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Lead poisoning is a significant health problem among some children living in inner-city homes in Toledo, Ohio, and elsewhere. The Department of Housing and Urban Development (HUD) provided a three-year grant to the city of Toledo for an environmental lead remediation program. This study retrospectively reviewed records of houses contaminated with lead and blood-lead levels (BLLs) in children for the period January 1995 to August 1998. The authors then evaluated the sources of lead exposure and the influence of chelation therapy and parent lead education on children's BLLs. The children who participated in this study lived in the inner city and were from low-income families. They occupied pre-1950 houses with lead-based paint concentrations that in some areas were greater than 9.9 milligrams per square centimeter (mg/cm2), well exceeding the HUD guideline of 1.0 mg/cm2. Levels of lead dust in soil and on surfaces in homes also were greater than the respective HUD guidelines of 400 micrograms per gram (microg/g) and 100 to 800 microgram per square foot (microg/ft[2]). About 88 percent of the 165 children evaluated had elevated BLLs--that is, BLLs greater than or equal to 10 micrograms per deciliter (microg/dL). Among children who received chelation therapy, the postchelation mean BLL was statistically lower (p < .001) than the prechelation mean BLL, but it remained elevated. Among nonchelated children, the mean BLL at the final screening was statistically higher (p < .001) than the mean BLL at initial screenings. These results suggest that chelation alone was not sufficient to lower the concentration of lead in children's blood to an acceptable level (less than 10 microg/dL) and that the single visit a health care worker made to each home to educate the parents about lead was inadequate. Both chelated and nonchelated children continued to occupy lead-contaminated homes through the duration of the study. Accordingly, the authors draw three conclusions: Lead poisoning is a significant health problem among some children living in inner-city homes in Toledo, Ohio, and elsewhere. The Department of Housing and Urban Development (HUD) provided a three-year grant to the city of Toledo for an environmental lead remediation program. This study retrospectively reviewed records of houses contaminated with lead and blood-lead levels (BLLs) in children for the period January 1995 to August 1998. The authors then evaluated the sources of lead exposure and the influence of chelation therapy and parent lead education on children's BLLs. The children who participated in this study lived in the inner city and were from low-income families. They occupied pre-1950 houses with lead-based paint concentrations that in some areas were greater than 9.9 milligrams per square centimeter (mg/cm2), well exceeding the HUD guideline of 1.0 mg/cm2. Levels of lead dust in soil and on surfaces in homes also were greater than the respective HUD guidelines of 400 micrograms per gram (microg/g) and 100 to 800 microgram per square foot (microg/ft[2]). About 88 percent of the 165 children evaluated had elevated BLLs--that is, BLLs greater than or equal to 10 micrograms per deciliter (microg/dL). Among children who received chelation therapy, the postchelation mean BLL was statistically lower (p < .001) than the prechelation mean BLL, but it remained elevated. Among nonchelated children, the mean BLL at the final screening was statistically higher (p < .001) than the mean BLL at initial screenings. These results suggest that chelation alone was not sufficient to lower the concentration of lead in children's blood to an acceptable level (less than 10 microg/dL) and that the single visit a health care worker made to each home to educate the parents about lead was inadequate. Both chelated and nonchelated children continued to occupy lead-contaminated homes through the duration of the study. Accordingly, the authors draw three conclusions: * Chelation therapy and parent education about lead do not always adequately lower children's BLLs if exposure continues. * Parents should receive more frequent and more comprehensive education about lead. * Residence in lead-free homes remains the most effective option to control children's BLLs. Chelation therapy and parent education about lead do not always adequately lower children's BLLs if exposure continues. * Parents should receive more frequent and more comprehensive education about lead. * Residence in lead-free homes remains the most effective option to control children's BLLs. [ABSTRACT FROM AUTHOR]

Abstract In 1989, the level of Aroclor 1254 (a mixture of polychlorihated biphenyls with 42 percent chlorine by weight) in fish collected from a recreational pond in Toledo, Ohio, was reported to be 44.4 milligrams per kilogram (mg/kg), prompting local health officials to declare a 'no fishing advisory' for the pond. A second study conducted in 1990 did not identify elevated levels of polychlorinated biphenyls (PCBs) in fish tissue. In other words, the two studies gave conflicting resets. The purpose of this study was to determine the level of Aroclor in fish tissues and then evaluate whether consumption of fish from the pond would pose a serious health risk. Fish samples collected on several occasions in 1998 and 1999 were filleted, and tissues were analyzed, as composite or individual samples, with gas chromatography. The levels of Aroclor 1254 ranged from 0.2 mg/kg in white crappies to 1.0 mg/kg in carp. These levels, while far less than the level reported in 1989, nevertheless were greater than 0.05 mg/kg, which is the maximum level established by the Great Lakes Fish Advisory Task Force for 'no restriction in fish consumption.' Levels of other Aroclor formulations ranged from less than the 0.02 mg/kg (the minimum detectable limit) to 0.1 mg/kg. Given current knowledge about the potential health consequence of exposure to PCBs and the results of this study, the authors have recommended that local health officials develop a new fish consumption guideline for PCBs. Any decisions about maintaining or lifting the restrictions on the pond, however, should be based on additional studies that determine the levels of other chemicals that are present in the pond and deemed hazardous to human health. [ABSTRACT FROM AUTHOR]

During the 2019-2020 academic year, 37 (17%) of 223 Council on Education for Public Health (CEPH) accredited or applicant schools and programs of public health offered Master of Public Health (MPH) degrees with concentrations in general global health. Concentration-specific competencies build on the foundational competencies required for all MPH students enrolled in CEPH-accredited programs. The most popular global health competencies focus on agencies and organizations, ethics and human rights, program management, social and environmental determinants of health, the global burden of disease, collaboration and partnerships, and cultural competency. There is significant overlap between the current concentration competencies and the ones recommended by the Association of Schools and Programs of Public Health in 2018. The online program descriptions for MPH concentrations in global health feature four key themes: globalization, low-income countries, social justice and equity, and culture and diversity. (1) Most programs emphasize transnational health issues and the effects of globalization on health in countries of all income levels. (2) Some programs have a special focus on preparation for serving low-income countries and other disadvantaged populations, such as refugees. (3) Most programs emphasize the social justice and equity issues underlying local and global health disparities. (4) Most programs promote development of the cultural knowledge, awareness, and skills required for serving diverse populations effectively as rising leaders in the international, national, or local public health workforce. Global health MPH programs prepare students for public health practice in resource-limited settings in their home communities as well as internationally.

Despite substantial financial and personnel resources being devoted to occupational exposure monitoring (OEM) by employers, workers' compensation insurers, and other organizations, the United States (U.S.) lacks comprehensive occupational exposure databases to use for research and surveillance activities. OEM data are necessary for determining the levels of workers' exposures; compliance with regulations; developing control measures; establishing worker exposure profiles; and improving preventive and responsive exposure surveillance and policy efforts. Workers' compensation insurers as a group may have particular potential for understanding exposures in various industries, especially among small employers. This is the first study to determine how selected state-based and private workers' compensation insurers collect, store, and use OEM data related specifically to air and noise sampling.  Of 50 insurers contacted to participate in this study, 28 completed an online survey. All of the responding private and the majority of state-based insurers offered industrial hygiene (IH) services to policyholders and employed 1 to 3 certified industrial hygienists on average. Many, but not all, insurers used standardized forms for data collection, but the data were not commonly stored in centralized databases. Data were most often used to provide recommendations for improvement to policyholders. Although not representative of all insurers, the survey was completed by insurers that cover a substantial number of employers and workers. The 20 participating state-based insurers on average provided 48% of the workers' compensation insurance benefits in their respective states or provinces. These results provide insight into potential next steps for improving the access to and usability of existing data as well as ways researchers can help organizations improve data collection strategies. This effort represents an opportunity for collaboration among insurers, researchers, and others that can help insurers and employers while advancing the exposure assessment field in the U.S.

Aims: A batch chlorination system was optimized for on-site wastewater treatment and reuse system (OWRS) and its efficiency was evaluated for reducing viruses, protozoa, bacteria and antimicrobial resistance in cold and warm seasons., Methods and Results: The OWRS performance in reducing microbial contaminants was determined by assessing three different faecal indicators (Escherichia coli, F-specific coliphages and Clostridium perfringens for measuring the disinfection efficiency of bacteria, viruses and spore-formers and surrogate for protozoa, respectively) using culture-based methods. Quantitative PCR was used to quantify pathogenic bacteria (Shiga-toxin-producing E. coli (STEC), Campylobacter spp., and Arcobacter spp.), a human-associated faecal marker (gyrB), and tetracycline resistant bacteria (tetQ). The levels of E. coli, coliphages and Cl. perfringens showed 5·4, 2·3, 2·5 log reduction, respectively, upon disinfection. In the final effluents, coliphages (1·7 × 10 2 PFU 100 ml -1 ) and Cl. perfringens (3·4 CFU 100 ml -1 ) were detected in 80 and 100% of the samples, but E. coli was not found. The removal and inactivation of E. coli and Cl. perfringens were not significantly different across the seasons, however, efficacy of removal and inactivation of F-specific coliphage was significantly reduced during the winter/spring season compared to the summer/autumn season (P = 0·009). The reduction of Arcobacter, gyrB and tetQ by 3·1, 2·3 and 2·3 log, respectively, was mostly due to peat biofiltration under the study conditions., Conclusions: This study demonstrated that peat biofiltration was the most important step of the OWRS to remove microbes and genes from wastewater before spray irrigation of the effluents. The irrigation system is not suitable for edible crops because of the potential presence of residual pathogens., Significance and Impact of the Study: On-site wastewater treatment systems are a practical option for reusing the wastewater for landscape, especially for those areas where geological and seasonal limitations impact the removal of microbial contaminants by soil infiltration., (© 2016 The Society for Applied Microbiology.)

Wetlands provide many valuable ecosystem services, including water quality improvement to protect downstream aquatic ecosystems such as lakes, rivers, and estuaries. However, their ability to improve water quality to safe levels for direct human exposure while largely surrounded by agricultural lands and hosting large wildlife populations remains unknown. Our aim was to examine the ecosystem service capabilities of an avian-dense coastal wetland surrounded by agricultural lands along the southwestern shore of Lake Erie in Ohio by assessing the quality of water as it flows through the wetland (Ottawa National Wildlife Refuge (ONWR)) and into Lake Erie beach waters. Our study used total phosphorus and fecal indicator (Escherichia coli) concentrations as water quality metrics across the wetland and at an adjacent Lake Erie swimming beach during the 2012 summer swim season. E. coli and total P levels were consistently highest at the site, where water enters the ONWR (mean E. coli = 507 CFU/100 mL; mean total P = 535 μg/L), and steadily decreased as water flowed through the wetland and into the adjacent beach (mean E. coli = 10 CFU/100 mL; mean total P = 41 μg/L). E. coli and total P showed statistically significant (α = 0.01) correlations with phycocyanin, chlorophyll-a, turbidity, specific conductivity, dissolved oxygen, and pH; total P was also significantly correlated with total N. The results suggest that this wetland may be contributing to improving water quality, which is beneficial for human health as well as to downstream ecosystem health (e.g., limiting eutrophication promoting conditions, etc.).

Background: In this study, we aim to identify key climatic factors that are associated with the transmission of Japanese encephalitis virus in areas located near the Three Gorges Dam, between 1997 and 2008., Methods: We identified three geographical regions of Chongqing, based on their distance from the Three Gorges Dam. Collectively, the three regions consisted of 12 districts from which study information was collected. Zero-Inflated Poisson Regression models were run to identify key climatic factors of the transmission of Japanese encephalitis virus for both the whole study area and for each individual region; linear regression models were conducted to examine the fluctuation of climatic variables over time during the construction of the Three Gorges Dam., Results: Between 1997 and 2008, the incidence of Japanese encephalitis decreased throughout the entire city of Chongqing, with noticeable variations taking place in 2000, 2001 and 2006. The eastern region, which is closest to the Three Gorges Dam, suffered the highest incidence of Japanese encephalitis, while the western region experienced the lowest incidence. Linear regression models revealed that there were seasonal fluctuations of climatic variables during this period. Zero-Inflated Poisson Regression models indicated a significant positive association between temperature (with a lag of 1 and 3 months) and Japanese encephalitis incidence, and a significant negative association between rainfall (with a lag of 0 and 4 months) and Japanese encephalitis incidence., Conclusion: The spatial and temporal trends of Japanese encephalitis incidence that occurred in the City of Chongqing were associated with temperature and rainfall. Seasonal fluctuations of climatic variables during this period were also observed. Additional studies that focus on long-term data collection are needed to validate the findings of this study and to further explore the effects of the Three Gorges Dam on Japanese encephalitis and other related diseases.

Concrete grinding exposes workers to unacceptable levels of crystalline silica dust, known to cause diseases such as silicosis and possibly lung cancer. This study examined the influence of major factors of exposure and effectiveness of existing dust control methods by simulating field concrete grinding in an enclosed workplace laboratory. Air was monitored during 201 concrete grinding sessions while using a variety of grinders, accessories, and existing dust control methods, including general ventilation (GV), local exhaust ventilation (LEV), and wet grinding. Task-specific geometric mean (GM) of respirable crystalline silica dust concentrations (mg/m³ for LEV:HEPA-, LEV:Shop-vac-, wet-, and uncontrolled-grinding, while GV was off/on, were 0.17/0.09, 0.57/0.13, 1.11/0.44, and 23.1/6.80, respectively. Silica dust concentrations (mg/m³ using 100-125 mm (4-5 inch) and 180 mm (7 inch) grinding cups were 0.53/0.22 and 2.43/0.56, respectively. GM concentrations of silica dust were significantly lower for (1) GV on (66.0%) vs. off, and (2) LEV:HEPA- (99.0%), LEV:Shop-vac- (98.1%) or wet- (94.4%) vs. uncontrolled-grinding. Task-specific GM of respirable suspended particulate matter (RSP) concentrations (mg/m³ for LEV:HEPA-, LEV:Shop-vac-, wet-, and uncontrolled grinding, while GV was off/on, were 1.58/0.63, 7.20/1.15, 9.52/4.13, and 152/47.8, respectively. GM concentrations of RSP using 100-125 mm and 180 mm grinding cups were 4.78/1.62 and 22.2/5.06, respectively. GM concentrations of RSP were significantly lower for (1) GV on (70.2%) vs. off, and (2) LEV:HEPA- (98.9%), LEV:Shop-vac- (96.9%) or wet- (92.6%) vs. uncontrolled grinding. Silica dust and RSP were not significantly affected by (1) orientation of grinding surfaces (vertical vs. inclined); (2) water flow rates for wet grinding; (3) length of task-specific sampling time; or, (4) among cup sizes of 100, 115 or 125 mm. No combination of factors or control methods reduced an 8-hr exposure level to below the recommended criterion of 0.025 mg/m³ for crystalline silica, requiring further refinement in engineering controls, administrative controls, or the use of respirators.

Clostridium botulinum toxins, the most poisonous substance known to humankind, are considered to be a [US] Centers for Disease Control and Prevention Category A bioterrorist agent. Despite this concern, little has been published with regard to the tactical aspects of triaging a mass-casualty event involving botulism victims arriving at an emergency department. Because neuromuscular-ventilatory failure is a principal reason for botulism's early morbidity and mortality, using a quick and sensitive test to evaluate this possibility is imperative. The purpose of this article is to propose the adoption of the Single-Breath-Count Test (SBCT). The ease and validity of the use of the SBCT in evaluating complications associated with various neuromuscular disorders make it an attractive adjunct for triage during a mass-casualty incident due to botulism. While education, immune globulin, antitoxin, and invasive airway techniques are well-recognized steps in treating botulism, incorporating a time-honored technique such as the SBCT, will be an important addition to the triage process.

Canada geese are increasingly abundant in Ohio, with large nesting populations throughout the state, and goose feces contaminate grassy areas and pavements in many public, commercial, and residential sites. In 1999 the authors found a high prevalence of Giardia, Campylobacter, and especially Cryptosporidium in collected feces of Canada geese. The purpose of this follow-up study was to survey known Canada geese sites in three counties in Ohio (Lucas, Ottawa, and Wood) and to determine the prevalence of sites testing positive for Cryptosporidium. The sites included golf courses, cemeteries, public parks, and health care and teaching facilities. At each of 11 sites, 12 goose feces of wet and loose appearance were collected and manually compressed into one composite sample representing that site. The samples were tested for Cryptosporidium with a sensitive monoclonal enzyme immunoassay (EIA) method. In 2000 and 2001, nine of 11 sites (81.8 percent) and nine of 10 sites (90 percent), respectively, were positive for Cryptosporidium. The species or genotypes of Cryptosporidium found in the geese feces and their potential to infect humans is unknown. A survey of the literature indicates, however, that while C. parvum (human genotype) is the main cause of cryptosporidiosis in humans, C. parvum (zoonotic genotypes), C. meleagridis (bird genotype), and C. felis (cat genotype) have occasionally been isolated from infected people. Further research is required to define the public health importance of Cryptosporidium in feces of Canada geese and other bird species.

Construction workers are at increased risk for fatal and non-fatal injuries. This study examined the effectiveness of employee orientation and training in reducing injuries among plumbers and pipefitters. We searched the Occupational Safety and Health Administration's "recordable" injury data and "documentable" safety and training records for six plumbing and pipefitting employers in northwestern Ohio. During the period 1996 to 1998, 133 injuries were recorded with the duration of 2,541,432 working hours. The most common types of injuries were cuts, lacerations, and abrasions. The majority of injuries resulted from workers being struck by objects. The injury rate was significantly higher for small companies and longer working hours. No difference was found between traveling and local workers. Seventy-five percent of workers received safety orientations on injury prevention. Among workers who received safety orientations, only 3.4% experienced injuries, compared with 11.1% of workers without orientations. Safety orientations were associated with a significant reduction in injuries (odds ratio, 0.23; 95% confidence interval, 0.15 to 0.35). Proper safety orientation and training could reduce the risks for occupational injuries in construction workers.

The effect of benzene on white blood cell and red blood cell counts, hemoglobin level, mean corpuscular volume (MCV), and platelet count was investigated among workers in a small petroleum company. The investigated cohort consisted of 105 workers exposed to low levels of benzene between 1967 and 1994. The average level of benzene exposure per year ranged between 0.14 parts per million and 2.08 parts per million (8-hour time-weighted average). The mean complete blood count (CBC) demonstrated values within normal ranges. With the exception of white blood cells, all other CBC values were significantly reduced during the follow-up period. Length of employment was significantly related to the changes in MCV and platelet counts. The reductions in MCV were significant only among workers who had been employed for more than 10 years at this particular company. The findings of this study suggest that low levels of benzene may affect CBC values. CBC values may serve as a useful tool for biological monitoring for workers with low-level benzene exposure.

Occupational illnesses and injuries are common problems facing workers and employers. The purpose of this study was to determine the nature and extent of illnesses and injuries among hospital workers in Ohio. All workers' compensation claims for 22 hospitals in Ohio during the period 1993-1996 were reviewed. The majority of the claims were for sprain and strain injuries. Most of the claims were approved. Back injury was the leading cause of injury in both genders, and females reported a significantly higher percentage of back injuries. The incidence rates for injuries and illnesses were lower than national rates for other industries. Generally, there was a downward trend in the number of claims during the study period. A negative linear trend in injury rates by hospital size was detected. Our findings suggest the need for safety programs, especially in smaller hospitals, with the goal of preventing sprain and strain injuries.

Wastewater treatment workers (WWTW) are potentially exposed to a variety of infectious agents and toxic materials. We conducted a retrospective epidemiological study to examine the prevalence of infectious diseases and associated symptoms in WWTW. From a possible 242 WWTW, 150 completed a questionnaire that provided data pertaining to the diagnosis of an infectious disease or the prevalence of associated symptoms over a 12-month period. Comparison data were obtained from questionnaires completed by 54 college maintenance and oil refinery workers. The WWTW exhibited a significantly higher prevalence of gastroenteritis, gastrointestinal symptoms (specifically abdominal pain), and headaches. No significant differences were found with regard to respiratory and other symptoms. Employees classified by exposure categories did not exhibit significant differences in the prevalence of symptoms. While significant differences were found with regard to the health status of WWTW and controls, it appears that these risks are confined to symptoms and infectious diseases associated with the gastrointestinal system and are not inclusive of all such symptoms or diseases.

The degree of comfort of personal protective equipment (PPE) was investigated in an automobile encapsulating plant. Up to 96.2% of employees used one or a combination of PPE. Only 8% of the workers felt their respirators were comfortable, 30% tolerated their respirators, and 62% rated them as uncomfortable. The percentage of employees who rated their PPE (other than a respirator) as comfortable ranged from 32 to 52%. For comfort factor, coveralls/aprons rated 52%, safety glasses 51%, rubber gloves 42%, and hearing protectors 36%. PPE was tolerable (just acceptable) for about 30% of the employees. To increase the effectiveness and safety of PPE, the human-factor aspects of PPE design should be emphasized more and quality improvement should cover the wearability of PPE.

Comparisons and contrasts are made between medical and environmental surveillance in New Jersey. These two approaches can be used together to address questions of association and prevention in occupational and environmental medicine, a field that needs to be expanded.

Formaldehyde exposure, acute pulmonary response, and exposure control options were evaluated in a group of 34 workers in a gross anatomy laboratory. Time-weighted average (TWA) exposure to formaldehyde ranged from 0.07-2.94 parts per million (ppm) during dissecting operations. More than 94% were exposed to formaldehyde in excess of the ceiling value of 0.3 ppm recommended by the American Conference of Governmental Industrial Hygienists (ACGIH). The eight-hour TWA exposure of 31.7% of the subjects exceeded the action level of 0.5 ppm set by the Occupational Safety and Health Administration (OSHA). Reported symptoms included irritation of eye (88%), nose (74%), throat (29%), and airways (21%). Forced vital capacity (FVC) and forced expiratory volume in 3 seconds (FEV3) decreased, and FEV1/FVC increased during the exposure. The changes of FEV3 were statistically different from those of the controls. The results strongly support the necessity for designing and testing special local exhaust-ventilated worktables with necessary flexibility for dissecting operations.

In view of the ability of several phosphoesterases to hydrolyze organophosphates to toxic phenols, the bioactivation of bis[p-nitrophenyl]phosphate (BNPP) by the earthworm Lumbricus terrestris was investigated. In a contact toxicity test, BNPP was was less toxic than the metabolite p-nitrophenol (PNP), but more toxic than the metabolite p-nitrophenylphosphate (PNPP). Results from an artificial soil test (soil containing BNPP) revealed that the phosphomonoesterase and phosphodiesterase activities from the enteric tissue of the annelid could be selectively depressed without significant reduction of these activities in other tissues. Since these esterase activities are 5 to 7 fold higher in the enteric tissue, these results suggest that the phosphoesterases in the annelid participate in the activation of BNPP to the more toxic metabolite, p-nitrophenol.

The primary (and inactive) enteric metabolite of 5-aminosalicylate is N-acetyl-5-aminosalicylate. Previous studies have demonstrated acetylation of this anti-inflammatory agent by intestinal and bacterial homogenates. To assess the contribution of anaerobic bacteria to the N-acetylation in vivo, we have measured the production of N-acetyl-5-aminosalicylate in anaerobic microculture. Our results indicate that enteric bacteria play a minor role in N-acetylation, but may contribute to the production of other metabolites of pharmacologic and toxicological interest.