Gastrointestinal (GI) infections are spread through food, water and the environment. They cause significant morbidity and mortality worldwide and are a UK public health priority. In England, local authority (local government) Environmental and Regulatory Services (ERS) play a crucial role in GI infection services. During the period of UK government ‘austerity’ policies in the 2010s there were significant cuts to national spending, including reductions to ERS budgets which may have compromised GI infection prevention and control. In this paper, we examine how reductions in ERS spending across contrasting local authorities in England have shaped the lived experience of staff providing GI infection work, within the context of the COVID-19 pandemic. Data were collected between June 2021—March 2022 from staff linked to ERS across two urban English local authorities with contrasting ERS budget cuts, contrasting socio-economic deprivation and different local authority structures. Data consisted of observations (14 h) and semi-structured interviews (n = 17) collected from staff from the following teams: regional UK Health Security Agency teams (n = 6); local authority public health teams (n = 2); public protection teams (including Environmental Health Officers (EHOs)) (n = 6); and local authority-commissioned infection prevention and control teams (n = 2). Data were analysed using a reflexive thematic analysis. Our analysis showed more significant impacts on GI infection prevention and control in our socio-economically ‘disadvantaged’ local authority, underpinned by a greater loss of EHO staff. Budget cuts in our ‘disadvantaged’ area have reduced the capacity for on-the-ground GI infection work in communities, hampered collaborative working across local health protection systems, and forced staff to ration and prioritise their work according to risk, reducing or discontinuing crucial preventative functions. Our ‘advantaged’ area was less affected. Contrasting levels of cuts have created socio-spatial inequalities in the experience of delivering GI infection prevention and control. Austerity may therefore be contributing to geographical inequalities in community vulnerability to GI infections. Staff should be supported in using risk assessment tools as they adapt their work practices to accommodate the impact of cuts. Illuminating these inequalities allows community vulnerability to GI infections to be more effectively targeted through policy measures.

Summary: Rock in Rio Lisboa, a prominent four-day music festival in Portugal, attracts over 160,000 attendees each weekend across two weekends. To safeguard public health and ensure medical readiness for such a large-scale event, comprehensive strategies were developed. These strategies required close coordination among emergency services, festival organizers, healthcare providers, and public health authorities to address challenges stemming from high-density crowds, extended event hours, fluctuating weather conditions, and the potential for public health hazards. A multi-tiered healthcare infrastructure was established on-site, which included a fully equipped medical center, advanced life support modules, and strategically positioned mobile response teams to provide immediate care. A strong focus was also placed on mental health support, with professionals trained in psychological first aid available to manage anxiety, stress, and other crowd-induced psychological concerns. Additionally, preventive measures such as hydration stations and effective crowd management were implemented to reduce the risk of serious health incidents. Public health teams, consisting of public health physicians, regulatory authorities, and environmental health officers, enforced stringent food and water safety measures. Daily water quality assessments were conducted, and strict audits were performed on the 79 food and beverage vendors to ensure compliance with safety regulations, thereby preventing outbreaks of foodborne and waterborne illnesses. Medical teams provided care to 1,644 individuals during the event, addressing issues such as dehydration, minor injuries, and heat-related illnesses, with fewer than 1% of cases requiring transportation to external healthcare facilities. This report illustrates the efficacy of proactive, multidisciplinary planning in managing health risks at large gatherings. The strategies employed at Rock in Rio demonstrate a scalable model for future events that prioritizes attendee well-being and resilience, showcasing how well-coordinated public health and medical interventions can minimize the impact of health crises in mass gatherings.

Background Prolonged dermal exposure to nickel (Ni), a heavy metal found in tattoo ink, is associated with allergic contact dermatitis and skin sensitization in susceptible individuals. Although the systemic toxicity of Ni following inhalation and dermal exposure has been documented, limited information exists on the toxicological effects of intradermal exposure. Therefore, this study conducted a risk assessment to evaluate the potential for skin sensitization induction and non-cancer systemic toxicity from intradermal exposure to Ni-containing tattoo ink. A systematic literature review was performed to identify studies relevant to intradermal Ni exposure from tattoo ink. Materials and methods Risk characterization was conducted using margin of safety (MOS) calculations for dermal and systemic exposure scenarios. The dermal MOS was calculated by dividing the acceptable exposure level (AEL) by the consumer exposure level (CEL). The AEL was calculated by applying a safety assessment factor of 300 to the Ni no expected sensitization induction level (NESIL) of 401.07 μg/cm2/day. The systemic MOS was calculated by dividing the systemic exposure dose (SED) by an adjusted Office of Environmental Health and Hazard Assessment oral reference exposure level (REL) of 0.0044 mg/kg, accounting for the 40% oral bioavailability. Results For dermal exposure, the AEL (1.34 μg/cm2) exceeded the CEL (0.03 μg/cm2), yielding an MOS of 44.67. For systemic exposure, the SED (0.000027 mg/kg/day) was below the adjusted REL, yielding an MOS of 162. Sensitivity analyses confirmed MOS values greater than 1. Conclusions Skin sensitization and non-cancer systemic toxicity are not expected from exposure to Ni in tattoo ink.

Background: Towards the end of 2019, communities in Wuhan City, China, began noticing the spread of a mysterious disease with pneumonia-like symptoms. Many of those infected had visited the Wuhan food market, which was later linked to the early outbreak of the COVID-19 pandemic. The disease initially spread rapidly among market stall owners, shoppers, and workers. However, as individuals without any travel history to the market began showing symptoms, it became evident that community transmission had begun. This research investigates the environmental implications of the COVID-19 outbreak. Materials and Methods: To achieve the research objective, a mixed method approach was adopted using a questionnaire survey with 36 participants drawn from five states affected by the COVID-19 outbreak. The sample was purposively selected to include only participants at the forefront of managing COVID-19 waste. Participants were drawn from various fields and organizations. The breakdown of participants (n = 36) included 24 workers and managers of waste management companies, 7 senior staff members of ministries and waste management agencies, 3 environmental health officers working in hospitals and 2 laboratory scientists. Results: The research found that outbreaks of infectious diseases act as a catalyst for increased waste generation. The study showed that COVID-19 waste is generated in three phases: home treatment and observation phase, diagnostic phase, and hospital treatment phase. The study revealed that waste management practices varied across these phases. For instance, waste generated in laboratories during diagnosis and treatment are often autoclaved and disposed of in landfills, incinerated, or subjected to open burning, while waste generated during home observation are collected and managed as domestic waste. Conclusion: The study concluded that the current infectious waste management process in Nigeria have a negative implication for the environment with the potential to degrade overall environmental quality.

The management of toxic and hazardous waste (B3) is a crucial aspect of environmental management. Solid medical B3 waste is the residue from activities or businesses containing hazardous or toxic materials that can pollute or damage the environment, either directly or indirectly. The research aims to evaluate the technical operations of solid medical hazardous waste management at Sultan Suriansyah Hospital and Suaka Insan Hospital, Banjarmasin. The research was conducted at Sultan Suriansyah Hospital and Suaka Insan Hospital in Banjarmasin City. Respondents were selected using purposive sampling, consisting of 15 medical personnel and 4 environmental health officers from Suriansyah Hospital, and 14 medical personnel and 3 environmental health officers from Suaka Insan Hospital. Data were analyzed using a Likert scale to assess the operational techniques of solid medical B3 waste management, including reduction and sorting, containerization, packaging, labeling, storage, and transportation, based on questionnaire responses. The technical and operational evaluation of solid medical hazardous waste management at Sultan Suriansyah Hospital and Suaka Insan Hospital Banjarmasin, namely at Sultan Suriansyah Hospital, showed that the implementation of management was still in the less appropriate category, with a total score of 65.26%, while the technical and operational evaluation of solid medical hazardous waste management at Suaka Insan Hospital, showed that the implementation of management was still in the appropriate category, with a total score of 73.33%.

Inclusive health services are vital for ensuring equitable access, especially for vulnerable groups such as women, persons with disabilities, the elderly, and children. However, environmental health (Kesling) strategies in many health facilities still emphasize technical aspects, often neglecting gender, disability, and social inclusion (GEDSI). This qualitative study aimed to explore GEDSI-responsive Kesling strategies through Focus Group Discussions (FGDs) involving 33 environmental health officers from various institutions. Data were collected from group discussions, observational notes, and documentation of strategy proposals. Using thematic analysis, researchers identified key ideas and categorized them into three main themes: (1) gender responsive; (2) disability inclusive; and (3) socially inclusion. Proposed interventions included gender-neutral toilets, menstrual hygiene facilities, wheelchair access, child-friendly waiting rooms, and inclusive health education. The study demonstrates that FGD is an effective method to elicit grounded insights and collaborative strategies. It concludes that integrating GEDSI principles into environmental health planning requires not only technical adjustments but also inclusive dialogue with stakeholders.

Food safety in the shadows: Understanding dark kitchens through the lens of necessity entrepreneurship and activity theory.

Consumers in Northern Ireland (NI) are eating too much saturated fat and sugar which can have detrimental health effects. With a commitment to improving the nutritional quality of foods available to consumers, the Food Standards Agency (FSA) and local council Environmental Health teams in NI sampled three popular types of traybake and sent them for nutritional analysis. Following this, the College of Agriculture, Food and Rural Enterprise (CAFRE) investigated consumer acceptability of traybake portion sizes. Environmental health officers collected 59 traybake samples for nutritional analysis. The traybake types sampled, Fifteens, Rocky Roads and Caramel Squares, were generally high in energy (230kcal to 1,026kcal per portion), saturated fat (4.9g to 29.7g per portion) and total sugar (17.7g to 103.2g per portion). Some traybakes contained more than the maximum amount of saturated fat and sugar recommended per day. Traybake weight varied significantly, ranging from 44.7g to 217.3g per portion. Weight was a key driver of the energy, saturated fat, and total sugar content of the traybakes. Consumer perceptions of small, medium and large traybake portions and purchasing attitudes were investigated using sensory analyses and consumer focus groups. Almost half (43%) of participants reported consuming traybakes once per week. The largest portion size of each traybake type was the least preferred option by participants. Participants reported that displaying nutritional information on packs may help influence their choices and that a gradual reduction in portion size could reduce the energy content of sweet snacks with little consumer impact. Consumer preference for smaller portion sizes of traybake products presents a reformulation opportunity that could be used by food businesses to produce smaller options that are lower in calories, saturated fat and sugar.

ABSTRACT The local authority private-rented housing sector regulatory workforce, often part of wider environmental health and housing service teams in England and Wales, has faced multiple challenges in recent years due to declining numbers entering and remaining in the profession, a rise in the number and complexity of the private-rented housing sector itself and austerity measures. Combined, this has led to a depleted workforce needing authentic, tailored, and appropriate training options. There has been very little research in this area. Therefore, an online Qualtrics survey focusing on the local authority private-rented housing regulatory workforce and training needs was developed and shared. Eighty-three completed responses were analyzed. Interrelated challenges were raised around workforce challenges. Results demonstrated challenges in recruitment and retention largely due to a shift in the profession from long term, accredited professional degrees with practice experience, leading to fewer Environmental Health Officers and Practitioners, to a range of “other staff” working in this space with some solutions suggested. Local authorities need to take these complex and interrelated issues forward with strategic plans around training, recruiting and retaining the workforce. Equally, education institutions need to work with the sector to design and deliver relevant flexible, accessible, and affordable training options.

Trachoma is responsible for the blindness or visual impairment of about 1.9 million people and causes about 1.4% of all blindness worldwide. In Zambia, trachoma is endemic and Western Province is one of the most affected provinces. The SAFE (surgery, antibiotics, facial cleanliness and environmental improvement) strategy is recommended for elimination of trachoma. In many settings, interventions particularly for facial cleanliness and environmental improvement are sub-optimally adopted due to lack of prioritization and inadequate funding of intervention activities. This study sought to establish the level of, and factors associated with adoption of facial and environmental hygiene promotion in the SAFE strategy among health workers in Western Province, Zambia. This was a cross-sectional study involving 24 health facilities selected from three districts using stratified random sampling. A total of 388 health workers comprising environmental health officers, community health assistants and community health workers were randomly selected. Adoption of facial and environmental hygiene promotion was self-reported, defined as participation in community distribution of information, education and communication (IEC) materials or community demonstrations of correct hand and face washing methods or both, within the past six months. Multiple logistic regression was used to identify the factors associated with adoption using STATA Version 15. The study was conducted in March and April 2023. Adoption of facial and environmental hygiene promotion was low at 47.68%. Having readily available transport (AOR = 3.06. 95% CI = [1.38, 6.80]), perceiving the intervention as relevant for trachoma prevention (AOR = 7.78, 95% CI = [4.38, 13.82]), having been trained in F and E (AOR = 2.17, 95% CI = [1.24, 3.78]) and availability of information, education and communication materials (AOR = 3.04, 95% CI = [1.69, 5.46]) were associated with higher odds of adoption of facial and environmental hygiene promotion among health workers. There was low adoption of facial and environmental hygiene promotion among health workers influenced by training, transport availability, IEC material availability and perceived relevance and complexity of the intervention. To increase adoption of facial and environmental hygiene promotion, program implementers must ensure that they consider the identified factors in the planning of the intervention activities.

Ready-to-eat (RTE) meats such as beef jerky, pepperoni, salami, prosciutto, bacon, ham, and smoked deli meats have been rising in popularity. Environmental Health Officers (EHOs) and other regulatory personnel have the responsibility to inspect and regulate small- and medium-sized food operations that may be producing these types of meat products. Many of these operators may have limited technical food safety knowledge of RTE meat products, with the responsibility of education falling on the shoulders of EHOs. This article will provide a brief overview of the new Ready-to-eat Meats Field Guide developed by the National Collaborating Centre for Environmental Health, which discusses general food safety considerations of RTE meat production.

The widespread and large number of Food Management Facilities and the limited number of environmental health officers as supervisors pose a unique challenge to the current inspection system in implementing field supervision. Effective monitoring efforts are essential to ensure food safety at TPP. The research aims to examine how risk-based sanitation and hygiene inspections are applied at the Banjarbaru City TPP. This research method is observational with a cross-sectional approach using the Environmental Health Inspection Instrument. Samples were taken based on five TPP categories: restaurants, catering services, food stalls, DAMIU, and IRTP. A risk-based analysis was conducted based on the cumulative value of food risks, including food profiles and mitigation of these food hazards. Business risks assessed business size and the risk of non-compliance during inspection. The research results show that 60% of TPPs are in the medium-risk category with an inspection frequency of once a year, 20% are in the high-risk category with an inspection frequency of twice a year, and 20% are in the low-risk category with an inspection frequency of once every two years. It is recommended that consistent supervision and periodic monitoring be implemented so that every food management facility can guaranty food safety and quality for consumers, thus protecting public health from hazardous food risks. Regular inspections not only increase consumer confidence but also strengthen businesses' commitment to providing high-quality and safe food.

Introduction Ebonyi State is a Lassa fever hotspot in Nigeria as it is the highest burdened South-eastern State, with a case fatality of 18.1%. Close rodent-human interactions drives Lassa fever virus transmission. We implemented a range of One Health interventions and evaluated the outputs across three high-risk local government areas (LGAs) in May 2024: Abakaliki, Ezza North, and Izzi. Methods Advocacy sessions, training for health workers, rodent hotspot mapping, and de-ratization using baited rodenticides were implemented. We held advocacy sessions with the State Ministries of Health, Agriculture and Environment and town hall engagement meetings with key state community structures through dialogue sessions. Trainings on rodent ecology, Lassa virus transmission pathways, and integrated vector control techniques were conducted for One Health surveillance officers (Environmental Health Officers (EHOs), health educators, veterinary and public health surveillance officers). We identified rodent hotspots in three Local Government Areas (LGAs) and utilized bait formulations for de-ratization, specifying the types of rats that were present. We thematically analysed the themes from the dialogues and engagement meetings. At the training, pre- and post-tests were used to assess knowledge gained. For data from the rodent hotspot mapping, we computed frequencies and proportions. Results Over 150 community members participated in dialogues on infection prevention, hygiene, and rodent control. Post-training assessments showed a 28% increase in knowledge of rodent ecology, Lassa virus transmission, and integrated vector control techniques. We mapped and targeted markets, rice mills, garri processing areas and stores for deratization. We recovered 149 rats, with 47 (31.5%) identified as Mastomys natalensis and Izzi LGA recorded the highest rat burden. Conclusion Continued rodent surveillance, sanitation enforcement, state-level One Health integration, and community-led waste management are essential to the control of Lassa fever.

ABSTRACT In health and social care, disagreements over referrals involve professionals contesting between them the power to define the situation. An aspect of practice that commonly gives rise to such disagreements is self-neglect because of its high ambiguity for services. Self-neglect therefore provides a useful case to explore how professionals anticipate and respond to interagency barriers to referral when criteria and thresholds are only loosely defined, and collaboration is often ad hoc. To investigate the dynamics of interagency referral for self-neglect, we interviewed 69 practitioners: health and social care professionals; and fire and rescue, environmental health, and housing officers, all of whom regularly respond to both crisis and chronic situations of self-neglect. Dynamics that influence referrers and hinder coordination between interprofessional networks included uncertainties about the right route, perceived barriers to referral acceptance, and feeling unable to refer. These present barriers to the anticipatory labor needed to make interagency referrals land successfully with the receiving agency and may lead to a self-fulfilling cycle that discourages practitioners from thoughtful referral practice. Although referral failures are often treated in research on referral in safeguarding as a technical knowledge-deficit problem, the data show the significance of wider interagency relations, perceptions, and expectations in accounting for the barriers.

IntroductionThis study evaluates the potential of machine learning (ML) to predict and manage weather-sensitive waterborne diseases (WSWDs) in selected Tanzanian districts, focusing on environmental health officers' (EHOs) knowledge and perceptions. It explores EHOs' familiarity with information and communication technology (ICT) and artificial intelligence (AI)/ML, alongside challenges and opportunities for integrating AI-driven public health solutions.MethodsA census-style survey was conducted among EHOs in three district councils. A structured questionnaire, piloted in one district, was administered to 76 EHOs, achieving a 66% response rate. Data were analyzed using descriptive and inferential statistics to assess knowledge levels, perceptions, and gender-related differences.ResultsMost EHOs were moderately familiar with ICT; however, only 54% had prior exposure to AI/ML concepts, and 64% reported limited AI familiarity. Among the variables examined, only prior exposure to AI/ML concepts and self-reported familiarity with AI demonstrated statistically significant associations with gender. Despite this, the majority recognized AI/ML's potential to improve disease prediction accuracy. Key barriers to ML adoption include inadequate technical infrastructure, data quality issues, and a shortage of expertise. Opportunities identified included utilizing historical disease data, integrating AI with meteorological information, and using satellite imagery for surveillance.DiscussionThe study highlights frontline health workers' perceived barriers to ML adoption and suggests that gender influences awareness and engagement with AI and ML technologies. Strengthening technical capacity, improving data quality, and fostering cross-sector collaboration are critical for successful AI/ML integration. These insights offer a roadmap for resilience to WSWDs in developing countries like Tanzania through data-driven technologies.

IntroductionIn urban areas of Ghana, key aspects of the pork production chain, such as pig handling, slaughter practices, and transportation, are critical yet often overlooked aspects of public health and food safety. Despite their significance, only a limited number of studies exist on the dynamics and implications of these practices. This study aims to address knowledge gaps regarding pig-keeping and slaughter practices in Ghana, specifically addressing pig-keeping, handling, slaughter practices, and transportation along the pork production chain.MethodsThis phenomenological qualitative research paradigm utilised eight (8) focus group discussions (FGDs) with pig handlers and slaughterhouse workers in Accra and the Upper East Region of Ghana. Five (5) FGDs were conducted with pig-keepers, and three (3) FGDs were conducted with slaughterhouse workers. Three (3) participatory observations were conducted, probing study participants' views and the information they provided against their actual behaviour. This was to ascertain pig-keeping practices, the slaughter process, means of transport to vending sites, and hygiene and sanitation issues. Four (4) key informant interviews were conducted—two with veterinary officers and two with environmental health officers—to gain insights into their respective supervisory roles.ResultsThe study results indicated that most of the pigs were housed in makeshift structures, and free-ranging was widespread to reduce the cost of feeding. It was observed that the activities of pig farmers and slaughterhouses need to be adequately supervised, leading to widespread poor practices. Little knowledge of zoonotic diseases was present among actors in the pork production chain in Ghana.ConclusionsThis study underscores the importance of addressing pig handling and slaughter practices as integral components of urban food systems in Ghana. By engaging stakeholders and raising awareness, policymakers can foster sustainable solutions to enhance food safety, protect public health, and promote animal welfare in urban Ghana.

The 4th pillar of the Community-Based Total Sanitation (STBM) program emphasizes household waste management, which is crucial due to the significant contribution of household waste to environmental pollution. This study aimed to analyze the influence of knowledge, education, and triggering on the implementation of the 4th pillar of STBM in Mojosulur Village, Mojosari District, Mojokerto Regency in 2025. An analytic observational design with a cross-sectional approach was applied, involving 92 housewives selected through systematic random sampling. Data were collected using questionnaires to measure knowledge, education, and triggering experience, and observation sheets to evaluate household waste management practices. The results showed that the overall implementation of the 4th pillar of STBM was still low, with only 15.2% of households practicing proper waste management. The Chi-Square test indicated that knowledge had no significant association with STBM 4th pillar implementation (p = 0.109), while education (p = 0.004) and triggering (p = 0.000) were significantly associated. These findings highlight that higher education and structured triggering activities play a key role in strengthening household waste management. Local governments and environmental health officers are recommended to intensify triggering interventions and strengthen community education programs, focusing on the three main components of STBM enabling environment, increasing demand, and increasing supply to promote sustainable waste management behavior at the household level.

Examination of air quality at Bhakti Dharma Husada Surabaya Hospital showed a non-conformity of standards in the LAF Room (Laminair air flow). The study aimed to analyse the physical and microbiological air quality factors in the cleaning process in the LAF (Laminair Air Flow) room. The study used an observational descriptive design with a cross-sectional approach. The study population was room air in the LAF room. The research variables included temperature, humidity, lighting, air germ count, Staphylococcus, and room cleaning process. Data collection techniques were observation, measurement, and laboratory examination. Data were analysed and presented descriptively. The study's results showed the value of the air germ number before the cleaning process was 16 CFU/m3, exceeding the required quality standard of 10 CFU/m³. Measurements after the cleaning process have met the requirements of 9 CFU/m³. Room temperature and humidity measurements before and after the cleaning process have met the quality standards of 16-25°C and 35-50%. The lighting measurement of 110.6 lux does not meet the minimum requirement of 500 lux. Environmental health officers should monitor room cleaners for compliance with the use of personal protective equipment. It is necessary to increase the intensity or modify the lighting.

Background: Tuberculosis remains the 10th leading cause of death globally, accounting for approximately 1.3 million fatalities. The physical conditions of a house, including ventilation, humidity, temperature, occupancy density, lighting, and Clean and Healthy Living Behavior (PHBS), are crucial factors that should be considered in relation to TB incidence. Objective: This study aims to analyze the relationship between house physical conditions and PHBS with the incidence of TB in the working area of the Kaluku Bodoa Public Health Center, Makassar City. Methods: This study employed an observational analytic design with a cross-sectional approach. The sample size for the study comprised 150 respondents. Data were processed using univariate analysis, presented in tables, and further analyzed descriptively and bivariately using the Chi-square test to determine the relationship between house physical conditions and CHLB with TB incidence in the working area of the Kaluku Bodoa Public Health Center, Makassar City. Results: There was a significant relationship between ventilation, lighting, occupancy density, and PHBS with TB incidence in the Kaluku Bodoa Public Health Center, Makassar City. At the same time, temperature and humidity were found to have an insignificant effect on TB incidence. Conclusion: The findings of this study can be used to guide government policies aimed at improving the quality of life for individuals with TB. Environmental health officers can implement intensive programs emphasizing the importance of handwashing, maintaining cleanliness, and ensuring proper ventilation to reduce the risk of TB transmission.

In June of 2024, I was asked by the Environmental Health Officer of Galway, Ireland, to recount my endeavors in support of the 2002 push to ban smoking in Irish workplaces, led by The Office of Tobacco Control (OTC) for The Republic of Ireland. At that time, OTC's smoke-free campaign was being vigorously opposed by publicans as well as the Irish tobacco industry. Their opposition had downplayed any effects of secondhand smoke on pub workers' health. As a researcher, I had published 46 peer-reviewed papers on the hazard, exposure, dose, risk, and control of secondhand smoke since 1980. In 1998, I had become a secondhand smoke consultant, assisting entities in the U.S. and abroad who were attempting to enact workplace smoking bans. In 2002, OTC's then Director, Tom Power, had contacted me to request my technical assistance to the Irish government in their campaign to enact a workplace smoking ban in Irish pubs. Accordingly, I asked for any local data that might aid me in my effort. He provided me with measurements of carbon monoxide from secondhand smoke in 14 Galway Pubs, performed by the Irish researcher Maurice Mulcahy in support of his Master's Thesis. Using a pharmacokinetic model that enabled mapping secondhand smoke carbon monoxide to its equivalent nicotine metabolite body fluid cotinine, I estimated that based on the Galway pub data, secondhand smoke exposures of nonsmoking Irish pub workers were at the upper extreme for nonsmokers when compared to a study of cotinine in London pub staff relative to the general population. Further, using a dose-response relationship, I was able to estimate that the working-lifetime risk of mortality from workplace secondhand smoke exposure would produce an estimated 150 deaths per year among the ∼28,000 full-time Irish pub workers. I presented this information to the Health Minister and Members of Parliament at the Dail, and in numerous multi-media interviews. These estimates rebutted bogus tobacco industry assertions that ventilation could control secondhand smoke, fired up the effort championed by Health Minister Micheál Martin to ban smoking in pubs, and helped to protect pub workers from being forced to trade their health for a pay cheque.