Environmental Health Practice Research Articles

‘We’re all brave pioneers on this road’: a Bourdieusian analysis of field creation for public health adaptation to climate change in Ontario, Canada

ABSTRACT Despite significant engagement with new and emerging issues in public health practice, the public health literature has few theoretical explanations for how new practices emerge, take root, and become institutionalized. In this contribution, we utilize Pierre Bourdieu’s sociological concepts of field, habitus and capital, and in-depth interviews with public health practitioners to document and describe the emerging field of public health adaptation to climate change Ontario, Canada. In doing so, we identify and explain three types of climate change action and associated practices – ‘wait and see’, repackaging existing actions and championing new actions – that practitioners relate to climate change adaptation in Ontario (i.e. business as usual, repackaging existing actions and championing climate new actions). We discuss the typology in relation to the dominant and emerging logics that practitioners ascribe to promoting practical action on this sub-field of environmental health practice to promote a discussion of how social change occurs within a well-established field of professional practice. Findings suggest, that change and innovation can result from exogenous shocks that force practitioners to adopt new practices (e.g. the increasing frequency and intensity of climate-related impacts on health), how the ‘rules’ of a given field are interpreted by practitioners and made actionable, and through the negotiation of new rules by practitioners with a ‘radical habitus’ who champion particular issues, albeit resulting in significant professional risk. We discuss these findings in relation to Bourdieu’s theory, concluding there is significant room for practitioner agency to cultivate normative dispositions and influence the adoption of policy and practice-change.

Factors that Sustain Health and Safety Management Practices in the Food Industry

Due to the significant change in business organizations, scholarly interest has diverted from studying the determinants of financial performance to understanding the environmental activities, sustainability practices, and health and safety management practices. Despite the extensive literature, it is yet to understand either internal or external factors that improve health and safety management practices in SMEs. This research examines the influence of the internal factors—intellectual capital, information technology capabilities (ITC), and entrepreneurial orientation, and the external capabilities—government financial support, institutional pressure, and managerial networking on six health and safety management practices: management commitment, staff training, worker involvement, safety communication and feedback, safety rules and procedures, and safety promotion policies. We researched 410 Pakistani SMEs from the food business industry. The results indicate that intellectual capital significantly improves management commitment, safety communication and feedback, and safety rules and produces; ITC significantly improves management commitment and safety communication and feedback; and entrepreneurial orientation significantly facilitates safety training and worker involvement only. In the external capabilities, government financial support has a significant influence on management commitment, worker involvement, safety rules and policies, and safety promotion policies. Institutional pressure has a significant influence on management commitment, safety training, safety communication, and feedback and safety promotion policies. Managerial networking significantly influences safety training, worker involvement, safety rules and procedures, and safety promotion policies of SMEs. Focusing only on the food industry is the major limitation of this research, this study recommends SMEs to give sufficient attention to their internal and external factors to enhance health and safety management practices. Further implications are discussed.

Environmental Health Knowledge, Attitudes, and Practices of French Prenatal Professionals Working with a Socially Underprivileged Population: A Qualitative Study.

Introduction: As environmental health knowledge of population is associated with social economic status, the objective of this study was to determine environmental health knowledge, attitudes, and practices of French prenatal professionals working with a socially underprivileged population. Material and methods: A focus group with eleven prenatal professionals working with socially underprivileged population was carried out in France in 2015. Content analysis of verbatim explanation was conducted with choice-of-subject categories carried out according to the triangulation principle, and topic trees were generated and applied. Results: The professionals have non-specialized experimental knowledge of emergent risks and were essentially preoccupied by infectious biological risks. In practice, however, they became increasingly cognizant of emergent risks. Their educational practices take cultural context into account but educational tools with imagination and affectivity have to be developed in order to reach socially underprivileged population. Discussion: Professionals are often sensitized to the field of environmental health in their apprehension of polluted biological environments, which they associate with social contexts and behavioral factors. In this study, we recommend adapted training programs and updated professional guidelines in view of reducing prenatal emergent risk exposures and social inequalities of health.

Improving Environmental Health Practice and Policy Through Convergence Research: A Case Study of Linked Food–Water Systems Enhancing Child Health

Promoting access to safe drinking water or access to nutritious food, each independently contribute uniquely to positive gains in human health. Nexus analysis—a systems-based approach to study interconnection and interdependence—provides a framework to expose interactions and interventions in linked food–water systems. Interactions result in unintentional changes in efficacy or toxicity creating poorer-than-expected health outcomes while synergistic interventions targeting both “water, sanitation, and hygiene” as well as “food security, nutrition, and safety” yield greater-than-anticipated improvements in health and wellness. Herein, we describe a case study of linked food–water systems, where discovery, integration, application, and the scholarship of teaching and learning, collectively enhanced child health through convergence research—a transdisciplinary approach to solve a compelling and specific problem. The method integrates five techniques predominant in the field of health care, including: (1) community-based participatory research, (2) structured reviews, (3) mixed methods, (4) structural equation modeling, and (5) interprofessional education—at multiple study sites in east Africa, Guatemala, Brazil, and South Africa. The compelling problem explored is, “the lack of an overarching framework to achieve improvements in interdisciplinary environmental health practice and policy,” to ultimately solve specific problems such as, “the eradication of childhood stunting.” Results demonstrate that convergence research improves environmental health practice and policy by exposing insights to be measured, validated, and disseminated.

The implementation of environmental health policies in health care facilities: The case of Malawi.

Establishing and maintaining safe and sufficient environmental health (EH) conditions in health care facilities (HCFs) is important to prevent and control infections. In 2018, the Government of Malawi finalized an environmental health policy that defines specific targets and programs for EH in healthcare settings. This and other related policies have been used since 2010 as a guide for EH practice in HCFs, but the implementation of these policies has been incomplete to-date. This study qualitatively examines the successes and shortcomings of implementing these policies in Malawi's public HCFs. Thematic analysis of interviews with 53 respondents from all levels of government was used to identify the successes of the policies and the barriers to effective implementation using Contextual Interaction Theory. The greatest identified strength lies in the design of the EH department and its ability to connect individual HCFs and EH actors directly to the policy-making level of government. Identified barriers to implementation include: insufficient financial support; lack of human resources; incomplete reporting; poor stakeholder coordination; and insufficient training of EH actors. We recommend refresher trainings for all EH actors, the establishment of a directorate level EH position, and strengthened coordination to improve the collection, analysis, and reporting of monitoring data to enable EH actors to advocate for the additional funding needed to develop programs for EH personnel and to apply effective EH interventions.

Biomonitoring and Ethnobiology: Approaches to Fill Gaps in Indigenous Public and Environmental Health

Ethnobiology is well positioned to work in tandem with biomonitoring research to create a more complete understanding of how people experience and are affected by contaminated environments. Indigenous communities in proximity to unconventional natural gas (“fracking”) facilities face potential health risks that are often poorly assessed or not assessed at all. This contribution reviews a biomonitoring pilot research project in British Columbia (Canada) that was informed by Indigenous Peoples' concerns of contaminant exposure from traditional foods and their environment. Preliminary biomonitoring results indicate higher levels of a benzene metabolite in pregnant Indigenous women near fracking facilities, compared to what measured in non-Indigenous women. We investigate how Indigenous Peoples' concerns of exposure to industrial contaminants should inform biomonitoring and toxicological studies and, conversely, how biomonitoring studies can complement ethnobiological research with assessable data. By focusing on environmental knowledge and human health in the context of oil and gas development, we critically evaluate how action, environmental justice, and scientific research can and should contribute to more ethical and methodological frameworks and practices. Together, ethnobiology and biomonitoring can be used to fill in important knowledge gaps in environmental health and ethical research practices.

Environmental Health Sciences in a Translational Research Framework: More than Benches and Bedsides.

Background:Environmental health scientists may find it challenging to fit the structure of the questions addressed in their discipline into the prevailing paradigm for translational research.Objective:We aim to frame the translational science paradigm to address the stages of scientific discovery, knowledge acquisition, policy development, and evaluation in a manner relevant to the environmental health sciences. Our intention is to characterize differences between environmental health sciences and clinical medicine, and to orient this effort towards public health goals.Discussion:Translational research is usually understood to have evolved from the bench-to-bedside framework by which basic science transitions to clinical treatment. Although many health-related fields have incorporated the terminology and context of translational science, environmental health research has not always found a clear fit into this paradigm. We describe a translational research framework applicable to environmental health sciences that retains the basic structure that underlies the original bench-to-bedside paradigm. We propose that scientific discovery (T1) in environmental health research frequently occurs through epidemiological or clinical observations. This discovery often involves understanding the potential for human health effects of exposure to a given environmental chemical or chemicals. The practical applications of this discovery evolve through an understanding of exposure–response relationships (T2) and identification of potential interventions to reduce exposure and improve health (T3). These stages of translation require an interdisciplinary partnership between exposure sciences, exposure biology, toxicology, epidemiology, biostatistics, risk assessment, and clinical sciences. Implementation science then plays a crucial role in the development of environmental and public health practice and policy interventions (T4). Outcome evaluation (T5) often takes the form of accountability research, as environmental health scientists work to quantify the costs and benefits of these interventions.Conclusion:We propose an easily visualized framework for translation of environmental health science knowledge–from discovery to public health practice–that reflects the crucial interactions between multiple disciplines in our field. https://doi.org/10.1289/EHP4067

NUTRITIONAL BEHAVIOR PATTERNS IN PROGRAM OF GIVING ADDITIONAL FOODS FOR INFANTS AGED 0-3 YEARS OF UNDER RED LINE

<p><em>Malnutrition in the mother and the baby will have impact to health and intelligence, while the child's intelligence ank itself impact to availability of qualified human resources. Weak ability to provide mothers and families parenting will result in even less nutrition incidence of malnutrition in babies. This research aims to: 1) describes the patterns of behavior of nutrients, foster performed the mother on a toddler's bottom is red. 2) supplementary feeding program implementation the recovery on a toddler under the red line. In this study used the theory of George Homans, namely social exchange. This theory rests on the assumption that people engage in behavior to gain rewards or avoid punishment. So that actions taken person is dependent on or punishment is given against such action.</em><em> </em><em>This study uses qualitative methods, qualitative, descriptive approach to describe the actual situation on the ground. The selected informer is the mother of a toddler down red lines that receive additional feeding program of recovery, a midwife, dietitian and posyandu cadre clinic. Data collection using in-depth interviews, observation, and documentation</em><em>. </em><em>The results showed that: 1) foster nutrition behavior patterns on a toddler under the red line is divided into knowledge include the feeding of pervades, the attitude of care and protection for children, psycho-social and parenting practices that include hygiene and environmental sanitation, health practices and health services search pattern and practice of breastfeeding and complementary feeding of breast milk. 2) Restore additional feeding program awarded to 4 toddler Toddler red down the line, extra food that is given in the form of raw food materials are unisex biscuits. There are constraints in the implementation of the programme including provision of additional food system i.e., a toddler who reluctantly taking Restore additional feeding as well as programs that have not been right on target</em><em>.</em><em></em></p>

Insect net: a novel technology to promote integrated pest management on horticultural crops in Africa

Fruits and vegetables are important commodities in global agriculture. However, in sub-Saharan Africa, production is sub-optimal in terms of yield, quality and environmental health practices due to several constraints such as insect pests which reduce yields through direct damage, or indirectly as disease vectors often promoting microbial diseases. Pest control still relies mainly on chemicals with their associated risks of resistance selection and toxicity to humans and environment. Several alternatives including biopesticides, semiochemical and nets are being explored in pest management. Insect nets applied on tomatoes, cabbages, beans and leafy vegetables protect them from flies, butterflies, moths, albeit to a lesser extent, whiteflies, aphids and thrips reducing their outbreaks as compared to open cultivation. As a result, pest control is limited and yield quantity and quality are improved. Insect nets are safe and cost effective for a period of 3-5 years if well maintained, and they may be re-used and recycled. Insect nets applied on cabbages in Benin yielded 3-fold more profit than current practice. However, insect nets are not effective against all pests inclusion of insect attractants or repellents may enhance efficacy of netting technology. The use of insect nets offers a cost-effective insect pest management option to among smallholder vegetable growers. The full benefit will be achieved with intensified extension efforts to make this technology better known.

Data Infrastructure and Gateway for Environmental Health Research

Datasets that provide information about environmental quality are increasingly large and complex, and include both spatial and temporal information. These data require specialized skills to clean, organize, integrate with other environmental quality data and health outcome data, and analyze. The objectives of this study are to: 1) evaluate interest of the environmental health research and practice communities in a data infrastructure that integrates diverse environmental quality data, and that is accessible and analyzable through a user-friendly interactive Web-based gateway; and 2) test a prototype data infrastructure and gateway with potential end-users. Herein we present initial ideas about the data content and design of the data infrastructure and the envisioned functionality of the gateway. Our goal is to stimulate conversation with potential end-users.

Planning to Practice: Developing Partnership-Building Skills Across the Curriculum

The ability to work in effective collaborations has long been a foundation of health promotion and environmental health practice and, more recently, has been explicitly identified in international accreditation competencies. While limited evidence is available on strategies to teach these skills within single courses, there are no guidelines on best practice, or how to develop the skills across a curriculum. In this article, we demonstrate the scaffolding of partnership building knowledge and skills across an undergraduate public health curriculum through the application of the cognitive apprenticeship model. Using a fading concept, students move from staff-directed to independent practitioners in the development and demonstration of partnership building skills. The model offers an example of cross-program scaffolding for skills that could be adapted to other competencies, disciplines, and contexts.

Attending to scalar ethical issues in emerging approaches to environmental health research and practice.

Accelerated changes to the planet have created novel spaces to re-imagine the boundaries and foci of environmental health research. Climate change, mass species extinction, ocean acidification, biogeochemical disturbance, and other emergent environmental issues have precipitated new population health perspectives, including, but not limited to, one health, ecohealth, and planetary health. These perspectives, while nuanced, all attempt to reconcile broad global challenges with localized health impacts by attending to the reciprocal relationships between the health of ecosystems, animals, and humans. While such innovation is to be encouraged, we argue that a more comprehensive engagement with the ethics of these emerging fields of inquiry will add value in terms of the significance and impact of associated interventions. In this contribution, we highlight how the concept of spatial and temporal scale can be usefully deployed to shed light on a variety of ethical issues common to emerging environmental health perspectives, and that the potential of scalar analysis implicit to van Potter's conceptualization of bioethics has yet to be fully appreciated. Specifically, we identify how scale interacts with key ethical issues that require consideration and clarification by one health, ecohealth, and planetary health researchers and practitioners to enhance the effectiveness of research and practice, including justice and governance.

Prioritizing professional competencies in environmental public health: A best–worst scaling experiment

The professional development of environmental public health professionals in Canada is guided by a set of 133 discipline-specific competencies. Given the diversity of practice in environmental public health, certain competencies may be more important to job effectiveness depending on a practitioner’s context. However, the most important competencies to job effectiveness by context are unknown. Thus, the objectives of this study were to prioritize the discipline-specific competencies according to their importance to job effectiveness, and determine if importance varied by demographic variables. A quantitative discrete-choice method termed best–worst scaling was used to determine the relative importance of competencies. Discrete choice information was electronically collected and analyzed using Hierarchical Bayesian analysis. Our analysis indicates that communication was most important to job effectiveness relative to the other categories. Competency statements within each category differed in their importance to job effectiveness. Further, management and front-line practitioners differed in the importance placed on five of the eight categories. This information can be used to guide new training opportunities, thereby investing in the capacity of environmental health professionals to better protect population health.

Predictors of Saudi nursing students' attitudes towards environment and sustainability in health care.

This study aimed to investigate the predictors of Saudi nursing students' attitudes towards the environment and sustainability in health care. With rising temperature and decreasing annual rainfall, Saudi Arabia is threatened by the harmful effects of climate change on its population. In response to these threats, the Ministry of Health adapted sustainable development and environmental preservation in their National E-Health strategy. To implement these policies successfully, healthcare practitioners should be educated on how climate change could impact human health negatively. A secondary analysis of 280 questionnaires from baccalaureate nursing students of a university in Hail City, Saudi Arabia, was completed. The New Ecological Paradigm (NEP) Scale and Sustainability Attitudes in Nursing Survey 2 (SANS-2) were used to investigate the predictors of student attitudes towards the environment and sustainable development in health care. The NEP score indicated moderate pro-environment attitudes, whereas the SANS-2 mean score showed very positive attitudes towards sustainability in health care. Learning about the environment and related issues in the nursing programme, raising climate change awareness and attending environment-related seminars and training positively influenced the environmental and sustainability attitudes of nursing students. Saudi nursing students moderately manifested pro-environment attitudes but exhibited extremely positive attitudes towards sustainability in health care. The results support the need to strengthen the education of nursing students about environmental and sustainability concepts and the inclusion of these topics in the nursing curricula. The study underscores the critical role of enriching the awareness of nursing students on environmental issues and concerns and sustainability in health care. The findings of this study can support the inclusion of course contents, which deal specifically with environmental health and sustainability practices, in the creation of new policies directed towards curricular revision.

Evaluation of Environmental Health Knowledge and Practice Among Youth Football Players in Benghazi, Libya

Environmental health issues and practices are important in sport to reduce the risk of diseases occurrence and transmission. However, there is lack of a data about them among football players in Libya. This study aims to assess the environmental health knowledge and practices among youth football players in Benghazi, Libya. The study involves 182 participants who were involved from five youth football clubs with age means (17 ± 1.3ys). Players filled self-prepared questionnaire, which contained two sections: environmental knowledge and practices. The collected data was analyzed using SPSS. Almost 62% of the participants had not attend any lecture about environmental health. Markedly, 58% of players sharing their tools with others; in particular towels and water bottles. 75% of the sample were non-familiar with the hazards of sharing tools and 65% did not know about blood-born infections and their transmission mode. 81% of participants did not receive vaccinations, and 125 did not receive any acclimation programs about playing in changed temperature environment. In this study, there was a lake of knowledge about essential environmental health issues as well as poor practices regarding to sharing tools, vaccinations and acclimation practices. Hence, establishment of environmental health education programs among footballer players is of great significant.

Hazard Identification and Risk Assessment in Water Treatment Plant considering Environmental Health and Safety Practice

Water Treatment Plant (WTP) is an important infrastructure to ensure human health and the environment. In its development, aspects of environmental safety and health are of concern. This paper case study was conducted at the Water Treatment Plant Company in Semarang, Central Java, Indonesia. Hazard identification and risk assessment is one part of the occupational safety and health program at the risk management stage. The purpose of this study was to identify potential hazards using hazard identification methods and risk assessment methods. Risk assessment is done using criteria of severity and probability of accident. The results obtained from this risk assessment are 22 potential hazards present in the water purification process. Extreme categories that exist in the risk assessment are leakage of chlorine and industrial fires. Chlorine and fire leakage gets the highest value because its impact threatens many things, such as industrial disasters that could endanger human life and the environment. Control measures undertaken to avoid potential hazards are to apply the use of personal protective equipment, but management will also be better managed in accordance with hazard control hazards, occupational safety and health programs such as issuing work permits, emergency response training is required, Very useful in overcoming potential hazards that have been determined.

The impact of self-help groups on pastoral women\u2019s empowerment and agency: A study in Nigeria

While women in pastoralist communities are key stakeholders in the production of milk and dairy products for income generation, they are largely ignored in other areas of development such as health. The need to involve women self-help groups, in pastoralist areas in both animal health and human health development programmes, is essential, particularly given the high incidence of zoonotic diseases in these communities (Maudlin I, Eisler MC and Welburn SC, Philosophical Transactions of the Royal Society B: Biological Sciences, 364(1530):2777-2787, 2009). Understanding the process and impact of social networks on livelihoods is essential for any development programme that aims to prevent and control zoonotic diseases. This study examines the roles and responsibilities of women self-help groups in Kachia Grazing Reserve and Bokkos, Jos Plateau, Nigeria.The findings show that groups promoting social, physical and psychological health strongly motivated women’s involvement in self-help groups. Self-help activities showed commitment to effect a change in their livelihoods, despite constraining environmental, cultural and social factors. Engagement of women’s self-help groups in livestock development programmes offers a powerful instrument for driving forward the One Health practice in pastoralist communities, promoting human, animal and environmental health and well-being.

CDC's National Environmental Public Health Tracking Program in Action: Case Studies From State and Local Health Departments

The Centers for Disease Control and Prevention's (CDC's) National Environmental Public Health Tracking Program (Tracking Program) is a multidisciplinary collaboration that involves the ongoing collection, integration, analysis, interpretation, and dissemination of data from environmental hazard monitoring, human exposure surveillance, and health effects surveillance. With a renewed focus on data-driven decision-making, the CDC's Tracking Program emphasizes dissemination of actionable data to public health practitioners, policy makers, and communities. The CDC's National Environmental Public Health Tracking Network (Tracking Network), a Web-based system with components at the national, state, and local levels, houses environmental public health data used to inform public health actions (PHAs) to improve community health. This article serves as a detailed landscape on the Tracking Program and Tracking Network and the Tracking Program's leading performance measure, "public health actions." Tracking PHAs are qualitative statements addressing a local problem or situation, the role of the state or local Tracking Program, how the problem or situation was addressed, and the action taken. More than 400 PHAs have been reported by funded state and local health departments since the Tracking Program began collecting PHAs in 2005. Three case studies are provided to illustrate the use of the Tracking Program resources and data on the Tracking Network, and the diversity of actions taken. Through a collaborative network of experts, data, and tools, the Tracking Program and its Tracking Network are actively informing state and local PHAs. In a time of competing priorities and limited funding, PHAs can serve as a powerful tool to advance environmental public health practice.

Assessment of Environmental Health Knowledge, Attitude and Behavior among High School Students in a USA Southeast Texas School District

This cross-sectional descriptive study assessed general environmental health literacy among students focusing on their knowledge, skills, attitudes and behaviors regarding the environmental health, stewardship, and sustainability, using a questionnaire consisting of 35 core questions from the Centers for Diseases Control (CDCs). Students (N = 185) from three high schools in the district were asked through their class teachers to voluntarily complete the questionnaire. Results indicated that about 41% (n = 77) of the students lacked knowledge regarding potential sources of radiation exposure and 70% (n = 133) lacked knowledge regarding radon gas being the number one risk factor for lung cancer among non-smokers. Additionally, the ANOVA test indicated significant knowledge differences among school location. Students in school #1, located in the most affluent area, had significantly higher knowledge scores (M = 4.39) than school #2 located in a moderately affluent area (M = 3.50). Furthermore, we found significant differences in ethnicity on the environmental health attitude of the high school students. Black students reported lower positive environmental health attitude (M = 29.86) than White students (M = 32.63), Hispanic students (M = 32.33) and Asian students (M = 33.84). These findings demonstrated knowledge deficiency in some key areas in environmental health particularly the environmental diseases and conditions caused by manmade hazards such as pesticides, chemicals, radiation, air, water, and soil pollution. Targeted educational interventions to increase awareness and understanding of health effects, exposure to environmental hazards and carcinogens as well as risks associated to direct exposure as in this study, radon and radiation, should be provided to high school students. Practical education through tours where students can observe directly and participating in laboratory experiments could empower the students to translate this knowledge into positive environmental health behaviors and practices now and in the future.

A novel approach to analyzing lung cancer mortality disparities: Using the exposome and a graph-theoretical toolchain.

The aim is to identify exposures associated with lung cancer mortality and mortality disparities by race and gender using an exposome database coupled to a graph theoretical toolchain. Graph theoretical algorithms were employed to extract paracliques from correlation graphs using associations between 2162 environmental exposures and lung cancer mortality rates in 2067 counties, with clique doubling applied to compute an absolute threshold of significance. Factor analysis and multiple linear regressions then were used to analyze differences in exposures associated with lung cancer mortality and mortality disparities by race and gender. While cigarette consumption was highly correlated with rates of lung cancer mortality for both white men and women, previously unidentified novel exposures were more closely associated with lung cancer mortality and mortality disparities for blacks, particularly black women. Exposures beyond smoking moderate lung cancer mortality and mortality disparities by race and gender. An exposome approach and database coupled with scalable combinatorial analytics provides a powerful new approach for analyzing relationships between multiple environmental exposures, pathways and health outcomes. An assessment of multiple exposures is needed to appropriately translate research findings into environmental public health practice and policy.