Environmental Health Officers Research Articles

The impact of new national guidance for the public health management of enteric fever in England

ObjectivesNew guidance was published in England in February 2012 to support the public health management of enteric fever and reduce the risks of secondary transmission. The new guidance was evaluated to assess:•The impact of reduced sampling schedules on secondary transmission of enteric fever.•The burden, compliance and yield associated with sampling.•User acceptability. Study designQuantitative and qualitative evaluation of the implementation of new public health guidance. MethodsA qualitative review of all non-travel–related cases from February 2010 to January 2014 to compare the risk of secondary transmission before and after the guidance introduction; an audit of clearance sampling for each case and their contacts reported in London from February 2012–January 2015 to compare with a previous London audit; and an online user survey in November 2014. ResultsThe proportions of non-travel cases reported before and after the introduction of the new guidance were similar, 6% in 2010–2012 compared to 7% in 2012–2014 (P = 0.33). There was a 32% reduction in the number of clearance samples required for cases and the estimated period of exclusion from work or school was reduced from 54 days to 16 days. Compliance in case clearance improved from 53% to 90% and contact screening compliance improved from 42% to 80%. The targeted screening of contacts led to a significantly higher positive yield (3.6% from 1.5%, P = 0.003). All symptomatic co-travellers presented to a healthcare professional, suggesting that screening could be restricted to those in risk groups for transmission. Feedback from users highlighted additional areas, such as management of large organised groups of co-travellers and those diagnosed abroad, which has informed the update of the national guidance. ConclusionsThe new guidance has not led to an increase in secondary transmission of enteric fever in England and findings have been used to inform an update of the guidance. The new guidance also represents a reduced burden of investigation and thus a likely reduced cost to patients, healthcare professionals, laboratories and environmental health officers.

Environmental health officers and climate change adaptation in British Columbia


 Background: The average annual temperatures in British Columbia have been steadily increasing in recent history and are expected to continue to rise. Climate change impacts have a significant effect on public health, and adaptation to these changes is necessary. Environmental health officers (EHOs) are in a position to deliver climate change adaptation programs in public health. The purpose of this study was to assess EHO perception of climate change adaption and identify knowledge or policy gaps. Methods: A self-administered online survey created used Google Forms was distributed through e-mail and social media to EHOs in BC. The survey asked for demographics information, beliefs about climate change, adaption, and public health. Chi-square tests and descriptive statistics were used to analyze results. Results: There was a significant association found between working in a mixed urban and rural environment and the incorporation of climate change adaptation into practice and the belief that climate change has impacted public health in BC. No association was found between years of experience and incorporation of adaptation. Conclusion: While EHOs generally recognize the public health impacts of climate change, there are many barriers preventing EHO involvement in climate change adaptation.

Methods for cleaning & sanitizing food contact surfaces (countertops) to prevent cross contamination in restaurant kitchens


 Background: Cross contamination can occur in restaurant kitchens when food contact surfaces such as countertops are inadequately cleaned between preparation of raw and ready to eat foods. Previous research has demonstrated that washing with detergent and water, rinsing, then applying a sanitizer solution is the most effective cleaning method. The second most effective cleaning method is to use detergent and water alone. In practice, the author has observed kitchen staff using sanitizer alone to clean kitchen countertops. This study surveyed British Columbia restaurant kitchen staff on current practices and makes recommendations to improve cleaning and sanitization practices for the purpose of preventing cross contamination. Methods: A survey was prepared using SurveyMonkey and distributed through Facebook to the author’s contacts in the restaurant industry. The Facebook post included a request for anyone to share the survey link with their contacts who work in BC restaurant kitchens. The survey was shared 21 times by 14 different people. The survey asked questions about restaurant type and position, Foodsafe level, and about cleaning practices such as frequency and cleaning compounds used. Results: When asked what cleaning compounds are most often used to clean work surfaces (countertops) in their restaurant, 56.5% of respondents reported sanitizer solution only, 30.4% of respondents reported soap & water followed by sanitizer solution, and 13.0% reported soap and water only. When asked why sanitizer solution only was used to clean countertops, 46.2% of respondents said it was company policy, 23.1% of respondents said time savings, and 15.4% of respondents indicated that an Environmental Health Officer had recommended sanitizer use and that is what lead to sanitizer alone being used to clean countertops. Conclusions: In practice, some restaurant staff do not use sanitizer effectively and may believe it is a substitute for detergent. Using sanitizer alone is not as effective as using detergent alone. Detergent alone can provide a 2-3 log bacterial reduction. If staff are busy and are only going to use one cleaning step, detergent alone is the best method. Environmental Health Officers should review sanitation plans and talk with operators to determine current cleaning practices in food service establishments. Operators and staff should be re-educated on the importance of the three-step method. It may be beneficial to recommend that sanitizer use be decreased overall to encourage the use of soap and water. It may only be necessary to use sanitizer after high-risk jobs such as preparing raw meat or at the end of the day.

Evaluation of public health interventions in shellfish tag compliance rates


 Background: The recent Vibrio parahaemolyticus outbreak in the summer of 2015 highlighted that shellfish tags are one of the key pieces of information used to trace back and determine the source of a foodborne outbreak or illness associated with raw or uncooked shellfish. According to the Canadian Food Inspection Agency, all shellfish tags must meet the requirements stated in the Section 7.3 of the Canadian Shellfish Sanitation Program (CSSP). Non-compliant tags may hinder national and regional regulatory agencies from identifying problems in harvest locations and at the processors, and further impede provincial control measures. As a result of the national outbreak, the BC Center for Disease Control (BCCDC), Ministry of Agriculture and the Canadian Food Inspection Agency (CFIA), as well as health authorities and Environmental Health Officers (EHO) have been involved in a variety of actions and interventions to improve compliance. These include efforts to promote education and to improve control and surveillance of V. parahaemolyticus and other shellfish associated illnesses. This study examined the effectiveness of health agencies’ interventions to improve shellfish tag compliance rates to Section 7.3 of the CSSP by comparing the numbers of shellfish tags in compliance before and after the interventions that were implemented in 2016. Methods: 120 randomly selected shellfish tags were grouped into “Before” and “After” interventions. By assessing the date of processing, 60 tags collected before September 2016 were placed into the “Before” group. Another 60 tags collected after September 2016 were placed into the “After” group. Within each group, shellfish tags were individually analyzed to determine whether the tag met or exceeded the required quality, information, and type and quantity criteria. Shellfish tags were considered “Compliant” if they completely fulfill 10 components embodied in the criteria, whereas shellfish tags that failed to meet all the components were labeled “Non-compliant”. Results: Based on the statistical analysis conducted on the data, there was a greater proportion of compliant shellfish tags post-intervention compared to pre-intervention. The Pearson’s Chi-square test confirmed that there was a statically significant association (p-value = 0.000) between the numbers of shellfish tags in compliance and the interventions that were implemented after the outbreak. Conclusion: The results have demonstrated that the interventions implemented by numerous regulatory authorities resulted in greater compliance to Section 7.3 of the CSSP. Public health regulators including the Ministry of Agriculture and the CFIA, as well as BCCDC and EHOs should continuously be involved in a variety of actions, such as promoting education at the processor and retail level and also implementing interventions to improve compliance. By doing so, successful interventions and increased compliance rates will lead to rapid identification of shellfish-related illnesses or outbreaks and facilitate control measures that can expeditiously remediate public health issues.

The practicality of using a smartphone as a sound level meter


 Background & Purpose: Sound is of vital importance for human life, it is one of the main forms of communication between people. However, sound that is a nuisance to others is considered noise. Too much noise can be disruptive and affects one’s enjoyment of life and can lead to ill health effects. In some municipalities, bylaw officers or Environmental Health Officers (EHOs) are tasked with enforcing the local noise bylaw. “Sound Level Meters” (SLM) are certified instruments enforcement officers use to accurately measure sound. However, accurate SLMs can be bulky and expensive. In this technological society, almost everyone has some type of smart phone capable of installing applications (apps) that mimic SLMs. The purpose of this project was to determine the accuracy of phone SLM apps compared to real SLMs. Method: Three Android & three iOS SLM apps were downloaded from the internet and installed on two Android and one iOS smartphone. The sound source was computer generated white noise. A type 1 SLM was used to set the white noise to three different sound levels, 80db, 65 dB, & 50 dB. Each Android and iOS smartphone measured the white noise at each sound level utilizing the three different SLM apps. Results were analyzed between the different apps and smartphones. The MANOVA and ANOVA statistical tests were used to analyze the data. Results: All MANOVA and ANOVA tests showed statistically differences between the apps and the SLM (p=0.00000). The power for all MANOVA tests was 100%, therefore there is confidence that the findings reflect the truth and there really is a difference between the different applications, smartphones, and interaction of applications and smartphones. Therefore, the smartphone/app combination tested were not able to replicate the noise level as measured by the SLM. Conclusion: It can be concluded that any individual Android SLM application can have significantly different mean decibels values across different Android smartphones. Different Android smartphones can also have significantly different means decibels across different Android applications. Results for iOS smartphones can only indicate significant mean decibels across the different SLM applications. Therefore, it is not recommended that smartphones with sound level measuring apps be used in place of SLMs.

Evaluating two methods of testing residual sanitizer concentrations in food service establishments


 Objective: Utensils and tableware are food contact surfaces that have the potential to transmit disease-causing microorganisms if not washed, cleaned and sanitized correctly in a food service establishment. To prevent utensils and tableware from becoming vectors of disease, it is essential that operators and staff are able to adequately sanitize them and accurately test for it in a quick and convenient manner. It is also essential that Environmental Health officers are able to test whether adequate sanitization is occurring during their routine inspections. Currently there are no guidelines indicating the correct method of testing. Therefore, this study investigated two methods used to test residual sanitation concentration in a dishwasher. The purpose of this research was to determine if there is any difference in the two methods currently being used, and if so, which method is the more reliable one. Methods: LaMotte Chlorine Test Strips were used to detect the levels of chlorine in a commercial dishwasher. The chemically treated strips were dipped onto a freshly wet and washed utensil and directly in the rinse water of a dishwasher. Results: The difference in the mean of 60 samples from two independent groups was analyzed. Thirty samples were obtained from location one, the dishware l, and thirty samples were obtained from location two, the rinse water of the commercial dishwasher. The mean residual concentration was calculated and compared. The means demonstrated there is a significant difference (p = 0.035)between the two groups; the average residual concentration was lower for the dishware compared to the rinse water. Conclusion: Dishware is a vector capable of transmitting disease causing microorganisms if not sanitized adequately. Thus, it is important to ensure that dishes in a food service establishment have been thoroughly sanitized. The testing of that requires a consistent and reliable method. It is safe to assume that testing on the dishware is the best course of action to err on the side of caution.

Are absorbent pads suitable alternatives for tattoo dressing?


 Background: Tattoo is a form of body modification that involves injecting ink underneath the epidermis using a needle. According to BC’s Guidelines for Personal Services Establishments this kind of invasive procedure will require wound dressing but the kind and sterility of the wound dressing has not been specified. During a tattoo convention an Environmental Health Officer (EHO) noticed that some tattoo artists were using absorbent pads for wound dressing. Absorbent pads are not sterile; therefore there is a concern of microbial infections at the tattoo wounds. This study examined the viability of using absorbent pads, which are non-sterile, as tattoo wound dressings. Method: 3M Quick Swabs were used to swab absorbent pads to collect the microorganisms present on the surface. 3M Petrifilm E. coli/Coliform Count Plates were used to culture E. coli and Coliform which could be present on the SanidermTM sterile tattoo dressing and absorbent pads. The presence of E. coli colonies on the petrifilm would show up as blue dots, while coliform colonies would be red dots. The total colony forming units (CFU), which include both E. coli and coliform colonies, were counted to assess the general sanitation conditions of both types of dressing. Results: Zero CFU were found from sampling the SanidermTM dressings and absorbent pads purchased from tattoo supply shops within Metro Vancouver. Conclusions: In the field of Environmental Health, coliform is often used as an indicator for the degree of sanitary quality; while E. coli is used as an indicator for fecal contamination. Therefore, the results of this study, indicated that the absorbent pads have high degree sanitation and are free from fecal contamination.

Knowledge and Attitudes towards Handling Eggs in the Home: An Unexplored Food Safety Issue?

Foodborne illness is a global public health issue, with food handling in the home identified as an underestimated source. In Australia, there has been a significant increase in the incidence of salmonellosis with the majority of outbreaks linked to eggs. This study investigated Australian eggs consumer attitudes, behaviours and risk perceptions associated with the handling of raw eggs in the home. It was identified that 67% of participants chose free range eggs, 11% kept poultry, 7% did not have any preference, 7% cage eggs, 4% barn eggs, 2% organic eggs and 1% pasteurized eggs. The majority of participants (91%) reported they stored eggs in the fridge. It was identified that there is an underestimation of “risky behaviour” associated with the consumption of raw eggs in the home, as 84% of participants indicated that they did not consume raw eggs, but subsequently 86% indicated that they had eaten mixture/batter containing raw eggs. Participants’ responses relating to food safety were also examined in relation to their profession and gender. Safer food handling practices were identified by Environmental Health Officers (EHO) and Food handlers compared to all other professions (p < 0.05). However, the gender of participants did not significantly affect (p > 0.05) their responses.

The Impact of Washing and Peeling of Cucumbers and Tomatoes in Reduction of Daily Intake of Dithiocarbamates

Background: Pesticides residues on foods are potentially toxic to humans. They may induce adverse health effects such as cancer, effects on reproduction, immune and nervous system complications. One of the important goals of public and environmental health officials is reducing exposure to pesticide residues on foods. Materials and methods: In the present study, 80 samples of cucumbers and 60 samples of tomatoes were collected from greenhouses and after preparation, dithiocarbamates (DTCs) residues were analyzed. Dithiocarbamates were determined using spectrophotometric method. During this procedure a mixture of cupper was shaped from the reaction between CS2 and the cupper after acid decomposition of the DTCs in a 3 trap responsive order. The concentrations of DTCs remnant were compared with MRLs and their daily intake were calculated and compared with ADI. Results: The outcome depicted that washing with water and peeling may able the reduction of absorption of daily intake of the rest of DTCs from 1.8% (as percent of ADI) in unwashed cucumbers to 0.6% ADI and 0.13% ADI respectively. The DTCs residues daily intake in unwashed tomatoes samples were 0.66% ADI and also in water-washed and peeled tomatoes were 0.43% ADI and 0.23% ADI respectively. Conclusion: The daily intake of DTCs was reduced by washing with water and peeling significantly. Although the estimated daily intakes of DTCs in the studied vegetables do not pose a health risk in consumers, but, because the entrance of fungicides into the human body by other commodities, these daily intakes are considerable.

Environmental Management Physical Conditions and Complaints in The Health Workers in The Garment Production Gresik

Abstract: Physical conditions in the work environment is something that must be kept clean, because if the environmental conditions are not good, then it will result in the workers’ health. This study aims to determine whether the management of the physical environmental conditions in the garment production in Gresik are in accordance with the Decree of the Minister of Health of the Republic of Indonesia Year 2002 Number 1405 About the Job Requirements Environmental Health Office and Industrial. This research uses descriptive and observational study using evaluative method. The results of the study will be treated descriptively. This study used a cross sectional approach. Sample size is 50 people who are working in garment production space in Gresik are taken randomly using simple random sampling. Obtained result is said to be good for the environment and are eligible for health complaints while ineligible said. Sheet observation shows that there are still some things about the application of the physical environmental conditions that are less in accordance with the regulations, among others, waste, noise, and toilet. Management of the physical environmental conditions in garment production space in Gresik can be categorized in accordance with applicable regulations.Keywords: physical conditions, health complaints

The Assessment of Food Safety Culture: An investigation of current challenges, barriers and future opportunities within the food industry

Following the 2005 E. coli O157 outbreak in the UK and the recommendations in the subsequent Public Enquiry Report in 2009, the topic of food safety culture became more prominent. In 2012, the United Kingdom's Food Standards Agency (FSA) commissioned a tool that enforcement officers could use to assess ‘softer aspects’ of risk such as safety culture, attitudes and behaviours. In the present study, we assessed the awareness of and views on safety culture in the food industry among a group of industry stakeholders (Environmental Health Officers, Food and Beverage Managers, Academics). The study also examines their attitudes towards the toolkit and ways in which it could be improved (e.g., its usability). The conclusions of the paper are that whilst there is broad support for implementing safety culture in the food industry, there are also some outstanding challenges (e.g., defining food safety culture, senior management commitment and the role played by ‘micro-cultures’ within food organisations). Assessing safety culture in the food industry is a realistic possibility, but needs to take account of some of the lessons which could be learnt from other industries (e.g., healthcare, rail, oil and gas) and their experiences with safety culture.

Current and future risks of asbestos exposure in the Australian community.

Australia mined asbestos for more than 100 years and manufactured and imported asbestos products. There is a legacy of in situ asbestos throughout the built environment. The aim of this study was to identify the possible sources of current and future asbestos exposure from the built environment. Telephone interviews with environmental health officers, asbestos removalists, and asbestos assessors in Australia sought information about common asbestos scenarios encountered. There is a considerable amount of asbestos remaining in situ in the Australian built environment. Potential current and future sources of asbestos exposure to the public are from asbestos-containing roofs and fences, unsafe asbestos removal practices, do-it-yourself home renovations and illegal dumping. This research has highlighted a need for consistent approaches in the regulation and enforcement of safe practices for the management and removal of asbestos to ensure that in situ asbestos in the built environment is managed appropriately.

Assessing Cancer Risk from Heavy Metals in Recycling Waste Electrical and Electronic Equipment: Preliminary Results from the WEENMODELS European Life Programme

Introduction The growing amount of waste derived from electrical and electronic equipment (WEEE) poses significant challenges to waste management, due to the presence of toxic chemicals with environmental and health implications for the general population and for occupationally-exposed workers. Methods Based on an toxicological and epidemiologic evaluation, we carried out a health risk assessment to evaluate the cancer risk deriving from environmental and occupational exposure to heavy metals released during different WEEE recycling procedures (electronic scrap in blister copper, treatment of metals recovery in copper smelter, treatment of shredding, pyrometallurgical treatment of Li-ion battery). We considered the typical WEEE production in a municipality of 150.0000 inhabitants, carrying out a Life Cycle Assessment. Outdoor (1 square km around a treatment plant) and indoor (for a factory volume of 3200 m3) emissions generated during the WEEE recycling procedures were computed. In particular, we estimated the amount of Cd, Ni and As inhaled by the potentially exposed population. We computed the cancer risk due to inhalation of these heavy metals in residents and workers using the methodology proposed by the California Office of Environmental Health and Hazard Assessment Results For the metals considered, our results showed negligible cancer risk (from 2,21x10-11 to 4,31x10-08) for the general population around the plant. On the converse, occupational exposures linked to specific procedures were associated with a cancer risk of 1,42x10-3 for workers in the shredding procedures mainly due to Ni exposure, and of 4,68x10-4 for workers with electronic scrap and exposed to As. Conclusions Based on our preliminary results from an integrated toxicological and epidemiologic approach, WEEE life cycle may be linked to health risks for workers in the recycling procedures, while it does not seem to adversely affect health of the general population around the treatment plants.

An Outbreak of Norovirus Infections Among Lunch Customers at a Restaurant, Tampere, Finland, 2015.

On January 29, 2015, the city of Tampere environmental health officers were informed of a possible foodborne outbreak among customers who had eaten lunch in restaurant X. Employees of electric companies A and B had a sudden onset of gastrointestinal symptoms. We conducted a retrospective cohort study to identify the vehicle, source, and causative agent of the outbreak. A case was defined as an employee of companies A or B with diarrhea and/or vomiting who ate lunch at Restaurant X on January 26, 2015. All employees of the companies attending the implicated lunch were invited to participate in the cohort study. Environmental investigation was conducted. Twenty-one responders were included in statistical analysis, of which 11 met with the case definition. Of the 15 food items consumed by participants, four food items were associated with gastroenteritis. Of four kitchen staff, three tested positive for norovirus GIP7, the strain was found earlier in the community. No patient samples were obtained. Level of hygiene in the kitchen was inadequate. Infected kitchen staff probably transmitted norovirus by inadequate hygiene practices. No new cases associated with Restaurant X were reported after the hygiene practices were improved.

Effort-reward imbalance and self-rated health among Gambian healthcare professionals.

BackgroundThe effort-reward imbalance (ERI) model of work stress has been widely applied in investigating association between psychosocial factors at work and health. This study examined associations between perceived psychosocial work stress as measured by the ERI model and self-rated health (SRH) among nurses and environmental health officers (EHOs) working in secondary public healthcare facilities in the Gambia.MethodA cross-sectional study on a random sample of 287 health care professionals (201 nurses and 86 EHOs). A 22-item ERI questionnaire was used to collect data on the psychosocial factors defined by the ERI model. SRH was assessed using a single item measure.ResultsThe distribution of subjective health was not statistically different between nurses and EHOs. However, our study uncovered significant associations between perceived psychosocial work stress and subjective health. Specifically, we found that a perceived high effort-reward imbalance (ER-ratio > 1) is a significant risk factor for poor SRH, in both occupational groups. However, over-commitment was not significantly associated with poor SRH in the two groups. When efforts and rewards were considered as separate variables in the analysis, rewards were inversely associated with poor SRH in both groups.ConclusionBecause of the high perceived Effort-Reward Imbalance among healthcare professionals at secondary public healthcare facilities, it is necessary to modify working conditions through improvement of psychosocial work environment, such as reasonable allocation of resources to increase pay, incentives or other forms of rewards from government. Interventions that could mitigate and prevent stress at work are worth considering in future healthcare policies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1347-0) contains supplementary material, which is available to authorized users.

An evaluation of British Columbia’s guideline for the sale of foods at temporary food markets in allowing the sale of potentially hazardous food

&#x0D; Background and the purpose: British Columbia’s Guideline for the Sale of Foods at Temporary Food Markets is a document that Environmental Health Officers’ (EHOs) and farmers’ market managers will have to consult with when determining what food products are allowed to be sold in farmers’ markets. This guideline plays a vital role because it indirectly influences EHOs’ and farmers’ market managers’ judgments and the public’s risk exposure to potentially hazardous foods (PHFs) in farmers’ markets. It is necessary to evaluate and compare BC’s guideline with other provinces’ to see where it sits in the spectrum with respect to its permissibility in allowing the sale of PHFs in farmers’ markets, perhaps contributing to the further revision or development of the farmers’ markets guideline or policy. Methods: An online Google Docs survey consisting of 20 questions was created to ask farmers’ market managers from British Columbia and other provinces in Canada whether their farmers’ markets allow the sale of the five food types: poultry, shell egg, sauerkraut, unpasteurized juice/cider and cheese and how these foods are handled and stored. Results: There were 56 farmers’ market managers who participated in this survey (46% from BC and 54% from outside BC). Chi-square results had p-values greater than 0.05 for all the five surveyed categories. Two-tail t test results had p-values less than 0.05 in the raw poultry and sauerkraut categories. Discussion: Although no association between the location of farmers’ markets in Canada and the sale of the five surveyed food categories, BC farmers’ market managers disallowed the sale of raw poultry and unpasteurized juice more often than markets outside BC whereas fewer BC farmers’ market managers disallowed the sale of eggs and cheese when compared to markets outside BC. A significant difference in the handling and storage practices of raw poultry and sauerkraut was identified between farmers’ market managers in BC and outside BC. Also, BC’s managers were shown to have safer food handling practices to raw poultry, sauerkraut and unpasteurized juice than managers from outside BC. Conclusion: The types of foods sold in BC and outside BC appeared similar as this survey found no differences between the five surveyed PHF categories allowed for sale. However, handling practices of these foods did vary, and that might be associated with guidelines, or with farmers’ market manager knowledge. Of concern, BC farmers’ market indicated that eggs and juices were sourced and made on farms. These two categories required more attention and food safety awareness from both EHOs and farmers’ market managers. Overall, the survey responses reaffirmed that review and approval for the sale of potentially hazardous food from EHOs and scrutiny from farmers’ markets managers must be in place to ensure public’s safety as well as minimizing public’s risk exposure to improperly handled PHF sold in farmers’ markets.&#x0D;

Environmental health officer’s knowledge of sensory deprivation tanks in BC

&#x0D; Background and Purpose: Personal service establishments are abundant such as piercing shops, tattoo parlours, spas and now float spas. Sensory deprivation tanks were popular in the 1980s and have come back as a new way to relax, reduce pain and relieve stress and to provide a complete deprivation of the senses. The sanitation of these tanks have caused concern in the public health field as bacteria and parasites can easily live and proliferate in the tank water. Environmental Health Officers (EHOs) have to keep up to date with new or returning technology in order to provide information to the public and to ensure their safety. This research project investigated EHOs with differing years of employment in the field, geographic working location and age and their knowledge of sensory deprivation tanks. Methods: A survey created in Google Forms and Survey Monkey was disseminated through e-mail who then forwarded an e-mail to all EHOs in BC. The survey asked demographic questions, health and safety, sanitation and disinfection and general knowledge of floatation tanks. A t-test and ANOVA was used to analyze the data. Results: Three comparisons were tested: first was the number of years an EHO has worked in the field and their test score; second was their age and test score; and last was their geographic location and test score. The null hypotheses were not rejected as the p-value was found to be greater than 0.05 for all of the variables analyzed. Discussion: Overall, there was weak knowledge in EHOs and due to the small sample size there was weak statistical significance between the associations found regarding the number of years an EHO has worked in the field, their age and geographic location where they work compared to their test scores. Conclusion: More information needs to be provided to all EHOs to keep them updated on new personal service establishments.&#x0D;

Evaluating the effectiveness of alcohol-based hand sanitizers compared to alcohol-free hand sanitizers

&#x0D; Background and Purpose: Hand washing is one of the most important critical control points in public premises in preventing the spread of bacteria and viruses. There is vast research on the effectiveness of alcohol-based hand sanitizers in killing germs. However, the efficacy of alcohol-free hand sanitizers lacks real-world evidence. With little to no guidelines in which one type of hand sanitizers may be more appropriate depending on the types of public premise such as food establishments, hospitals, work place, or schools, Environmental Health Officers(EHOs)/ Public Health Inspectors(PHIs) will need to educate the public and operators on the effectiveness of these hand sanitizers and their advantages and disadvantages. The purpose of the study was to compare the effectiveness of alcohol-based hand sanitizers and alcoholfree hand sanitizers by conducting statistical analyses of the reduction in mean E.coli counts. Methods: 60 pigskins were prepared (30 for alcohol-based hand sanitizers, 30 for alcohol-free hand sanitizers), which were inoculated with E. coli, then applied either alcohol-based hand sanitizers or alcoholfree hand sanitizers. After 48 hours of incubation for E.coli growth, E.coli was counted. The difference in mean E.coli counts before applying hand sanitizers and after hand sanitizers was calculated, then compared between the two hand sanitizers. Results: The mean E.coli reduction count (CFU) from alcohol-based hand sanitizers (30 samples) was 10.200; the median was 11; the standard deviation was 1.7889; the range was 5.0000. The mean E.coli reduction count (CFU) from alcohol-free hand sanitizers (30 samples) was 10.233; the median was 10.5; the standard deviation was 0.8976; the range was 3.0000. The statistical t-test resulted in p-value of 0.1034. Conclusion: There was no significant difference between the two types of hand sanitizers. Both the alcohol-based hand sanitizers and alcohol-free hand sanitizers effectively reduced the number of E.coli counts (CFU) by averages of 10.2000 (92.7% reduction) and 10.2333 (93.03% reduction) respectively. While the BC Centre for Disease Control recommends 60 percent alcohol hand sanitizers to prevent the spread of germs, this research showed that alcohol-free hand sanitizers with sulfactants, allantoin, and benzalkonium chloride (SAB) formula is just as effective in killing germs. Therefore, EHOs/PHIs can educate the public and operators on the advantages and disadvantages on the two types of hand sanitizers in preventing the spread germs during the flu season and give practical advice or guidance on which type of hand sanitizers would be most appropriate in restaurants for example.&#x0D;

Changing exposures in a changing world: models for reducing the burden of disease.

Environmental exposures are changing dramatically in location, intensity, and frequency. Many developing countries are undergoing a transition in which they face the double burden of infectious diseases as well as chronic diseases. Noncommunicable diseases have emerged as the leading cause of death and disability in developing countries. Globally, pollution is insufficiently appreciated and inadequately quantified as a cause of disease. The health burden from both noninfectious diseases and infectious disease, especially parasites, is high among exposed people. Mothers and children are particularly vulnerable to pollution-related diseases in developing countries. Exposures to pollution can cause protracted noncommunicable diseases across their life span. A global initiative to promote human health sciences and technologies would enhance collaborations and communications amongst investigators and public environmental health officials. Existing models that facilitate the transfer of information and research results exist and can provide insight into building such an international network, allowing better prediction of disease risk and provide ways to reduce exposure to environmental contaminants. A global network would bring together scientists from multiple disciplines and countries to work toward a better understanding of the double burden of disease, especially in low and middle income countries, and promote ways to improve public health.

Hospital disaster emergency preparedness: A study of Onandjokwe Lutheran Hospital, Northern Namibia

This study explored disaster emergency preparedness at Onandjokwe Lutheran Hospital in Northern Namibia. It utilized quantitative and qualitative research methods, using a self-administered questionnaire, semi-structured key informant interviews, and a hospital disaster plan checklist. A stratified sample of 120 participants was used with a response rate of 75% and the sample included all staff categorises within the hospital. Five key informants were purposively selected from the management team. In addition, one environmental health officer was selected from non-managerial staff members. The key informants were members of the hospital emergency preparedness committee and command and control unit. The questionnaires were self-administered which enabled the respondents to respond freely and at their convenience. The questionnaire was pre-tested, adjusted and finalised. Face-to-face semi-structured key informant interviews allowed for clarifications and followup questions on overall disaster emergency preparedness process. Through the use of open-ended questions the respondents were encouraged to express their opinions and offer more information. The checklist was used to check and determine the components of the hospital’s disaster plan against the actual processes in the hospital. Most of the respondents were young females aged between 20 and 30 years. The results indicated a fair knowledge of the principled conduct and abilities to respond to emergencies including disease outbreaks. It was established that positive efforts in disaster preparedness were being effected. However, even though the hospital has a good draft disaster plan, more is to be done on training, revisions, and infrastructure alignments. Keywords: disaster emergency preparedness, hospitals, disaster, disaster management, Namibia