab session and leave ready to implement these techniques in their training session.

A Regional Strategy to Address Bedbugs: A Diverse Partnership Model for Addressing Emerging Public Health Issues

Multnomah County, the most populous and most dense area in the state of Oregon has been experiencing the re-emergence of bedbugs since 2007 with increases in complaints and rising costs for agencies, community members, and businesses that have had infestations. Many other areas of the state are now reporting the re-emergence of bedbugs and resultant impacts on community resources.

In response to this emerging issue, Multnomah County Environmental Health, in partnership with local elected officials convened a “Bedbug Summit” in March 2011 to begin identifying collaborative approaches to address bedbugs in the region. Summit attendees represented professionals from a broad spectrum of affected sectors including housing providers, homeless-shelters, education, pest control services, public health, waste stream management and social services.

This led to the formation of a Bed Bug Workgroup that includes regional and state partners. The workgroup created a two year work plan focused on five key areas to address the resurgence of bedbugs:

1. Public Information,
2. training and certification,
3. surveillance,
4. waste stream management and reduction, and
5. funding and resources.

Through close collaboration the workgroup partners have made significant achievements including successful advocacy for additional funding, launching an information telephone hotline, developing a multi-lingual educational clearinghouse website and identification of a collaborative surveillance system that protects pest control operators and the communities they serve.

The success of the group is attributed to the diversity of multiple organizations coming together to create an environment that supports prevention and public information as key strategies for the reduction of the spread of bedbugs.

Is your Pool Safe - Todays Technology for Determining Water Quality in Swimming Pools

The responsibility of keeping the public safe when using municipal swimming pools and spray-pads can be a daunting task however having the right equipment to test pool water is critical to ensuring a safe environment.

Numerous equipment configurations exist in the marketplace today that allow Environmental Health Officials to test water quality parameters however each configuration is vastly different, has different levels of accuracy and different features.

Visual tests or comparative tests have played a key role in water quality testing up to this point but with recent advancements in electronics, digital technology and sensor technology, the guess work in determining water quality parameters has been removed.

This learning lab will showcase the latest water quality measurements devices available today and provide attendees the opportunity to conduct various water quality tests. Additionally, the session will guide attendees through calculations which will demonstrate how slight differences in instrument accuracy can lead to dramatic changes in water quality and how those changes can affect public safety and equipment safety.

Enumeration of the Environmental Health Workforce

Workforce enumeration is the foundation for identifying workforce needs. In 2000, the Health Resources and Services Administration (HRSA) sponsored an enumeration of the public health workforce (HRSA, 2000), but since then, no comprehensive enumeration has occurred. The Centers for Disease Control and Prevention (CDC) and HRSA are now collaborating on an effort to determine the number and composition of the U.S. workforce at the federal, state, and local levels.

One of the more difficult groups to enumerate and categorize accurately is the environmental public health (EPH) worker because, of all the public health disciplines, they might be the group with the most diverse assignments. EPH workers in a state health department or in a state environmental protection agency might have similar job functions described within a state personnel system, but as with other public health professions, job titles for EPH workers vary widely and are difficult to enumerate precisely. This can also be observed at the local level and in large cities where EPH workers often are situated in agencies outside the traditional health department.

Given the complexity of the EPH workforce, in terms of the specialization of the occupations and workplace settings, conducting an accurate characterization of the workforce is imperative. One of the grandfathers of the EPH profession, Larry Gordon, drew an important distinction between EH professionals and professionals working in EH. Later, in 2009, a message from then president of the National Environmental Health Association, Welford C. Roberts, said, “There is a current need for a comprehensive enumeration of the environmental health workforce” (Roberts, 2009). Enumeration is important because it leads us to question why the EPH profession does not have a standardized curriculum or competency standards, and how broad job descriptions and titles can obscure identification of the actual EPH discipline. This stands in stark contrast with the medically based disciplines within public health, which tend to have required board certifications, competency standards, and distinct titles for practicing professionals. Students might perceive this as a barrier to entering EPH, leaving our pipeline supply diminished.

Let Me Float One By You - Is UV Disinfection the Right Choice for Ensuring Public Safety in Swimming Pools and Spray-pads

Ultraviolet Disinfection has gained increasing acceptance as secondary disinfection for the treatment of swimming pools and spray-pads over the past decade. However, as a technology it is vastly different from the standard chemical treatments that are typically used as primary disinfection. Today architects, consultants and engineers are faced with the challenge of designing facilities around the ever changing complex regulations of each state and local governing body. Further, understanding the uses of UV for swimming pools and spray-pads along with the different configurations available can be a daunting task. The responsibility has become increasingly more complex due to the competing lamp technologies and equipment configurations currently available to the swimming pool industry.

This presentation provides an overview of UV treatment technology for the aquatics industry, how that technology is used to ensure public safety and the regulations that attempt to govern public safety.

Public Health Accreditation and Environmental Health

In September 2011, the first ever national public health department voluntary accreditation program was launched. . The program’s goal is to advance the quality and performance of public health departments. The program intends to strengthen health departments’ internal procedures and the services they provide, leading to a more robust public health infrastructure nationwide.

The Centers for Disease Control and Prevention (CDC) and the Robert Wood Johnson Foundation (RWJF) co-funded the national accreditation program’s development and startup. Key national partners, some of whom represent constituencies the program will accredit, also supported the program’s development. The Public Health Accreditation Board (PHAB) was incorporated in May 2007 as a nonprofit organization to serve as the accrediting body. Since then, PHAB has provided leadership for the program’s development and startup.

Collaboration between PHAB and its critical partners and constituencies has been an important aspect of these efforts, and PHAB’s work with the environmental public health community has been a successful initial example of such collaboration. The National Center for Environmental Health (NCEH) and the Office for State, Tribal, Local and Territorial Support (OSTLTS) at CDC work with many partners to strengthen the nation’s public health infrastructure and to improve environmental public health practice. To this end, PHAB, NCEH, and OSTLTS worked together to explore how the PHAB standards can best relate to environmental public health (EPH) and how EPH staff can become involved in accreditation. This resulted in numerous actions that have measurably enhanced the visibility and accuracy of EPH within the accreditation process and standards.

This session will briefly review the EPH involvement in the Accreditation process. The speakers will show what has been learned in the initial phase of testing of the Accreditation Standards and in the actual Accrediting process. The session will update participants on what is likely to occur in this evolving field, where in-depth analysis of services and programs reveals areas for continuous quality improvement within environmental public health agencies.

Developing Community Health and Brownfields Indicators [POSTER]

Using the grass-roots ATSDR Brownfields/Land Revitalization Action Model, a diverse development community comprised of residents; city planners; government; non-profits; and public and environmental health stakeholders can create and track public health indicators associated with redevelopment. Commonly selected factors include: traditional health indicators such as asthma and cardiovascular disease; indicators of the built environment such as measures of green space, access to healthy foods, and abandoned or vacant properties; and socio demographic indicators such as poverty, educational attainment, and ethnicity.  The end result provides information on the community health indicators that may be used to address health and other disparities in these communities. 

This poster demonstrates the beginnings of a consistent set of land revitalization community health indicators from national, state, and local perspectives. Inherent challenges in creating indicators are discussed.  These challenges include issues related to geographic scale, data access, confidentiality, data quality, uncertain estimates due to small numbers, and the resources needed to collect the data. 

1.      See how communities across the U.S. with common land reuse issues led to the creation of core indicators now used to track impacts of redevelopment on public health

2.      Learn a method to engage communities while addressing environmental public health issues

3.      Understand how to overcome challenges associated with this process

 

Engagement of government agencies with environmental public health issues surrounding industrial food animal production in eight states: An example of environmental public health systems research

Industrial food animal production (IFAP), the dominant form of meat production in the U.S., involves housing thousands of animals in close quarters. Evidence of environmental public health concerns resulting from community exposures to air releases and water pollution from these operations continues to accumulate. The purpose of this study was to examine the role of health departments, environment and natural resource departments (the agencies responsible for permitting large IFAP sites), and agriculture departments in responding to citizens' environmental health concerns stemming from IFAP operations. Instead of interviewing staff at just one type of government agency, the study followed an environmental public health systems approach by including the main government agencies that may be involved in these issues. This approach allowed the researchers to discern gaps in state and local agency responsibilities and resources that affect agency responses to environmental public health issues associated with IFAP. We investigated the extent to which health concerns associated with IFAP sites are reported to these agencies, the nature of agencies’ involvement with preventing or responding to these concerns, and challenges to addressing these concerns. Semi-structured qualitative interviews were held with staff members of county and state health departments, state permitting agencies, state agriculture departments, and community members in eight states with high densities (or rapid growth in number) of IFAP operations. The interview data reveal that government agency involvement in these matters is limited by political barriers, a lack of jurisdiction, and finite resources, expertise, and staff. Community members reported difficulties in getting agencies to respond to their concerns about environmental public health issues associated with IFAP. The findings from this study may inform future education or training efforts and policy measures aimed at expanding agencies’ capacities to address gaps in environmental public health protection. 
*Photo credit: SRA Project - www.sraproject.org

PMS Toxicology

Pesticides, metals, and solvents are general classifications of chemicals by either intended use or chemical nature. Within each group, one can find similar benefits and adverse health effects. Explore the common themes of toxicity, benefits and route specific hazards for these groups of chemicals. Learn what public health professionals need to know for effective risk assessment, exposure reduction, and risk communication. [Graphic credit:
http://middlesextwp.com/departments/trash/recycling/household-hazardous-waste/attachment/househols-hazardous-waste]

Toxin-free Cleaning of Schools and other Instiitutions

The presentation will examine and showcase innovative cleaning technologies and strategies that are changing the way school buildings and other critical institutional environments are cleaned. It will introduce toxin-free systems and strategies that go beyond Tools for Schools recommendations; with emphasis on surface treatments, engineered water systems and low-moisture steam vapor. Budget, health, and environmental consequences will be explored and critiqued. Regulatory information, end-user case studies, peer networking, and equipment demonstrations will highlighted. Interaction with participants is encouraged.

Who’s Protecting The Children in Child Care? [POSTER]

60% of U.S. preschoolers spend time in child care. Yet many environmental health concerns in child care settings are almost virtually unaddressed. Fortunately, baseline data on contaminants in child care is finally emerging and a variety of new resources are now available to help child care professionals create healthier child care environments. Recent results of contaminant testing in child care facilities from several geographic areas will be presented, as well as tools for child care providers. This poster will provide an overview of research, tools, and programs addressing environmental health in child care.

On-Site Generation of Chemical Sanitizer in Retail Food Establishments

The Amendment to Chapter 4 of the 2009 Food Code allows on-site generation of chemical sanitizers. This presentation will review the various technologies available for use in food establishments and introduce the new NSF Protocol P415 which addresses Electrochemically Activated Water Cleaning and Sanitizing Devices. The Protocol specifying performance and safety for subsequent listing of equipment is detailed. Field regulatory evaluation of these units is given.

Navigating The World of Child Care

Although 60% of U.S. preschoolers are in child care, and many of these settings are highly regulated, environmental health is almost completely unaddressed through licensing, child care teacher training, and quality improvement programs. Those who seek to assist child care professionals in creating healthier environments will be more effective if they understand the institutions and frameworks of child care.

This presentation and discussion will provide an overview of the institutions, acronyms and challenges faced by child care providers, from an environmental health perspective. Participants will be invited to share their challenges and successes in dealing with this unique environment.

Enforcement Case Studies Using California’s Unified Approach of Administrative Enforcement

Sacramento County Environmental Management Department is one of 83 Certified Unified Program Agencies (CUPA) in the State of California that has been certified by CAL EPA to implement six hazardous materials programs. The six unified programs consist of the following:

1. Community Right to Know Program EPCRA/ Hazardous Materials Business Plan Program
2. Hazardous Waste Generator (CESQG, SQG & RCRA)
3. Tiered Permitting (Treatment of Hazardous Waste)
4. Above Ground Tanks
5. Underground Tanks
6. California Accidental Release Program

As a Unified Program agency it is EMD’s goal to achieve compliance with applicable environmental laws and regulations through an extensive inspection program, educational outreach efforts and, if necessary, the initiation of appropriate enforcement actions. The goal of any enforcement action is to
Return the facility to compliance in a timely manner; Eliminate economic benefit realized by the noncompliant facility; Deter future noncompliance.
Administrative Enforcement uniquely allows EMD (or any CUPA) to pursue action independent of an outside prosecutorial agency. This process allows for a streamlined but effective approach to enforcement. EMD determines the appropriate penalty based on the circumstances of the violation and the violator and statutory or regulatory penalty criteria. EMD may set the penalty and the time frame for the violator’s return to compliance. If the alleged violator chooses to contest the case, EMD schedules a hearing at which there is the opportunity to refute the allegations and present any mitigating factors that may affect the penalty.
EMD does encourage the respondent to enter into settlement discussions at any time. An Administrative Enforcement case can be a much more efficient way of achieving compliance with the violator. An enforcement case can be closed within 30 days or even sooner from the first date of issuance of the administrative enforcement order thus making it an efficient and cost effective tool in maintaining a level playing field within the regulated business community.

During the presentation, the application of the administrative enforcement process will be discussed while reviewing actual enforcement case studies involving hazardous materials and waste violations. By attending this session attendees will:

1. Review actual enforcement case studies involving businesses with hazardous materials and hazardous waste violations and the use of the administrative enforcement process.
   
2. Evaluate the use of administrative enforcement and its effectiveness in regards to timeliness, staff costs and return to compliance by the regulated business.
   
3. Understand that appropriate enforcement action is necessary in maintaining a level playing field amongst the regulated business community.  

Opportunities for Improving Sanitation Practices in North Carolina and South Carolina Child Care Facilities [POSTER]

In the United States, approximately 60% of young children (under age of five) spend time in child care settings. Adequate sanitation practices in child care environments will help reduce risks of contracting enteric disease. This poster describes sanitation practices in a sample of child care facilities and identifies opportunities for reducing the spread of pathogens in the child care environment. The poster will:

1. Describe child care facilities’ adherence to sanitation guidelines for cleaning diaper change surfaces.
    
2. Describe child care facilities’ adherence to sanitation guidelines/best practices for cleaning flooring.
3. Identify improvements needed to reduce the risk of enteric disease within child care facilities.

Dipterans as Vectors of Pathogenesis

Dipterans are capable of vectoring disease to man by contaminating food and food contact surfaces. Effective measures must be taken to manage their presence. This program will provide environmental health professionals with essential knowledge to solve challenging flying insect issues within environmentally sensitive structures.

Survival of health significant bacteria in packaged drinking water: planktonic versus sessile life

In the present study an attempt has been made to evaluate the quality of packaged drinking water (108 samples) and experimental studies were carried out to determine the growth kinetics of health significant bacteria in various drinking water microcosms and biofilms developed on the walls of glass and PET containers. While HPC were analysed using R2A medium, membrane filter technique with appropriate media were used for the enumeration of Total Coliforms (TC), Faecal Coliforms (FC), and Faecal Streptococci (FS). Nutrient concentration in these samples was monitored using standard methods. Various types of drinking water microcosms prepared in triplicate for monitoring the biofilm analysis. The viable bacterial load was determined by plate count method using R2A medium and biofilm development was observed using Scanning Electron Microscope. Survival of selected microorganisms such as Escherichia coli, Pseudomonas fluorescence and Aeromonas hydrophila in bottled drinking water and biofilms were studied using microcosms. Risk associated with HPC bacteria were carried out in terms of antibiotic resistance analysis and virulence factors. The nutrient concentration of these water samples was very low and found to be within the permissible limits of WHO. Biofilm associated life was encountered in most samples and found to be higher in number than their planktonic counterparts. TC was encountered in most of the samples, FC and FS in 10% and 34% samples respectively. Significant positive correlations were found between TC and FC, HPC of water and TC and HPC of water and FC. The growth patterns of the biofilm associated bacteria indicated periodical build up and sloughing off biofilms. Many of the HPC bacteria from the drinking water were multi drug resistant and showed Beta haemolytic property. Survival kinetics of the selected bacteria showed that they were able to live better in biofilms, though the capabilities varied significantly among them. Biofilm development was more on glass surface. The result of the study calls for stringent monitoring of packaged drinking water quality by regulatory authorities and refrigeration of drinking water at all times by retail and wholesale vendors.

Community-Based Water Resiliency and All-Hazards Preparedness

A critical component of public health is the availability of clean, safe, and reliable drinking water. In the event of a water service interruption, communities must be prepared to face human health risks, as well as the risks to other critical community services such as food sanitation, patient care, and firefighting. To aid communities with this responsibility, the U.S. Environmental Protection Agency (EPA) launched the Community-Based Water Resiliency (CBWR) initiative in 2011.

The CBWR initiative raises awareness about how communities use water and provides resources to help build resiliency in emergencies that cause drinking water and wastewater service interruptions.   The CBWR electronic tool allows communities to assess their preparedness for, and resiliency to, water service interruptions from both man-made and natural events, and recommends resources that would aid in enhancing water resiliency.

This session will provide participants with training on the CBWR tool, including lessons learned from other communities who have implemented water resiliency programs. Participants of this session will better understand how to prepare for water service interruptions from all-hazards, including: hurricanes, tornadoes, drought, and many others. Session participants will also learn how increased preparedness enhances public health preparedness and community resiliency through scenario-based activities. After completing this training, participants will have the tools necessary to take CBWR back to their individual communities and begin implementation.