Public Health Risk Assessment Research Articles

Breast Milk: A Potential Route of Tick-Borne Encephalitis Virus Transmission from Mother to Infant.

Tick-borne encephalitis virus (TBEV) is a global public health concern, and understanding its transmission routes is crucial for effective prevention and control. While tick bites are the primary mode of TBEV transmission, emerging evidence suggests the potential for TBEV transmission through breast milk from infected mothers to their infants. This review article provides an overview of the current knowledge regarding TBEV transmission through breast milk and its clinical implications. It explores the presence and persistence of TBEV in breast milk, potential mechanisms of transmission, and the role of immune factors in facilitating or inhibiting viral transmission. The clinical outcomes and complications in infants infected with TBEV through breast milk are discussed, along with the epidemiological patterns and geographical considerations of this transmission mode. Preventive and management strategies are also addressed, including public health measures, risk assessment, and potential interventions. Future research directions are highlighted, emphasizing the need for further epidemiological studies, investigations into viral load dynamics, immune responses, and the development of preventive measures targeting TBEV transmission through breast milk. By expanding our knowledge in these areas, we can improve strategies to reduce the risk of TBEV transmission from mothers to infants and protect vulnerable populations.

Assessment of air quality and community health risks in Di An city - Binh Duong province

Based on research methods such as data collection and processing, air quality index calculation methods, and public health risk assessment methods to assess air quality and effects of substances on the health of people in Di An city. The data for the calculation are inherited from the environmental monitoring report of the Department of Natural Resources and Environment of Di An City in the period of 2019. The calculation results show that the air quality in the city is. Di An is fluctuating at an average-poor level (especially in the Cay Lon junction area with the highest index of 150), the health risk assessment results show that when exposed to dust, the total group of people Adults (Women and Men) had a high fluctuating cancer risk index with the highest index of 2 subjects being in the first quarter 0.310, 0.295, in the second quarter 0.269, 0.282, in the third quarter 0.296, 0.282, Fourth quarter 0.289, 0.275. As for other indicators, the subjects assessed when exposed to substances in the air environment in Di An city can be affected their health, of which the group of adults is still the group of people. Women and men) are the most affected group.

Using science to respond to public exposures from chemical hazards during emergencies in England.

This paper describes how toxicological considerations are an essential component of acute chemical incident response, and how the UK Health Security Agency (UKHSA), as Category 1 responders under the Civil Contingencies Act (2004), provide that expert, authoritative, and timely advice to protect people from exposure to harmful substances. Background information about the general response to emergencies is provided, which gives context to how scientific advice has a positive impact. The importance of chemical identification and speciation, local, and systemic effects, and exposure characteristics are described. The public health risk assessment is considered in conjunction with mixtures, mass casualties, recovery, and psychological impacts. A brief summary of the type of incidents that the UKHSA are notified about is also provided.

Public Health Risk Assessment of Treated and Untreated Produce Water Effluent

Discharge of produced water into the aquatic environment may release chemicals that are highly toxic to sensitive marine species even at low concentrations, causing bio-degeneration/transformation of the biota. Some metals and hydrocarbons may accumulate in sediments, bio-accumulate in bottom living biological communities which may pose threat to humans and animals. Physicochemical quality of untreated and treated produced water were assessed.Toxicity and pollution levels as well as human health risk assessment of treated and untreated produced water were also determined to ascertain the level of environmental safety vis-à-vis effects of treatment, in order to identify potential environmental concerns from existing treatment practices. Microbial density and concentration of eight heavy metals in produced water samples were assessed following standard procedures and different indices were used to assess the health risk.Concentration (in mg/L) of iron was 6.9 (untreated) and 0.001 (treated wastewater), arsenic 0.001 for both untreated and treated wastewater, zinc (0.002 for both untreated and treated wastewater), mercury (0.001 for both untreated and treated wastewater), chromium (0.001 for both untreated and treated wastewater), cadmium (1.1 for untreated and 0.001 for treated wastewater), lead (0.9 for untreated and 0.001 for treated wastewater) and nickel (0.005 for both untreated and treated wastewater). Further, statistical analysis showed correlation between physicochemical parameters of untreated and treated wastewater as well as heavy metal concentrations. Health risk assessment showed major potential non-carcinogenic risk was via ingestion, with led as the main contributor. Overall non-carcinogenic risk evaluation of produced water showed that humans are not susceptible. Similarly, chromium was the major contributor to the carcinogenic health risk but values for lethal average daily doses and cumulative carcinogenic risk were within permissible limits.

148 Keynote: Should We Rely on Air Monitoring? What Can Biomonitoring Bring to the Party?

Abstract Measuring concentrations of chemicals in media air, water and soil is inadequate for assessing human exposures and the effects of exposure. Human biomonitoring (HBM) offers an improved understanding of potential health risks through the detection of “biomarkers” of exposure that indicate the progressive response to exposures in the human body that lead to disease… before disease occurs. Do you agree? From a public health perspective HBM was used to reduce human exposures to lead, PCB’s and the pesticide DDT. Examples of how UKHSA (formerly PHE) has used HBM to protect human health illustrate the need for HBM data. The use of HBM data as well as measurements of arsenic in drinking water is an example of the need for both. UKHSA is planning a national HBM program for the UK building on the work of the European HBM Initiative - HBM4EU. Public health risk assessments are based on evaluation of environmental exposure compared to Tolerable Dailey Intakes: HBM data can reduce uncertainty in human health risk assessment. But HBM is not a magic bullet and there are ethical issues that need to be considered.

The Risks and Harms Associated with Modern Slavery during the COVID-19 Pandemic in the United Kingdom: A Multi-Method Study

ABSTRACT The COVID-19 pandemic has considerably affected global economies and societies, exacerbating existing social inequalities. This “syndemic” pandemic has placed people and communities affected by modern slavery and human trafficking at elevated risk of multiple harms. This paper uses a mix of methods – an evidence synthesis, a survivor survey, web-monitoring, and dialogue events – to explore how COVID-19 has affected the risks and pathways to harm associated with modern slavery/human trafficking in the UK. We use concepts of hazard, risk, exposure, and harm and the tools of public health risk and resilience assessment to examine how COVID-19 has amplified existing risks of harm and generated new pathways to further harm. We also use a novel complex systems approach to represent risk relationships and demonstrate how the economic shock of COVID-19 and mandated social isolation have led to negative outcomes for affected people. The paper provides policy and practice insight into interventions can be implemented across systems to minimize exploitation and how locally led intervention can offset the damaging effects of the pandemic (SDGs 5 & 16).

Heavy metal contamination in retailed food in Bangladesh: a dietary public health risk assessment

Introduction Contamination with heavy and toxic metals along the food value chain is a public health concern in Bangladesh. Methods In this study, 608 fish and chicken samples from traditional and modern retail outlets in urban, peri-urban, and rural areas were collected and analyzed for chromium (Cr), cadmium (Cd), and lead (Pb) contamination, using atomic absorption spectrometry method. The daily intake, target hazard quotient and the target carcinogenic risk (for lead only) as a result of fish and chicken consumption was calculated based on mean results, and by Monte Carlo simulation in @Risk with 100,000 iterations (quantitative risk assessment). Results Cr and Cd were detected in 80–86% of both chicken meat and fish samples, while Pb positivity found in chicken meat and fish was 54.9 and 23.3%, respectively. The mean concentration (±SD) of Cr, Cd, and Pb in chicken meat were 0.66 ± 0.93, 0.02 ± 0.03, and 0.09 ± 0.10 mg/kg, respectively; and in fish were 0.49 ± 0.62, 0.02 ± 0.03, and 0.06 ± 0.09 mg/kg, respectively. The estimated daily intakes of Cr, Cd, and Pb from chicken and fish were lower than the maximum tolerable daily intake in all studied areas. In addition, the target carcinogenic risk for Pb in chicken was lower than the negligible range, which indicated the risk of cancer due to exposure to Pb through chicken meat and fish consumption was very low. Discussion The present study concludes that consumption of chicken meat and fish in Bangladesh, currently at very low levels, is unlikely to constitute a major health risk for humans in respect to these metals. However, continuous market surveillance for heavy metals in food stuff is recommended, especially since consumers may increase their meat intake.

Parameters for health risk assessment associated with chronic exposure to hydrogen sulphide in ambient air

High levels of chemical pollution in ambient air due to industrial emissions can facilitate development of functional disorders in various organs and systems. They are a significant component to be considered when assessing health risks under expo-sure to combined multi-factorial pollution. However, the issue of methodical approaches to assessing possible effects on health under exposure to combinations of chemicals has not been studied enough as regards public health risk assessment. Given that, we suggest a trend to develop the methodology that involves revising and substantiating indicators applied in health risk assessment. This should be done as new research data on influence exerted by chemicals on health (including exposure to levels higher than reference ones) become available. We have substantiated a system of quantitative indicators (including additional reference concentrations) for health risk assessment under chronic exposure to hydrogen sulphide in ambient air (including its elevated levels). Points of departure and modifying factors were established by analyzing studies on effects produced on health by hydrogen sulphide. On their basis, we developed parameters for non-carcinogenic health risk assessment. The reference concentration equaled 0.002 mg/m3 (the critical systems were respiratory organs and the nervous system). The additional reference concentration for risk assessment under elevated exposure to hydrogen sulphide was substantiated as equal 0.07 mg/m3 (impaired development being the critical system in the case). The suggested system of quantitative indicators enhances and specifies parameters for health risk assessment. This makes it possible to perform more adequate assessment of health risks under combined exposure to chemicals in ambient air including those contained in levels higher than reference ones. The suggested system of quantitative indicators was tested properly; as a result, the system was established to give an opportunity to obtain more comprehensive and accurate results of health risk assessment under combined exposure to chemical pollutants.

Параметры для оценки риска, связанного с хронической аэрогенной экспозицией сероводорода

High levels of chemical pollution in ambient air due to industrial emissions can facilitate development of functional disorders in various organs and systems. They are a significant component to be considered when assessing health risks under expo-sure to combined multi-factorial pollution. However, the issue of methodical approaches to assessing possible effects on health under exposure to combinations of chemicals has not been studied enough as regards public health risk assessment. Given that, we suggest a trend to develop the methodology that involves revising and substantiating indicators applied in health risk assessment. This should be done as new research data on influence exerted by chemicals on health (including exposure to levels higher than reference ones) become available. We have substantiated a system of quantitative indicators (including additional reference concentrations) for health risk assessment under chronic exposure to hydrogen sulphide in ambient air (including its elevated levels). Points of departure and modifying factors were established by analyzing studies on effects produced on health by hydrogen sulphide. On their basis, we developed parameters for non-carcinogenic health risk assessment. The reference concentration equaled 0.002 mg/m3 (the critical systems were respiratory organs and the nervous system). The additional reference concentration for risk assessment under elevated exposure to hydrogen sulphide was substantiated as equal 0.07 mg/m3 (impaired development being the critical system in the case). The suggested system of quantitative indicators enhances and specifies parameters for health risk assessment. This makes it possible to perform more adequate assessment of health risks under combined exposure to chemicals in ambient air including those contained in levels higher than reference ones. The suggested system of quantitative indicators was tested properly; as a result, the system was established to give an opportunity to obtain more comprehensive and accurate results of health risk assessment under combined exposure to chemical pollutants.

Development of physiologically based toxicokinetic models for 3-monochloropropane-1,2-diol and glycidol.

3-Monochloropropane-1,2-diol (3-MCPD), glycidol, together with their fatty acid esters are commonly presented in various food and have shown carcinogenicity in various laboratory animals. Public health risk assessment of 3-MPCD and glycidol exposure relies on quantitative tools that represent their in vivo toxicokinetics. In order to better understand the absorption, distribution, metabolism, and excretion profiles of 3-MCPD and glycidol in male rats, a physiologically based pharmacokinetic (PBTK) model was developed. The model's predictive power was evaluated by comparing in silico simulations to in vivo time course data obtained from experimental studies. Results indicate that our PBTK model successfully captured the toxicokinetics of both free chemicals in key organs, and their metabolites in accessible biological fluids. With the validated PBTK model, we then gave an animal-free example on how to extrapolate the toxicological knowledge acquired from a single gavage to a realistic dietary intake scenario. Three biomarkers, free compound in serum, urinary metabolite DHPMA, and glycidol-hemoglobin adduct (diHOPrVal) were selected for in silico simulation following constant dietary intakes, and their internal levels were correlated with proposed external daily exposure via reverse dosimetry approaches. Taken together, our model provides a computational approach for extrapolating animal toxicokinetic experiments to biomonitoring measurement and risk assessment.

Re-assessing human mortality risks attributed to PM2.5-mediated effects of agricultural ammonia

How can and should epidemiologists and risk assessors assemble and present evidence for causation of mortality or morbidities by identified agents such as fine particulate matter or other air pollutants? As a motivating example, some scientists have warned recently that ammonia from the production of meat significantly increases human mortality rates in exposed populations by increasing the ambient concentration of fine particulate matter (PM2.5) in air. We reexamine the support for such conclusions, including quantitative calculations that attribute deaths to PM2.5 air pollution by applying associational results such as relative risks, odds ratios, or slope coefficients from regression models to predict the effects on mortality or morbidity of reducing PM2.5 exposures. Taking an outside perspective from the field of causal artificial intelligence (CAI), we conclude that these attribution calculations are methodologically unsound. They produce unreliable conclusions because they ignore an essential distinction between differences in outcomes observed at different levels of exposure and changes in outcomes caused by changing exposure. We find that multiple studies that have examined associations between changes over time in particulate exposure and mortality risk instead of differences in exposures and corresponding mortality risks have found no clear evidence that observed changes in exposure help to predict or explain subsequent changes in mortality risks. We conclude that there is no sound theoretical or empirical reason to believe that reducing ammonia emissions from farms has reduced or would reduce human mortality risks. More generally, applying CAI principles and methods can potentially improve current widespread practices of unsound causal inferences and policy-relevant causal claims that are made without the benefit of formal causal analysis in air pollution health effects research and in other areas of applied epidemiology and public health risk assessment.

Endocrine-Disrupting Chemicals and Their Effects in Pet Dogs and Cats: An Overview.

Over the past few decades, several pollutants classified as environmental endocrine-disrupting chemicals (EDCs) have become a matter of significant public health concern. Companion animals play a major role in human society, and pet ownership is substantially increasing worldwide. These intimate human-pet relationships imply sharing much of the same environment, thus including exposure to similar levels of EDCs in daily routine. Here, we review the current knowledge on the sources and routes of exposure to EDCs in domestic indoor and outdoor environments and discuss whether endocrine disruption is a health concern in pets. We summarize the phenomenon of endocrine disruption, providing examples of EDCs with a known impact on dog and cat health. Then, we propose an overview of the literature on the adverse effects of EDCs in domestic pets, with a special focus on the health of reproductive and thyroid systems. Finally, we explore the potential role of companion animals as unintentional sentinels of environmental exposure to EDCs and the implications for public health risk assessment in a "shared risk" scenario. Overall, this review supports the need for an integrated approach considering humans, animals, and the environment as a whole for a comprehensive assessment of the impact of EDCs on human and animal health.

Benzodiazepines and elderly : challenges of prescribing and deprescribing

The elderly represent a group at risk of receiving problematic benzodiazepine (BZD) prescriptions in terms of duration or dose. The objective of this article is to investigate the difficulties related to the initial prescription, renewal, and withdrawal of BZDs in two university hospitals in French-speaking Switzerland. Specifically, we studied the actual use and perceived usefulness of clinical guidelines, the assignment of responsibilities among prescribers, and the assessment of public health risks. Eight semi-structured interviews were conducted with professionals from different specialties. A lack of usable clinical recommendations was noted, attributable to the lack of scientific knowledge and the complexity of geriatric cases. The introduction and renewal of prescriptions should be the result of systematic consultations between hospitals and ambulatory care.

Health risk assessment associated with priority potentially hazardous chemical compounds detected in canned meat and meat-and-vegetable food for infants

Assessment of public health safety associated with chemical contaminants consumed with food is an important component for solving the tasks of ensuring the sanitary and epidemiological well-being of the population. For these purposes, it is necessary to establish priority potentially dangerous compounds among the identified undeclared and unintended chemical contaminants for further consumers risk assessment. In conditions of unacceptable levels of health risk, it is necessary to decide whether it is advisable to develop new or change existing hygiene standards for these substances. The aim of the study was to assess the health risk associated with priority potentially dangerous unintended chemical components of contamination in canned meat and meat-and-vegetable products for infants (using the example of N-nitrosoamines). Material and methods. The selection of priority chemical compounds and public health risk assessment were carried out in accordance with the procedure for identifying undeclared and potentially dangerous unintended chemicals in food and using modified approaches based on the results of previous studies. Health risk assessment for infants consuming canned meat and meat-and-vegetables containing priority chemicals was carried out in accordance with the methodology approved by the Eurasian Economic Commitee, as well as using the Guidelines for assessing risks to public health when exposed to environmental pollutants. To characterize the calculated risk levels, the classification proposed in the draft document «Guidelines for assessing risks to public health when exposed to environmental pollutants» was used. Results. N-nitrosoamines are classified as chemical contaminants that are a priority for public health risk assessment, identified on the basis of the potential hazard category. A comparative health risk assessment for the target group consumers of canned meat and meat-and-vegetables sold on the territory of the Russian Federation and the Socialistic Republic of Vietnam showed the presence of an unacceptable risk to the health of the Russian population in relation to non-carcinogenic adverse health effects associated with the intake of N-nitrosodimethylamine (NDMA) (hazard quotient HQ=1.1) and N-nitrosodibuthylamine (HQ=5.25). Many experimental (animal) researches confirm the formation of negative effects and potential harm to humans, formed by the consumption of N-nitrosoamines with food. At the same time, the level of the exposure of N-nitrosoamines during oral administration was assessed mainly from the side of carcinogenic effects, however, this study reflects the hazard, including from non-carcinogenic risks associated not only with NDMA and N-nitrosodiethylamine, for which there is a hygienic standard, but also for other N-nitrosoamines, for which there is no hygienic regulation. In turn, the European Food Safety Agency's (EFSA) study notes that it is necessary to conduct a risk assessment for human health in relation to other N-nitrosoamines identified in food, and, if necessary, rationing of these compounds, which is also confirmed by this study. Conclusion. The conducted health risk assessment of the target population of Russia (infants from 6 months to 3 years) consuming the studied types of products containing N-nitrosoamines showed the presence of unacceptable levels of non-carcinogenic health risks in relation to the development processes and impaired liver function. In connection with the identified risks to the health of the target population, it is advisable to establish maximum permissible levels not only for the amount of NDMA and N-nitrosodiethylamine, but also for other N-nitrozoamines identified by the results of the study, with their subsequent regulation.

Pulmonary hazard identifications of Graphene family nanomaterials: Adverse outcome pathways framework based on toxicity mechanisms.

Graphene-family nanomaterials (GFNs) are revolutionary new nanomaterials that have attracted significant attention in the field of nanomaterials, but the ensuing problems lie in the potential threats to public health and the ecosystem caused by these nanomaterials. From the perspective of GFN-related health risk assessments, this study reviews the current status of GFN-induced pathological lung events with a focus on the damage caused to different biological moieties (molecular, cellular, tissue, and organ) and the mechanistic relationships between different toxic endpoints. These multiple sites of damage were matched with existing adverse outcome pathways (AOPs) in an online knowledge base to obtain available molecular initiation events (MIEs), key events (KEs), and adverse outcomes (AOs). Among them, the MIEs were discussed in combination with the structure-activity relationship due to the correlation between toxicity and physical and chemical properties of GFNs. Based on the collection of information regarding MIEs, Kes, and AOs in addition to upstream and downstream causal extrapolation, the AOP framework for GFN-induced pulmonary toxicity was developed, highlighting the possible mechanisms of GFN-induced lung damage. This review intended to combine AOP with classic toxicological methods with a view to rapidly and accurately establishing a nanotoxicology infrastructure so as to contribute to public health risk assessment strategies through iteration from and animal models up to the population level.

Molecular detection and public health risk assessment of Cryptosporidium spp., Giardia duodenalis, Enterocytozoon bieneusi, and Blastocystis sp. of animals in a tropical wildlife park of Hainan Island, China

Objective: To detect the prevalence and characterize of Cryptosporidium spp., Giardia (G.) duodenalis, Enterocytozoon (E.) bieneusi and Blastocystis sp. of animals at a tropical wildlife park in Hainan Province, China, and to assess zoonotic risks and the potential threat of public health. Methods: Fecal specimens were collected from animals of 27 species at the wildlife park in Hainan Province, China, and detected these pathogens using polymerase chain reaction (PCR) amplifications and sequencing of gene fragments based on small subunit ribosomal RNA (SSU rRNA) gene, glutamate dehydrogenase (GDH), internal transcribed spacer (ITS) and SSU rRNA gene, respectively. Results: A total of 99 animals were studied, and 33 (33.3%) animals were found to harbor intestinal parasite, and the prevalence of Cryptosporidium spp., G. duodenalis, E. bieneusi and Blastocystis sp. were 9.1%, 2.0%, 5.1%, and 25.3%, respectively. Five Cryptosporidium species (C. parvum, C. ubiquitum, C. scrofarum, C. xiaoi and C. parvum-like), one G. duodenalis assemblages (E), four E. bieneusi ITS genotypes (CM1, HLJD-I, HNR-III and 1 novel genotype HNED-III) were detected, and seven subtypes of Blastocystis sp. (ST1, ST2, ST3, ST5, ST10, ST14 and ST15) were also identified. Conclusions: This is the first molecular detection and public health risk assessment of four intestinal protozoa species in Hainan Tropical Wildlife Park and Botanical Garden, China. Almost all species/genotypes/subtypes of four intestinal protozoa identified in this study have the potential of zoonosis and may cause public health risks.

Public health risk assessments associated with heavy metal levels in panga fish fillets imported from Vietnam

Pangasius hypophthalmus (panga fish) is farmed in the Mekong River (Vietnam), which is known as a polluted river, and exported to many countries. The present study aimed to determine heavy metal levels in frozen panga fillets imported from Vietnam as well as the risks of heavy metals to human health. Panga fillets belonging to four brands were bought from three supermarkets in Adana city, Turkey, and heavy metals (As, Cd, Hg, Pb, Ni, Cu, Mn and Co) were analyzed. To analyze the potential risks to human health, EWI (estimated weekly intake), THQ (target hazard quotient), and CR (lifetime cancer risk) values were calculated to assess the potential risks to consumer health of the metal content in panga fillets. The health risk assessment values were calculated for children and adults according to the frequency of consumption once, three and seven times a week. The results revealed that the presence of heavy metals in the studied panga fillets was below permissible limits indicated by WHO (World Health Organization), EPA (United States Environmental Protection Agency) and TKB (Turkish Fisheries Laws and Regulations). The EWI, THQ or ∑ THQ and CR values were below PTWI (provisional tolerable weekly intake), 1 and 10-5, respectively. Remarkably, the highest values of the EWI/PTWI ratio and THQs were found for children.

Ege Bölgesinde üretilen ve yerel olarak satılan tek kullanımlık (PET) şişelerdeki sularda mikroplastik tespiti ve halk sağlığı risk değerlendirmesi

Intensive use of plastic has led to the accumulation of plastics in all ecosystems and inevitable environmental pollution. Plastic wastes have undergone structural degradation with the effect of environmental factors and have been disintegrated into nano and microparticles; thus, might accumulate in living organisms and reach unpredictable levels in the food chain. In recent years, the impacts of these particles called "microplastics" (MP’s) have become one of the most important issues in the scientific world. The aim of this study is to evaluate the possible presence of MP’s in drinking water, that represents the most important nutrition element for human beings. For this purpose, samples of 6 different brands of disposable (PET) bottles produced and sold locally were examined. A total of 36 samples in bottles with 2 different volumes were analyzed in accordance with international standards and the results were evaluated. As a result of the study, the presence of MP’s was detected in all samples analyzed. A total of 207 MP’s were found in 36 samples. As a result of the analysis, a mean of 7.35 ± 9.66 MP L-1 particles was detected. It was determined that the most dominant type in terms of shape was fiber (91%), the most dominant type in terms of color was blue (57%) and the most dominant type in terms of size was 0.1-1 mm (71%). When Estimated Daily Intake (EDI) rates were calculated for public health risk assessment, it was determined that the most affected group is the 3-6 age group (EDI (avg) = 0.42). The importance of making recycling more widespread, raising awareness of consumers and making the necessary legal regulations on the issue was emphasized in order to reduce the problem at its source.

Spatial analysis of health risk due to contamination groundwater resources (a case study in Bandung District, Indonesia)

Population growth affects the need for water which increases in quantity, followed by an increase in quality and continuity. The development of anthropogenic activities, agriculture, industry, and domestic resulted in a declining rate of clean water in Bandung District, especially in three areas, namely Ciparay, Dayeuhkolot and Margaasih sub-districts. Analysis samples of groundwater in South Bandung District showed an average pollution index of 11.42, which is included in the category of heavily polluted. Therefore, a public health risk assessment is carried out due to groundwater resources for hygiene and sanitation use. Risk characterization is carried out by quantitative methods of calculating the value of the Hazard Index with Monte-Carlo simulation analysis. Spatial analysis is carried out to show the range of risks that can be exposed to the community in the area. Spatial analysis can describe the effect of groundwater pollution and land use on health risk by calculating elevation on the Inverse Distance Weighted interpolation method in Geographic Information System Software. The Hazard Index value categorized child and adult values in each area, with spatial analysis resulting in high – low gradation. Range of hazard index show for Child – Ciparay and Adult – Ciparay respectively 1.15 – 0.08 and 1.16 – 0.22, for Child – Dayeuhkolot and Adult – Dayeuhkolot respectively 0.77 – 0.04 and 0.69 – 0.08, and for Child – Margaasih and Adult – Margaasih respectively 0.47 – 0.11 and 0.55– 0.14. Dermal exposure due to groundwater showed a non-carcinogenic risk in Ciparay Area in the Agriculture land use. Therefore, the stakeholder must periodically evaluate groundwater quality as hygiene and sanitation water, and the land use masterplan and management must be revised to reduce public health risks.

Establishing intersectoral ‘Schools Teams’ to mitigate SARS-CoV-2 school transmission, 2020/2021

Abstract The SARS-CoV-2 pandemic disrupted the lives of up to 100,000 school-going children in Ireland. Consequently, intersectoral ‘Schools Teams’ were established for the 2020/2021 school year to reduce SARS-CoV-2 transmission in school settings. This novel public health intervention provides learning to inform future cross-sectoral collaborative work in Public Health in responding to infectious disease threats. For the 2020/2021 school year in Ireland, intersectoral Schools Teams were formed within each of eight regional Departments of Public Health to manage mitigation of SARS-CoV-2 transmission in school settings. These teams comprised of staff from Departments of Public Health and redeployed staff from the Department of Education. A nationally agreed schools process was followed by Schools Teams to manage SARS-CoV-2 cases and outbreaks in schools. Relevant cases were referred to the regional Schools Team for a public health risk assessment (PHRA). Close contacts were determined using appropriate definitions of close contact within a school setting through the PHRA. This model with centralised procedures and linked health/education teams was novel and adaptable to additional settings. Results from the East region of Ireland showed testing of close contacts of COVID-19 was conducted in 71.8% (676/942) of schools, with 43881 tests completed. Most Schools Team members reported efficient communication within the team (88.7%), a positive team culture (96.3%) and feeling comfortable in their roles following training (82.7%). The majority of members felt the team was able to effectively support schools to reduce COVID-19 transmission (92.5%). Lessons learnt include the synergistic working of educational and health professionals towards a common goal, maximising the skills of all, ensuring a better outcome for school children. Involving educational teams in active contact tracing of COVID-19 cases in schools maximised engagement of the educational sector in the COVID-19 response. Key messages • Establishing intersectoral ‘Schools Teams’ pooled skills, resources and expertise, enabling development of synergistic solutions to a complex problem. • This exemplifies a large national cross-sectoral collaborative working process involving education and public health sectors, providing a model for future responses to infectious disease threats.