Environmental Health Officers Research Articles

Opportunities for environmental public health action on the social determinants of health and health inequity

Karen Rideout,* Dianne Oickle, Julie Scarpino, Heejune Chang, Tim Ness, Vittoria Vecchiarelli, and Lydia Ma** *Environmental Health Policy Analyst, BC Centre for Disease Control and National Collaborating Centre for Environmental Health, Vancouver, BC. Knowledge Translation Specialist, National Collaborating Centre for Determinants of Health, Antigonish, NS. Public Health Inspector, Manitoba Health, Moose Lake, MB. Medical Officer of Health, Winnipeg Regional Health Authority, Winnipeg, MB. Senior Environmental Health Officer, First Nations and Inuit Health Branch, Health Canada, Ottawa, ON. Senior Public Health Inspector, Health Protection Division, Community and Health Services Department, The Regional Municipality of York, Markham, ON. **Manager, National Collaborating Centre for Environmental Health, Vancouver, BC.

Epidemiological investigation of an outbreak of cutaneous sporotrichosis, Northern Territory, Australia.

BackgroundAn outbreak of cutaneous sporotrichosis occurred in the Darwin region of the Northern Territory (NT) in 2014. We aimed to determine the source and risk factors associated with the outbreak and describe the clinical spectrum of cases seen.MethodsEpidemiological investigation of cases of cutaneous sporotrichosis identified through the Royal Darwin Hospital was undertaken to investigate risk factors and potential sources of infection. Data were collected through chart review and individual patient interviews. Environmental investigation followed identification of a common risk factor.ResultsNine confirmed cases of cutaneous sporotrichosis caused by Sporothrix schenckii were identified with onset of symptoms between April and July 2014. Patients were aged 29 to 70 years and seven were male (78 %). Two strains of S. schenckii were identified, neither of which have been previously documented. One common risk factor was identified: all patients were occupational or recreational gardeners, with each reporting exposure to mulching hay, originating from a single NT farm. Local environmental health officers visited the farm and the owners confirmed that the implicated hay had been stored over the monsoon season and had been affected by rain. Storage of hay over the wet season was a new practice.ConclusionsThis constitutes the third reported outbreak of S. schenckii sporotrichosis attributable to contaminated hay in Australia and the first outbreak of sporotrichosis in the NT. This outbreak prompted public health interventions, including distribution of information to general practitioners, farmers and suppliers in the Top End. Media reporting led to the identification and treatment of an additional case. Local practitioners should remain alert to the possibility of further occurrences of sporotrichosis.

Inside the black box of food safety: a qualitative study of 'non-compliance' among food businesses.

Issue addressed This paper examines the meaning of food safety among food businesses deemed non-compliant and considers the need for an insider perspective to inform a more nuanced health promotion practice. Methods In-depth interviews were conducted with 29 food business operators who had recently been deemed 'non-compliant' through Council inspection. Results Paradoxically, these 'non-compliers' revealed a strong belief in the importance of food safety as well as a desire to comply with the regulations as communicated to them by Environmental Health Officers. Conclusions The evidence base of food safety is largely informed by the science of food hazards, yet there is a very important need to consider the practical daily application of food safety practices. This requires a more socially nuanced appreciation of food businesses beyond the simple dichotomy of compliant/ non-compliant. So what? Armed with a deeper understanding of the social context surrounding food safety practice, it is anticipated that a more balanced, collaborative mode of food safety health promotion could develop, which could add to the current model of regulation.

Enforcement of science-using a Clostridium perfringens outbreak investigation to take legal action.

We report an outbreak of Clostridium perfringens in a care home in North East England. A retrospective cohort study was used to investigate this outbreak. Faecal samples were obtained from symptomatic residents. Environmental Health Officers carried out a food hygiene inspection and formal statements were taken. Fifteen residents reported illness and the epidemic curve was suggestive of a point source outbreak. Results suggest that illness was associated with consumption of mince & vegetable pie and/or gravy. There were a number of issues with food served, in particular the mince products had been cooked, cooled, reheated and served again over a period of several days. Faecal sampling revealed the presence of C.perfringens enterotoxin gene and four samples were indistinguishable by fluorescent amplified fragment length polymorphism, indicating a likely common source. The operator of the home was charged with three offences under the General Food Regulations 2004 and the Food Hygiene (England) Regulations 2006 and was convicted on all counts. An outbreak of C.perfringens occurred in a care home. The likely cause was consumption of mince & vegetable pie and/or gravy. Epidemiological evidence can be used to help prosecute businesses with food safety offences in such circumstances.

Assessment of sous vide knowledge and inspection/cooking practices


 Background: In September 2014, BCCDC developed “Guidelines for Restaurant Sous Vide Cooking Safety in British Columbia” providing Environmental Health Officers (EHO) and sous vide cooking chefs safety knowledge about sous vide cooking. To assess whether the guidelines improved sous vide safety knowledge, a study was conducted to examine and compare knowledge differences between EHOs and chefs who had read the guidelines to those who had not read the guidelines. Methods: An online survey was created and advertised by publishing on the BCCDC website, in newsletters and magazines (Vancouver Costal Health newsletter, Fraser Health news Letter, Chefs Quarterly magazine), and through e-mail distribution lists to EHOs and chefs, including chefs at Vancouver Community College. The questions in this survey were developed based on the guide-lines. T-tests and Chi square analyses were conducted to assess knowledge difference between those who read the guidelines and those who did not. Results: A total of 65 people completed the survey, including 45 EHOs (69.3%), 15 chefs (23%), and 5 others (7.7%). EHOs who read the guidelines had significantly higher average knowledge scores in the multiple choice section of the sous vide safety knowledge survey (p=0.00028, t-test) when compared to EHOs who had never read the guidelines. No differences were found in the true and false section (p=0.43925, t-test). With regard to inspection practices, EHO who read the guide-lines were more likely to frequently check for the internal temperature of sous vide foods, water bath temperature, time/temperature in the recipes, calibration of thermometer and proper labels on sous vide pouched foods than EHOs who never read the guidelines. Chefs who read the guidelines had similar average score as chefs who never read the guidelines in T/F (p=0.79878, t-test) and multiple choice (p=0.97, t-test). With regard to cooking practice, chefs who read the guidelines were more likely to frequently calibrate thermometers than chefs who never read the guidelines. However, chefs who never read the guidelines were more likely to frequently find their sous vide pouch floating dur-ing the cooking process, to check for internal temperature of sous vide food, and to label their sous vide pouch properly. Conclusion: These results show that EHOs who have read the sous vide guidelines have better sous vide knowledge in comparison to EHOs who have never read the guidelines. They are also more likely to have overall better inspection practices. Nevertheless, results show chefs who read the guidelines have similar sous vide knowledge in comparison to chefs who never read the guidelines. In terms of cooking practices, these chefs are likely to have better cooking practices only in certain areas.

A study on allergen knowledge and its perceived importance in food safety


 Background: Studies have shown that one out of every thirteen Canadians suffers from a significant food allergy, and that 1.2 million Canadians may be affected by food allergies in their lifetime. As food allergies are common, many would assume that allergen safety would be a significant component of public health promotion and food education. This study, on food allergen knowledge, is one step towards addressing the deficit that exists with regards to understanding food allergens in public health. Method: The study was conducted by surveying Environmental Health Officers (EHOs) nationwide using an online questionnaire. It was distributed via email with the aid of the Environmental Health faculty at British Columbia Institute of Technology (BCIT). The survey was also posted to the BCIT Environmental Health and Canadian Institute of Public Health Inspectors (CIPHI) groups on the online social networking service Facebook. The results helped determine whether opinions, behaviors, and knowledge level regarding food allergens and food allergen safety depended on having a food allergy themselves. Results: The data extracted from the survey was analyzed using the statistical software NCSS. The results of the Allergen Knowledge portion (t-test) concluded that there is no association between the score of the Allergen Knowledge test, and whether or not the participants have a food allergy, inferred by its p-value of 0.268010. The results of a chi-square test indicated that there is a borderline association between how often EHOs educate restaurant operators on allergen safety, and whether or not they have a food allergy (p = 0.049) Conclusion: The t-test performed concluded that the participant’s knowledge regarding food allergens was not dependent on the presence or absence of a food allergy. The second statistical analysis (chi-square test) supported an association between how often EHOs educated restaurant operators on allergen safety, and whether or not they have a food allergy. Health Authorities can use these results to provide a basis for establishing a food allergen training program for EHOs in the future, thereby raising awareness and helping to better manage the presence of food allergens in public health.

A study on the public perception of waste-to-energy facilities in Metro Vancouver


 BACKGROUND: Metro Vancouver is proposing a second waste-to-energy (WTE) facility to be built within the regional district. WTE facilities are used to reduce the volume of waste going to landfill sites. With Metro Vancouver’s desire to become the Greenest City in the World by 2020, WTE facilities are one option to achieve this goal. The proposal is currently in its second phase, and is looking for an ideal location. However, there are debates over whether the use of WTE facilities is an ideal method of municipal waste disposal. The aim of this research project was to measure the public knowledge and opinion of WTE facilities across various demographics. METHODS: A survey regarding knowledge and opinion of WTE facilities was generated and distributed online via social media platforms. Microsoft Excel and NCSS software were used to analyze the data to determine statistical significance. RESULTS: There were a total of 111 respondents. Demographic information was analyzed against the respondent’s knowledge score of WTE facilities. There is no statistically significant difference between educational background, age group, or place of residence and attaining a particular knowledge score of WTE facilities (p=0.51, p=0.31, p=0.22 respectively). The results indicated a limited knowledge of WTE facilities in the general public, with a mean score of 3.6 out of a maximum of 5. 59% of respondents indicated that they felt neutral towards WTE facilities, while 24% believed they were the most desirable method of managing municipal waste, and 21% believed they were least desirable. CONCLUSION: Results suggests that WTE facilities are not well understood, and not enough knowledge has been provided to the public in order for them to formulate a consensus on supporting or rejecting the use of WTE facilities. In such cases, the Environmental Health Officer (EHO) can act as an educator to help the public make an informed decision on the effects of WTE facilities and the consequences of different methods of handling municipal solid waste.

Electronic cigarettes


 Background: Since 2011, the popularity of electronic cigarettes in North America has increased dramatically. However, with a lack of scientific data performed on long term health effects and the limited number of short term studies, it is difficult for Environmental Health Officers to effectively educate the public on concerns relating to the health and safety of the general public. The increase of teenage users demonstrates the need for better government legislation and enforcement, in order to prevent the re-glamorization of smoking in younger generations. Therefore, the following study conducted a chemical analysis on artificially inhaled vapor from two different types of e-cigarettes (disposable and rechargeable), to determine if any heavy metal concentrations; specifically cadmium, chromium, lead and arsenic, are detectable. Methods: The vapor from one of two e-cigarette types was artificially inhaled through a cellulose filter cassette by a personal sampling pump. A two tailed t-test was performed to determine if there were any differences between the heavy metals and the type of e-cigarette used in the study. Results: There was no statistical significant difference in heavy metal concentration by the type of e-cigarette used (for cadmium the p-value was 0.00, and power was 0.00, for chromium the p-value was 0.181220, and power was 0.008976342, for lead the p-value was 0.333711, and power was 0.001825742, for arsenic the p-value was 0.00, and power was 0.00). Conclusion: Based on the results, it was determined that there was no statistical significance between disposable e-cigarettes and rechargeable e-cigarettes with respect to concentration of the four heavy metals of interest (eg. cadmium, chromium, lead and arsenic). Although there was no statistical significance between the types of e-cigarettes used, the average concentration of chromium (IV) from the rechargeable e-cigarette was 0.13mg/m3, which is ten times the recommended 8-hour time weighted average (TWA) set by the BC Occupational Health and Safety Regulations. Hence, further studies must be conducted to determine if the average concentration found in this study truly reflects the concentration found in inhaled vapor from rechargeable e-cigarettes. Furthermore, environmental health officers can provide the public with the concentration found in this study and warn of potential health risks associated with e-cigarettes until further studies are released.

Kimchi


 Background: The increasing number of kimchi consumers in Metro Vancouver raises food safety concerns over the kimchi being out in the ambient temperature. Although kimchi is known to have lactic acid pro-ducing bacteria as its normal flora, environmental health officers have no specific reference to the change in pH with respect to time. The purpose of this study was to understand the rate at which kimchi ferments at different temperatures and determine whether kimchi is a hazardous food or not. Methods: Freshly made kimchi at researcher’s residence were divided into two groups; 4 oC and 25 oC. 30 samples for each set with equal amounts were left at these two different conditions. PH and temperature were measured at the time of separation and for three weeks weekly using the Waterproof Palm pH analyzer. Results: There was a steeper decline in the 25 oC set compared to 4 oC. It took some time between 22 hours and 34 hours for 25 oC set to show a drop in pH. On the other hand, 4 oC set did not show a significant decline in pH within the time period of the experiment.

Investigation on the cold temperature retention capacity of the 1.5 Liter Thermos® double wall vacuum stainless steel thermal container when filled to different volumes and with different types of milk


 Introduction: Customers sometimes question the freshness of milk inside thermal containers in coffee shops. Milk that is kept between 4°C to 60°C can support the growth of pathogens, hence it should be kept below 4°C. Thermal containers are often advertised as being able to retain the temperature of their contents for a prolonged period of time. Yet, the extent of their temperature retention capacity is not clearly defined by the manufacturers. This study investigated the effectiveness of the 1.5 Liter Thermos® Double Wall Vacuum Stainless Steel Serving Carafe thermal container in keeping milk at ≤4°C when it was filled to different volumes and with different types of milk over a nine hour period. Methods: Four tests were carried out in this study: The 1.5L Skim Milk, The 1.5L Creamo, The 0.75L Skim Milk and The 0.75L Creamo Test. For each test, the milk was placed into the 1.5L Thermos® Double Wall Vacuum Stainless Steel Serving Carafe with the initial temperature between 3.1°C to 3.4°C. Change in temperature was recorded for nine hours using the Thermocouple data logger. Results: The descriptive data demonstrates that the mean temperatures over the nine-hour period for The 1.5L Skim Milk Test, The 1.5L Creamo Test, The 0.75L Skim Milk Test and The 0.75L Creamo Test were 4.41±0.88°C, 4.51±0.95°C, 5.59±1.52°C and 6.05±1.77°C, respectively. MANOVA results suggested that “volume”, “time”, “type of milk”, “volume and time”, “volume and type of milk”, “time and type of milk”, and “volume, time and type of milk” did have effects on the temperature retention capacity of the thermal container with p-values <0.05. The temperatures of all samples were <4°C at hour zero. All of the samples’ temperatures began to increase once they were inside the thermal container and all of the samples entered the danger zone (>4°C) after four hours. A Chi Square test was conducted to determine whether Creamo or skim milk was safer (≤4°C) from hour one to four. Results showed that 123/240 (51%) skim milk and 110/240 (46%) Creamo samples were safe, but the result was not statistically significant. Conclusion: This study’s results indicate that the tested thermal container had a better cold temperature retention capacity when it was filled up (1.5L) compared to when it was only half filled (0.75L). In addition, when the thermal container was filled with skim milk, it also had a better cold temperature retention capacity compared to Creamo. Finally, this specific thermal container was not successful in maintaining the temperature of milk out of the danger zone (≤4°C) after four hours. These results should be disseminated to Environmental Health Officers whose job it is to keep the public safe from foodborne illnesses. As well, policies should be established pertaining to time permitted to keep milk in thermal containers.

Personal and food hygiene practices of subsistence food vendors operating in Kano metropolis, northwestern Nigeria

Background: Foodborne diseases are on the increase throughout the world due to poor attention given to personal and food hygiene measures by both lawmakers and people in charge of food preparation, especially in the developing countries. Objective: To examine the knowledge and practices of food vendors operating in urban Kano on personal and food hygiene. Materials and Methods: We used a descriptive cross-sectional design to study a random sample of 380 food vendors in Kano metropolis. Data were collected using pretested interviewer administered semi-structured questionnaire. Data were analyzed using Epi Info® software, version 3.5.1. Results: The mean age of the food vendors was 27.78 ± 7.63 years. The majority (61.1%) of them were men (53.2%), married (61.8%), and had at least secondary education (51.1%). More than two-thirds (89.7%) had fair knowledge of personal hygiene, although there were deficiencies in some of the key hygiene areas, but 62.4% and 36.6% had good and fair knowledge of food hygiene, respectively. Most of the food vendors had good practices of personal hygiene (93.2%). Paradoxically, only 17.1% had good practice of food hygiene. Furthermore, more than half (54.2%) showed bad workplace hygiene practices. Conclusion: Food vendors operating in Kano generally knew about personal and food hygiene, but this was not reflected in their hygienic practices. It is the statutory responsibility of the environmental health officers to safeguard and implement food hygiene laws in Nigeria. But despite the available structure and personnel at the local government area level, the laws are still inactive. The health authorities at the state and federal levels should empower the environmental health officers with the necessary policy and logistic support they require to fully implement the laws in Kano and Nigeria as a whole. The laws should also be reviewed to ensure more severe penalty for offenders.

Response Preparedness to Viral Hemorrhagic Fever in Nigeria: Risk Perception, Attitude towards Lassa Fever

Objectives: The objective of the study was to determine the knowledge, attitude, and practices towards Lassa fever of tertiary health workers. Setting: Two Federal Teaching Hospitals in Nigeria. Participants: Doctors, nurses, laboratory scientists, health educator, environmental health officers, mortuary attendants, cleaners, pharmacists, physiotherapists, and health technicians. Primary and secondary outcome measures: A cross-sectional study was conducted using a standardized, self-administered questionnaire, which enquired about the risk perception, knowledge, attitude, and health-seeking behavior towards Lassa fever. Results: Risk perception among participants was fairly good, while compliance with universal precautions amongst these highly exposed populations should be improved. Conclusions: Training on Lassa fever should be paired with appropriate and corresponding training on personal protective equipment. Trial Registration: Not applicable.

Effect of local authorities' field monitoring visits on awareness of regulation and hygiene practices among street food vendors: the case of two district capitals in Ghana

Background: Street food vending is increasingly popular in Ghana though some studies show their association with high risk of infection. Most studies focus on microbial risks instead of the linkage between officials’ field visits and vendors’ awareness of regulation and hygienic practices. This paper therefore assesses the association between perceived rate of authorities’ field visits and vendors’ awareness of regulation and hygiene practices. Method: A total of 125 street food vendors from two district capitals, Mankranso (50) and Ejura (75), in the Ashanti region of Ghana, were sampled for interview around April – May 2013. Also a principal environmental health officer from each town was interviewed concerning food vending permit acquisition processes and field monitoring visits. Results: The key informants were confident that the existing processes and mechanisms could ensure compliance with food vending regulations and standards among street food vendors. Most vendors from Mankranso (78%, 39/50) reported that officials’ field visits were frequent unlike few vendors from Ejura (17%, 13/75). A good number of food vendors (80%, N=125, p=.000) claimed they have permits but few (19%, N=125, p=.036) could prove their claims. Meanwhile, almost all vendors (94%, N=125, p=.014) claimed they knew their trade is regulated by law. However, a good number of vendors could not list two or more regulatory requirements and that consequently affected the overall regulatory consciousness levels to 74% (Mankranso) and 81% (Ejura) below average. Significant association and correlation was established between personal hygiene practice and reported field visits at Ejura (p=.028; R=.343 with p=.004) but not at Mankranso (p=.395; R=.175 with p>.05). The detailed results of all hygiene practices, and awareness of food vending regulations are discussed. Conclusion: Street food vendors’ perception about officials’ visits do not necessarily influence hygiene practices since enforcement during visits could be weak or not fully embedded.

Using environmental health officers' opinions to inform the source attribution of enteric disease: further analysis of the "most likely source of infection".

BackgroundPolicies and programs are needed to mitigate the burden of enteric disease in Canada. Source attribution, a goal of FoodNet Canada, can inform such strategies and can be accomplished with the information provided by expert opinion. This includes environmental health officers’ (EHOs) opinions on the “most likely source of infection” (MLSI) of confirmed cases of enteric disease that are investigated by the Fraser Health Authority in British Columbia, FoodNet Canada’s second sentinel site.MethodsExposure data from the MLSI were categorized into ten groups and summarized for five enteric disease groups using endemic cases in the first analysis, and a combination of endemic and international travel cases for the second analysis. An exploratory analysis was also conducted on risk setting information in the MLSI. The final analysis involved using a logistic regression model (Wald test) to describe the inherent biases in the data.ResultsExposure proportions, by disease group, were similar to those of an analysis of MLSI data from FoodNet Canada’s Ontario sentinel site. Food exposure represented the greatest proportion of overall enteric disease (32.0%), as well as for salmonellosis (45.0%), verotoxigenic E. coli (VTEC) infection (38.1%), and campylobacteriosis (30.0%) cases. The majority of parasitic diseases (41.2%) were attributed to water exposure. Food safety practices and consuming unpasteurized products were more frequently reported for campylobacteriosis (19.7% and 5.4%, respectively) compared to other enteric diseases. More VTEC infection was attributed to domestic travel (4.8%) than the other enteric diseases. Among endemic and international travel-related cases combined, VTEC infection was attributed more to endemic food exposure (35.5%) than international travel (16.1%), but similar proportions of campylobacteriosis were attributed to endemic food exposure (25.1%) and international travel (25.1%). Variations existed in the exposure and risk setting information that EHOs included in the MLSI, and in their propensity to enter food sources over other types of exposures.ConclusionsResults from the MLSI analysis for exposure, risk setting, and EHO bias, are valid contributions for informing source attribution. Important considerations from this work, including strategies to standardize and improve the quality of MLSI data, will enhance source attribution hypotheses.

Clinic of environmental pediatric care in a high complexity hospital

Children environmental health is considered by The World Health Organization as one of the main challenges of Public Health during the Century XXI. They promote the development of programs that allow approaching, disclosure or mitigation of the impact of polluting agents on health at every level of pediatric attention. The Children Hospital "Prof. Dr. Juan P. Garrahan" has created an Environmental Health Office in order to address the demands of those patients with suspected or verified exposure to environmental risks. An Environmental Clinical History has been elaborated with this purpose.

The effectiveness of Metro Vancouver’s green bin program


 Background and Aims Metro Vancouver is implementing a disposal ban on all food scraps from entering the landfills and incinerators by the year 2015. In order to prepare the city’s residents, a food scraps recycling program, known as the Green Bin Program, was initiated in 2013 for all single family households. The aim of this research project was to measure public knowledge and awareness of the program across various demographics and collect data on the general opinion of it. Methods An online survey was created using SurveyMonkey, a survey generating website, and distributed online via Facebook and e-mail. The results from these surveys were analyzed using NCSS software to determine statistical significance via a chi-squared analysis with alpha (a) = 0.05. Results There were a total of 70 respondents. Of these, 68% of the respondents indicated that the Green Bin Program should stay the way it currently is without any further changes. 8% of the respondents were in favour of stopping the program and the remaining 24% indicated that the program needed some modifications such as more education/promotional material, implementing the program into apartment complexes and more garbage pickup days to prevent pest and odor problems. Age category, location of residence, and educational background were analyzed against other variables in the survey that tested the knowledge and usefulness of the Green Bin Program. Looking at these 3 variables in relation to knowledge: there was no association between location of residence, age, and educational background, with knowledge of what could go into the green bin (p= 0.76, p= 0.53, p= 0.33, respectively). These same 3 demographic variables were also analyzed against frequency of food scraps recycling and there was a positive association between age and frequency (p= 0.037), indicating that respondents aged 19-29 were recycled food scraps more than respondents over the age of 29. However, there was no association between location/education and frequency (p= 0.32 and p= 0.10, respectively). Non demographic variables were also analyzed, such as determining if household size and garbage bin size had an effect on frequency of food scraps recycling: household size did not have a significant association (p=0.70) while garbage bin size did have a positive association (p= 0.025), showing that residences with smaller garbage bins were more likely to recycle their food scraps. Conclusion These results indicated limited knowledge of the Green Bin program and pinpointed deterrents (mostly pests and odors) from participating in it. Environmental Health Officers’ involvement would be important as educators to emphasize that certain organic wastes (like pet fecal matter) should not go into the green bin as they create health hazards. EHOs can also collaborate with the municipality to promote the program. Several participants reported recycling their food scraps; as a result, the Metro Vancouver Green Bin Program has achieved some of its aims in creating a greener and more sustainable city.

A study of indoor air quality investigations in B.C health authorities


 Canadians spend 90 percent of their lifetime indoors and are currently aware that poor indoor air quality (IAQ) can negatively impact human health. If there are any IAQ problems, the Health Authorities will conduct IAQ investigations to respond to the complainants or resolve the conflicts. An online survey to Environmental Health Officers (EHOs) and specialists was used to understand the frequencies that B.C. Health Authorities conduct IAQ investigations, the locations Health Authorities encountered most IAQ queries, the different types of pollutants that IAQ instruments are used for and the preference for instruments chosen. Five common indoor air pollutants, such as mould, volatile organic compounds (VOCs), radon, particulate matters (PMs), CO and CO2, were chosen and the Chi-Square test was used to analyze the data in this study. This study showed that most EHOs had never conducted IAQ investigations since they had worked in the B. C Health Authorities. Mould problems between landlord and tenant were EHOs mostly encountered. The study found that EHOs referred to other agencies or consultants when they received complaints. The data showed that the method of managing IAQ problems was associated with the Health Authorities because few EHOs from Vancouver Coastal Health indicated they had used equipment to conduct IAQ investigations. The mostly encountered location and frequency of conducting radon investigations were significantly associated with the Health Authorities due to an on-going project in Northern Authority. Most EHOs and specialists had shown that they educated public regarding to the information of IAQ instead of monitoring the IAQ pollutants. The results of this study indicate that EHOs did not get involved in IAQ investigations often and also showed that mould problems were the mostly encountered IAQ problems between the Health Authorities. The most important role of EHOs and specialists in this area is to educate public to solve or prevent IAQ problems.

Survey of the general public to determine perceptions and precautions taken when choosing personal service establishments


 Objective: Personal service establishments (PSEs) include tattoo parlors, piercing shops, and beauty salons. Many of the services provided have potential to spread diseases due to the invasive nature and possibility of cross contamination if sanitation procedures are not followed. Potential infections such as nontuberculosis mycobacterium, staphylococcus aureus and blood borne infections such as Hepatitis and HIV are possible. There is concern among Environmental Health Officers (EHOs), and professionals in the industry regarding the lack of regulations and training of employees within the industry. This study investigated the criteria and safety measures the public takes when determining which personal service establishment they receive treatments from. Methods: A questionnaire was administered online through social media and Google Docs. Inferential statistical analyses determined if there were associations between certain demographic information and the responses given from participants. Results: There were six associations that were found when comparing demographic groups (age, gender and education) with the survey questions. A p value of 0.021008 was found in the association between age and perceived level of regulation of the industry, a p value of 0.014407 was found in the association between education and asking about sanitation procedures before an appointment, and a p value of 0.008668 was found in the association of education and if participant asks for references. In addition, p values of 0.028151 and 0.011739 with associations of gender and education, respectively, and the participants perceived ability to recognize bad practices during a procedure. Finally, a p value of 0.029766 was found in the association of gender and participants interest in additional information about how to choose an establishment. Conclusions: There were six hypotheses that resulted in statistically significant associations between a demographic and the survey question. Over 30 year olds chose PSEs were minimally regulated, while higher education groups were more likely to ask about sanitation and for references before a procedure. Females and people with some post secondary education felt they were more able to recognize bad practices during a procedure. Finally, females were most interested in additional information about PSEs.

Safety and pH measurements of sushi rice in Japanese restaurants in Burnaby BC, Canada


 Background and Purpose: The increasing popularity of sushi in Metro Vancouver raises public health concerns over the consumption of sushi rice being held out of temperature control. Although sushi rice is acidified to control growth of pathogenic microorganisms, there is no existing documented system to monitor the pH of sushi rice, and pH testing is rarely performed by Environmental Health Officers(EHOs)/Public Health Inspectors(PHIs) during routine inspections. The purpose of the study was to measure the pH of sushi rice samples collected from different sushi restaurants in Burnaby, BC and determine whether the pH meets the accepted standard of 4.6 or below. Methods: 30 sushi rice samples were collected from 30 randomly selected sushi restaurants in Burnaby, British Columbia. The samples were kept at room temperature and then tested for pH using the Waterproof Palm pH Meter. Results: The mean pH of the samples was 4.09; the median was 4.115; the standard deviation was 0.198; and the range was 0.82 with the minimum value of 3.71 and the maximum value of 4.53. 100% (30 out of 30 samples) had the pH less than 4.6. The statistical z-test resulted in a p-value of 0.00. Discussion: All of the sushi rice samples had pH values less than 4.6. Therefore, the samples were adequately acidified to inhibit the growth of pathogens. The low pH values indicate that the samples are not considered potentially hazardous food, thus safe to be stored at room temperature for extended periods of time. However, due to the nature of Bacillus cereus that can grow at a pH 4.3 or higher, the target pH of sushi rice is 4.3 or lower. Conclusion: Inadequately acidified sushi rice may pose a health risk if it is stored out of temperature control. The study shows that sushi rice being consumed by the public in Burnaby, BC is generally safe and has a low public health concern. Therefore, EHOs/PHIs can feel assured that sushi rice stored at room temperature is unlikely to cause potential foodborne illness.

The effectiveness of ozone-chlorine treatment for reducing chloramine concentration compared to chlorine treatment in swimming pools and whirlpools


 Objectives: Chloramines are by-products of chlorine disinfected swimming pools and are hazardous to people if chloramines evaporate into the air. There is evidence that chloramines cause upper respiratory tract and eye irritation. It was suspected that ozone treatment in addition to chlorine disinfection will reduce chloramine levels in the pool. The following study compared chloramine concentration in a strictly chlorine disinfected swimming pool and whirlpool (C.G. Brown) in Burnaby, BC with an ozone-chlorine disinfected swimming pool and whirlpool (Killarney) in Vancouver, BC. The study also compared each pool and whirlpool to the 1.0 mg/L combined chlorine concentration limit in the B.C. Pool Regulation. Methods: Chloramine concentrations were determined by using a Hach Pocket Colorimeter 2 Analysis System which used a DPD method of analysis. Chloramine was determined by subtracting total chlorine by the free chlorine. Thirty pool water samples were analyzed based on two samples per pool per day for fifteen days. A two sample t-test was used to compare the ozone-chlorine treated pools with the chlorine only treated pools using the Mann-Whitney U test. A z-test was used to compare all types of swimming pools and whirlpools to the 1.0 mg/L limit. Results: The chloramine concentration in both the ozone-chlorine disinfected swimming pool and whirlpool was not statistically significantly lower than in the chlorine disinfected swimming pool (p=0.263597) and whirlpool (p=0.523672). Both types of swimming pools were found to be statistically significantly greater than the 1.0 mg/L chloramine limit (p=0.000023 in the chlorine pool and p=0.00001 for the ozone-chlorine pool). Similarly, both types of whirlpools were determined to be statistically significantly greater than the 1.0 mg/L chloramine limit (p=0.000001 for the chlorine pool and p=0.000001 for the ozone-chlorine pool). Conclusion: It was determined that there was no difference between ozone chlorine treated pools and chlorine only treated pools. Environmental Health Officers can suggest other forms of secondary treatment instead of ozone since there is no significant difference compared to chlorine only treated pools in reducing chloramine concentrations. This information is also beneficial for pool operators because they can increase their flow rates for pools that use ozonation or strictly chlorination relative to what they were originally designed for.