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Building on the success of initiatives put forth during the COVID-19 pandemic response, US health officials are expanding wastewater surveillance programs to track other target pathogens and diseases of public health interest. The Houston Health Department in Houston, Texas, USA, conducted a hypothesis-generating study whereby infectious disease subject matter experts suggested potential targets. This study addressed 2 criteria recommended by the National Academies of Sciences, Engineering, and Medicine for selecting wastewater targets. Results can be used as a basis of a questionnaire for a future population-based study to recommend targets of highest priority to include for expanded wastewater sampling. [ABSTRACT FROM AUTHOR]

Background: Exposures to environmental contaminants can be influenced by social determinants of health. As a result, persons living in socially disadvantaged communities may experience disproportionate health risks from environmental exposures. Mixed methods research can be used to understand community-level and individual-level exposures to chemical and nonchemical stressors contributing to environmental health disparities. Furthermore, community-based participatory research (CBPR) approaches can lead to more effective interventions. Objectives: We applied mixed methods to identify environmental health perceptions and needs among metal recyclers and residents living in disadvantaged neighborhoods near metal recycling facilities in Houston, Texas, in a CBPR study, Metal Air Pollution Partnership Solutions (MAPPS). Informed by what we learned and our previous findings from cancer and noncancer risk assessments of metal air pollution in these neighborhoods, we developed an action plan to lower metal aerosol emissions from metal recycling facilities and enhance community capacity to address environmental health risks. Methods: Key informant interviews, focus groups, and community surveys were used to identify environmental health concerns of residents. A diverse group from academia, an environmental justice advocacy group, the community, the metal recycling industry, and the local health department collaborated and translated these findings, along with results from our prior risk assessments, to inform a multifaceted public health action plan. Results: An evidence-based approach was used to develop and implement neighborhood-specific action plans. Plans included a voluntary framework of technical and administrative controls to reduce metal emissions in the metal recycling facilities, direct lines of communication among residents, metal recyclers, and local health department officials, and environmental health leadership training. Discussion: Using a CBPR approach, health risk assessment findings based on outdoor air monitoring campaigns and community survey results informed a multipronged environmental health action plan to mitigate health risks associated with metal air pollution. https://doi.org/10.1289/EHP11405, Introduction Communities of color bear higher burdens of chemical exposures, (1-4) which are due in part to the proximity of their neighborhoods to key exposure sources, including hazardous waste sites [...]

Industrial disasters have caused hazardous air pollution and public health impacts. Response officials have developed limited exposure guidelines to direct them during the event; often, guidelines are outdated and may not represent relevant elevated‐exposure periods. The 2019 Intercontinental Terminals Company (ITC) fire in Houston, Texas led to large‐scale releases of benzene and presented a public health threat. This incident highlights the need for effective response and nimble, rapid public health communication. We developed a data‐driven visualization tool to store, display, and interpret ambient benzene concentrations to assist health officials during environmental emergencies. Guidance values to interpret risk from acute exposure to benzene were updated using recent literature that also considers exposure periodicity. The visualization platform can process data from different sampling instruments and air monitors automatically, and displays information publicly in real time, along with the associated risk information and action recommendations. The protocol was validated by applying it retrospectively to the ITC event. The new guidance values are 6–30 times lower than those derived by the Texas regulatory agency. Fixed‐site monitoring data, assessed using the protocol and revised thresholds, indicated that eight shelter‐in‐place and 17 air‐quality alerts may have been considered. At least one of these shelter‐in‐place alerts corresponded to prolonged, elevated benzene concentrations (~1000 ppb). This new tool addresses essential gaps in the timely communication of air pollution measurements, provides context to understand potential health risks from exposure to benzene, and provides a clear protocol for local officials in responding to industrial air releases of benzene. Integr Environ Assess Manag 2024;20:533–546. © 2023 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals LLC on behalf of Society of Environmental Toxicology & Chemistry (SETAC). Key Points: We present a newly developed tool to communicate real‐time air pollution measurements and risk during an industrial emergency event.Acute risk guidance values are based on updated literature for benzene and are 6–30 times lower than those derived by the Texas regulatory agency.The platform displays ambient benzene levels, risk information, and action recommendations for the public.The action recommendation includes suggested protocol for emergency response to air releases of benzene, given on‐the‐ground information gathered during the event. [ABSTRACT FROM AUTHOR]

Societal Impact Statement: Planting trees is considered an effective method for climate change adaptation and mitigation. This framework provides a replicable blueprint to improve health, urban heat, flooding, and air pollution via a multisectoral, collaborative, environmental data‐driven approach. Native tree species with targeted ecosystem services are selected, and sites are strategically identified based on environmental and health benefits, with the intent of engaging community involvement through education and large‐scale tree plantings. Including non‐traditional partners in the framework provides heightened awareness of the relationship between climate change and health, thus catalyzing decision‐making regarding sustainable actions that reduce effects of climate change. This native tree planting framework is highly adaptable in other cities. Summary: A multidisciplinary framework is presented for a data‐driven, climate change adaptation and climate change and air pollution mitigation project. This framework leverages heightened awareness of the connections between climate change, air pollution, and health to expand the cadre and societal impacts of those working to intervene in resilience planning and implementation.The framework, implemented in Houston, Texas, USA, beginning in 2019, consists of three parts: (1) identification of optimal native tree species for climate change adaptations and air pollution mitigation around variables important locally; (2) selection of large‐scale native tree planting locations where populations are already disproportionately experiencing flooding, increased heat, and air pollution‐related health effects that could be further exacerbated from climate change; and (3) engagement of multisectoral leadership broadened beyond those traditionally working on climate change resilience through heightening awareness of the link to human health.Native tree species were identified that had the highest combination of absorption of carbon dioxide, other air pollutants, and water absorption (aiding in flood adaptation and air pollution/heat mitigation). Thousands of the top tree species were planted in locations that experience substantial flooding during large rain events, have high rates of health effects exacerbated by air pollution (e.g., cardiac arrest and asthma attacks), and experience multiple days of elevated heat and air pollution.This multidisciplinary framework addresses a critical need to provide interventions accessible to the community; educate on the connection between climate change adaptation, air pollution mitigation, and health; and foster multisectoral leadership to accelerate local resilience actions. [ABSTRACT FROM AUTHOR]

In 2020, the Houston Health Department (HHD) in Texas launched a citywide wastewater surveillance program, including a pilot program that monitored manholes at schools in Houston’s largest school district (prekindergarten–12th grade). By 2022, the pilot program monitored wastewater for SARS-CoV-2, influenza A and B, and respiratory syncytial virus. To ensure effective communication of wastewater surveillance results to school communities, HHD designed and implemented a text- and email-based alert system using existing City of Houston resources. This alert program informs recipients about the presence of a virus at their schools and actions to protect themselves and others against that virus. To promote alert program sign-ups, a dedicated bilingual community involvement coordinator conducted in-person outreach geared toward school nurses and student caregivers. From September 2023 through February 2024, a combined 5178 alerts for 43 schools were sent following virus detections. As a supplemental initiative, HHD offered vaccination events to pilot program schools with consistent virus detection. As wastewater surveillance becomes more common across the United States, this alert program presents a framework for other public health agencies to scale and adapt according to their resources. [ABSTRACT FROM AUTHOR]

Since the start of the COVID-19 pandemic, wastewater surveillance hasemerged as a critical tool for tracking the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and other pathogens in communities throughout the United States. In 2020, the Centers for Disease Control and Prevention (CDC) launched the National Wastewater Surveillance System (NWSS), which partners with state, local, tribal, and territorial health departments to develop and implement wastewater collection and analysis systems and to share data. In 2022, the CDC established the first two NWSS Centers of Excellence to lead its implementation and coordination efforts—one in Colorado (Colorado CoE) and one in Houston (Houston CoE). As the NWSS expands, it is becoming more important to support the training needs of jurisdictions at different stages of developing their wastewater surveillance infrastructure. To evaluate these needs, the Colorado CoE and Houston CoE conducted a needs assessment study of NWSS-funded public health agencies and public utilities departments located in the United States using surveys developed by the Colorado CoE. The results of the surveys showed that although some training needs were universal, it will be most beneficial to develop training modules tailored to the needs of entities that operate wastewater surveillance programs of various sizes, workforce experience levels, and at different stages in the infrastructure development process. [ABSTRACT FROM AUTHOR]

Since the start of the COVID-19 pandemic, wastewater surveillance has emerged as a public health tool that supplements traditional surveillance methods used to detect the prevalence of the SARS-CoV-2 virus in communities. In May 2020, the Houston Health Department (HHD) partnered with a coalition of municipal and academic partners to develop a wastewater monitoring and reporting system for the city of Houston, Texas. The HHD subsequently launched a program to conduct targeted wastewater sampling at 52 school sites located in a large, urban school district in Houston. Data generated by this program are shared with school district officials and nurses from participating schools. Although initial feedback from these stakeholders indicated that they considered the wastewater data valuable, the emergency nature of the pandemic prevented a systematic evaluation of the program. To address this gap in knowledge, the HHD and Rice University conducted a study to determine how wastewater data are used to make decisions about COVID-19 prevention and mitigation practices in schools. Our findings indicate that maximizing the utility of wastewater data in the school context will require the development of communication strategies and education efforts tailored to the needs of specific audiences and improving collaboration between local health departments, school districts, and school nurses. [ABSTRACT FROM AUTHOR]

Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Martin Shafer reports serving on several Association of Public Health Laboratories’ advisory boards that support wastewater surveillance practice. Sandra L. McClellan reports service on the National Academies of Science, Engineering, and Medicine Community Wastewater-based Infectious Disease Surveillance Committee. Dagmara Antkiewicz reports institutional support from Epidemiology and Laboratory Capacity, Wastewater Surveillance 2020–2021 National Wastewater Surveillance System Budget Period 2, and Wisconsin Alumni Research Foundation COVID-19 Challenge; and uncompensated board membership on the Midwest Society of Environmental Toxicology and Chemistry. Alexandria B. Boehm reports institutional support from Sergey Brin Family Foundation, grants from the U.S. National Science Foundation, public health partnerships with the Sloan Foundation, and membership on the state of California wastewater-based epidemiology committee of the State Water Board. Bradley White reports contract support from Stanford University. Loren Hopkins reports uncompensated leadership of the National Academies for Science, Engineering, and Mathematics’ Committee on Wastewater. Marlene K. Wolfe reports subaward from a gift to Stanford University, grants for implementation of wastewater-based epidemiology in Bangladesh and Ghana from the Rockefeller Foundation, consulting fees from Verily related to the WastewaterSCAN program led by Stanford University, and conference attendance support from the American Society of Microbiology. Lauren Stadler reports support from the Houston Health Department, grants from the National Science Foundation, Jacobs Engineering Group, Dow Chemical Company, U.S. Department of Agriculture’s National Institute of Food and Agriculture, U.S.–Egypt Joint Science and Technology Fund, Colorado State University, and National Academies of Science, Engineering, and Medicine; and consulting fees from the Royal Society of Chemistry and State Analytics, LLC. No other potential conflicts of interest were disclosed.