Topics A to Z

As part of NEHA's continuos effort to provide convenient access to information and resources, we have gathered together for you the links in this section. Our mission is "to advance the environmental health and protection professional for the purpose of providing a healthful environment for all,” as well as to educate and inform those outside the profession.


The objective of this study was to evaluate the association of asthma hospital visits with ozone concentrations in Maricopa County, Arizona. We used time plots and distributed lag nonlinear models to achieve these objectives while accounting for some potential confounders including temperature and day of the week. A total of 90,381 asthma hospitalizations were retrieved from the dataset (daily median = 39, range: 8–122). Asthma hospitalizations were highest in 2008 (16,949), during the months of November through December, and lowest in 2011 (13,213), during the months of June through July. By contrast, the average daily ozone concentration ranged from 27.05 parts per billion (ppb) in 2012 to 30.15 ppb in 2008 and from 13.96 ppb in December to 40.58 ppb in May. The association between asthma hospitalizations (relative risk [RR/per 10 ppb increase of ozone]) start at ~1.046 (95% confidence interval [1.029, 1.064] at lag 0) and gradually decrease over several days. Our findings suggest exposure to ozone is associated with increased RR of asthma hospital visits in Maricopa County lasting several days. This study used recently developed methods that are freely available and could be used to evaluate other health events that are measured over time.

May 2016
May 2016
78.9 | 8-13
Ahmed Mohamed, MSc, PhD, Kate Goodin, MPH, Ronald Pope, PhD, Mark Hubbard

Most prior research investigating the health effects of extreme cold has been limited to temperature alone. Only a few studies have assessed population vulnerability and compared various weather indicators. The study described in this article intended to evaluate the effects of cold weather on admissions due to ischemic heart disease, especially acute myocardial infarction (AMI), and to examine the potential interactive effects between weather factors and demographics on AMI. The authors found that extremely low universal apparent temperature in winter was associated with increased risk of AMI, especially during lag4–lag6. Certain demographic groups such as the elderly, males, people with Medicaid insurance, people living in warmer areas, and areas with high PM2.5 concentration showed higher vulnerabilities to cold-AMI effects than other groups.

January 2016
January/February 2016
78.6 | 66-74
Shao Lin, MD, PhD, Aida Soim, MS, MD, Kevin A. Gleason, Syni-An Hwang, PhD

Article Abstract

Exposure-response relationship between particulate matter less than 10 µm in diameter (PM10) and human health in different seasons from 2001 to 2005 was examined based on hospital admissions data of respiratory system diseases from four major hospitals in Lanzhou, China. To quantify associations of respiratory system diseases with multiple air pollutants and meteorological conditions, a semiparametric generalized additive model was used in the authors’ study by implementing daily ambient sulfur dioxide, nitrogen dioxide, and PM10 data collected from the Lanzhou Environmental Monitoring Station and daily meteorological data from Lanzhou Meteorological Bureau.

Results showed that daily averaged PM10 increased per interquartile range the hospital admissions number of respiratory diseases by 3.3% in spring, 1.4% in summer, 3.6% in autumn, and 4.0% in winter from a single-pollutant model, or 3.1%, 1.4%, 3.0%, and 4.0% from a multi-pollutant model, respectively. The effect of PM10 on respiratory hospital admissions was lowest in summer and highest in winter. The relative risks of PM10 on female or the elderly (≥65 yrs.) were higher, showing a stronger association of PM10 with respiratory diseases in female and the elderly groups than in males and people younger than 65.

Jan/Feb 2015
77.6 | 64-71
Tao Yan, An Xingqin, Mi Shengquan, Sun Zhaobin
Additional Topics A to Z: Ambient Air


Ultrafine particles (UFPs) are ubiquitous in urban air and have been recognized as a risk to human health. The aim of this study was to measure the relationships among ultrafine particles and other ambient air pollutants and meteorological factors in the Tampa Bay Area. This study measured continuous UFPs, black carbon, oxides of nitrogen (NOx), nitrogen dioxide (NO2), nitric oxide (NO), carbon monoxide (CO), ozone (O3), sulfur dioxide (SO2), particulate matter having an aerodynamic diameter of 10 microns or less (PM10), relative humidity, wind speed, and ambient temperature during January to March 2014. Moreover, the study compared the relationship between UFPs and various co-pollutants daily, including during morning rush hour periods. This study found a moderate correlation among UFPs and black carbon, NOx, NO2, and NO during hourly continuous measurements and rush hour periods, and a low level of correlation among UFPs and CO, O3, SO2, PM10, relative humidity, wind speed, and ambient temperature. This study indicates that co-pollutants should not be used as a surrogate to assess the human health risk from ultrafine particles exposure.

May 2016
May 2016
78.9 | 14-21
Ushang Desai, MPH, CPH, Alain Watson

Article Abstract

Asthma is a substantial public health burden among children. Disease and risk-factor discrepancies have been identified between racial, ethnic, and socioeconomic groups. At a rural health clinic (Salud) with primarily underserved and Latino patients in Colorado, the authors evaluated 250 medical records and administered 57 parental surveys to describe this population with respect to asthma diagnosis, asthma-like symptoms, and environmental/occupational risk factors among children. Wheeze and asthma were indicated in 9.7% and 8.9% of medical records, respectively. Twenty parents (35.7%) reported in a questionnaire that their child had experienced wheezing or whistling in the chest. Parents reported that children play in farming fields (21.8%) and feed livestock/animals (10.9%). Additionally, 13.2% and 9.4% of children have a household member who works around livestock or around grain, feed, or dust, respectively. Information from the Salud population can be used to develop larger-scale research and public health initiatives to eliminate health and risk factor disparities among underserved children.

Jan/Feb 2014
76.6 | 8-16
Maggie L. Clark, PhD, Stephen J. Reynolds, PhD, CIH, Edward Hendrikson, PhD, PA-C, Jennifer L. Peel, MPH, PhD
Additional Topics A to Z: Children's Environmental Health


Some African-American communities in the U.S. South are excluded from nearby municipal water and sewer services and therefore rely on private wells and septic systems. These “underbounded” communities are disproportionately exposed to water contaminants and face elevated risks for poor health outcomes. Outreach efforts encouraging proper well testing and maintenance are needed to protect health in these communities. To identify knowledge gaps and misconceptions that such outreach programs should target, we conducted semistructured interviews with 18 residents of such communities in Wake County, North Carolina. Only one interviewee conducted annual well testing as recommended by the county health department. Interview results suggest that testing is inhibited by lack of awareness of well maintenance guidelines, overreliance on sensory information, poor understanding of exposure pathways, and cost. Links between private septic systems, well water contamination, and health are poorly understood, hindering proper septic maintenance. These findings highlight the need for risk communication materials targeting at-risk communities.


December 2018
December 2018
81.5 | 8-15
Chelsea Fizer, MS, Department of Environmental Sciences and Engineering, University of North Carolina, Wändi Bruine de Bruin, PhD, Leeds University Business School, Carnegie Mellon University, Frank Stillo, MSPH, Department of Environmental Sciences and Engineering, University of North Carolina, Jacqueline MacDonald Gibson, PhD, Department of Environmental Sciences and Engineering, University of North Carolina

Chuck Lichon, R.S., M.P.H., Deputy Health Officer at District Health Department #2 in Michigan, developed a Children’s Environmental Health Power Point Program with the financial assistance of the Dow Chemical Company, Midland, MI.  The Power Points are approximately 25-35 minutes in length, allowing for a presentation to be made during one classroom setting, or to be used for a community presentation, allowing time for Q & A.  Some of the topics include: Sunwise, Body Art, Household Hazardous Waste, Meth, Recreational Water, and more.  They are free to download and use for presentations in your school, health department community presentations, or for media use.  Changes in the presentations should not be made without consent from the author, and/or the NEHA Board of Directors.  


The Bats and Rabies PowerPoints is available via the link listed below:   

Chuck Lichon, R.S., M.P.H.
Additional Topics A to Z: Vectors and Pests


Most populations now derive benefits as well as risks from a global economy. Local environnmetal health can be impacted positively through importation or adoption of foreign technological advances, administrative approaches, and cultural attributes, to name only a few. Similarly, risks are now commonly shared on an international scale, as illustrated by cross-border food source contamination, emerging or recognized disease spread, unchecked international pollution, and a host of other incidents in recent years. Beyond the case study, historical record of the textbook approach, affordable study abroad programs now exist to more concretely educate students about such impacts. Once considered simply a perquisite for more financially able students, or a requirement for language arts students, both short- and long-term study abroad programs increasingly add a necessary global perspective to the college environmental health graduate. This special report details the ways in which a number of accredited programs are using and integrating study abroad experiences into their curriculums to better prepare their graduates to meet the international environmental health and safety challenges of the 21st century.


July 2017
July/August 2017
80.1 | 30-33
Timothy J. Ryan, PhD, CIH, CSP, Ohio University
Additional Topics A to Z: Workforce Development


Rats are a common problem in cities worldwide. Impoverished urban neighborhoods are disproportionately affected because factors associated with poverty promote rat infestations and rat–human contact. In public health, most studies have focused on disease transmission, but little is known about the nonphysical consequences of this environmental exposure. Mental health often is neglected but is receiving increasing attention in public health research and practice. The objective of this study was to use a systematic review and narrative synthesis of the published literature to explore the effect of rat exposure on mental health among residents in impoverished urban neighborhoods. Although the literature addressing this topic was sparse, the results of this review suggest that rat exposure consistently has a negative impact on mental health. These effects can be elicited directly (e.g., fear of rat bites) or indirectly (e.g., feeling of disempowerment from inability to tackle rat problems). By developing a better understanding of potential rat-related health risks, both mental and physical, public health officials can better evaluate, refine, and develop their policies regarding rats.


November 2018
November 2018
81.4 | 8-12
Raymond Lam, MSc, CPHI(C), School of Population and Public Health, University of British Columbia, Kaylee A. Byers, MSc, University of British Columbia, Chelsea G. Himsworth, MVetSc, DVM, Dipl ACVP, School of Population and Public Health, University of British Columbia