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June 2013
INSIDE THIS ISSUE:
President's Message 1-2
Updates From NEHA 3
Food Handler Changes 4
EH in the News 4
Meth and LHD 5
Who Am I? 5
I recently had the opportunity to attend the NEHA Radon Resistant New Construction Workshop in Washington DC. The workshop was designed to allow participants to gain more knowledge in the technical components of radon resistant new construction and building code processes. Participants also learn the dynamics of implementing a community-wide action plans that encourage residential testing and mitigation. NEHA administers radon training programs through a cooperative agreement with the U.S. Environmental Protection Agency, Indoor Environments Division.
This workshop was one of the best trainings I have ever attended and is one of the many reasons NEHA is vital to our association and environmental public health. For 2½ days I was on the edge of my seat as the different instructors taught us about radon. There were no dull
President’s Message By Richard Worley
moments. Each instructor was very knowledgeable and conveyed a real sense of interest and excitement in the subject matter. I have come back from this workshop with a renewed sense of working to get radon programs at more of a forefront in environmental health for Utah.
Radon programs at the state and local level operate on small budgets and thus may receive little emphasis or importance. By this fact, radon may be stigmatized as unimportant. Radon health effects may also be thought of as Pseudoscience due to a lack of education and misinformation. If you will please indulge me, I would like to briefly communicate some of the interesting points that impressed me from the workshop.
Through extensive epidemiological studies, the best estimate of US population risk in homes is about 21,100 lung cancer deaths per year. Please keep in mind that this estimate is
based on the US average indoor radon concentration of 1.4 pCi/L and includes both smokers and non smokers. It is very important to note that the EPA action level for radon is a concentration at or above 4 pCi/L. So what are the risks to people at the action level?
At the action level of 4 pCi/L, 6 out of 100 people will get lung cancer each year for smokers, and 7 out of 1,000 people will get lung cancer each year for non-smokers. How do these numbers compare with some other lifetime odds of dying: Heart disease: 1-in-5, Car accident: 1-in-100, Electrocution: 1-in-5,000, Airplane travel: 1-in-20,000, and Lightning strike: 1-in-83,930. As radon levels increase above the action level, the risk verses radon level goes up in a near linear manner. For example, at a radon concentration level of 10 pCi/L, 15 out of 100 will get lung cancer for smokers, and 18 people out of 1000 will get lung cancer for non-smokers. (continued next page)
UEHAPO Box 572104
Salt Lake City, UT 84157E-Mail:
[email protected]’re on the
Web!See us at:
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Special pointsof interest:
Spring Conference dates are April 24-26th in Price, Utah
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The five year survival rate for lung cancer is 16 percent. That is why radon is the leading environmental cause of cancer mortality and the seventh leading cause of cancer mortality overall. This fact is very staggering. I like the quote by Irving Selikoff: “Death statistics are people with the tears wiped away.”
Have you tested your home? I tested my home several years ago and results showed radon levels from 4.1 to 6. I was not very concerned about it at the time and am ashamed to say it was because of my ignorance. I thought that my levels were close enough to the action level of 4 and I did not need to do anything. The action level can be misleading. There is no safe level of radon exposure. We cannot do anything about the average outdoor level of radon which can vary from 0.4 to 1.5, but we can, through radon remediation principles, decrease indoor levels of radon to an equilibrium that is at or near outdoor radon levels.
For much of Utah, there is risk for radon concentrations in all areas of the home (not just the basement if applicable) to be above average outdoor concentration levels and potentially much higher. So with that risk, we need to educate people that new homes can be built with radon control systems. We also need to educate people to get their homes tested. If testing
Presidents Message Continuedshows elevated radon levels, all existing homes can be fixed, no matter how high the levels are. For a few thousand dollars, the risk can nearly be eliminated. How much are we willing to gamble with risk?
If there is any doubt to the radon risk assessment numbers, please note the following strengths: Known human carcinogen (group A), Extensive epidemiological studies, Consistency in magnitude of risk, Extensive review by national and international groups, Consensus of expert committees, ID as serious public health risk, Risk model derived from human data, Well characterized exposure of general population, Analysis of dosimetry in mines and homes, Extrapolation not large, Extensive peer review and detailed uncertainty analysis, international consensus on risk, and New residential pooling results. The greatest strength supporting radon risk assessment for me was hearing R. William Field, PhD, MS, College of Public Health, University of Iowa, present his Iowa Radon Lung Cancer Study. This was a population-based, case-control study in Iowa. The subjects were female residents who occupied their current home for at least 20 years. The study found a statistically significant association between residential radon exposure and lung cancer. I was very impressed with the
thoroughness and completeness of the study. It was clear to me that no stone was left unturned in conducting the study and interpreting the data. The complete study can be found in the American Journal of Epidemiology, Vol. 151, No. 11. Perhaps we could have Dr. Field present at a future UEHA conference.
In closing, the Utah legislature recently passed a Radon concurrent resolution. The resolution does two things. First, it designates January 2014 as Utah State Radon Action Month, coinciding with the National Radon Action Month. Second, it asks all Utahns - business owners, property owners, citizens, home builders, realtors schools, etc. - to get educated about radon and to take measures to protect themselves. It also asks state and local government agencies to devote programs and resources to radon. Thanks to Senator John L. Valentine and others for working on this as we move onward and upward with radon. Also, Please visit the Iowa Cancer Consortium website http://www.canceriowa.org/BreathingEasier.aspx and watch the 12 or 23-minute version video. It will be worth your time. One last thought; Radon induced lung cancer is nearly 100 percent preventable and at a low cost.
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Updates From NEHAThe National Environmental Health Association (NEHA) is holding its 2013 Annual Educational Conference (AEC) & Exhibition in the Washington, DC area, July 9-11, 2013. The NEHA 2013 AEC will offer expansive training and education that covers a wide genre of environmental health (EH) topics. Sessions at the NEHA AEC will cover over 15 different environmental health topic areas including emerging EH issues, food safety and defense, environmental justice, healthy homes and communities, sustainability/climate change and general environmental health.
At this year’s NEHA AEC, there will also be a focused exploration into the facet of policy involvement with discussions of impacts of policy making and how it may affect environmental health around the country and in your community.
The NEHA AEC also offers the opportunity to network with a diversified group of professionals. Meet others from across the country and around the world, and collaborate with professionals in environmental health and related industries and officials from various levels of government and federal programs.
The designated hotel for the NEHA 2013 AEC is the Hyatt Regency Crystal City at Reagan National Airport (in Arlington, Virginia just minutes away from DC) and rooms are available at a discounted rate of $154/night + taxes and fees for AEC attendees.
NEHA 2013 AEC registration and information are available via neha2013aec.org
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Food Handler Changes
Contributed by Ron Marsden
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The Utah Legislature passed Senate Bill 187 in March which has outlined by statute the procedures food handler training programs must follow and how food handler permits will be issued by the local health departments in the future. The Utah Department of Health has written a draft rule based on the new statute requirements which will be out for public comment June 1 to July 1, 2013, with the earliest enactment date of mid -July, 2013. Below is a summary of what the statute and proposed rule will be requiring:
Summary of SB 187
Food HandlersFood Handler Permits:The bill changed the term food handler “card” to “permit”. Permits will be valid for 3 years.Food handlers will receive a certificate of completion when they finish a course and pass a test from the Training Provider. The food handlers unique information regarding the certificate of completion and information necessary to issue the food handler permit will be transmitted electronically or by mail to the LHDs who can either mail out the permit, or give the permit out in person. Providers will have the responsibility of collecting training and permit
fees, and will be responsible to transmit the permit fee to the local health department.The rule will outline the minimum requirements of what must be placed on the food handler permit.The fee LHDs can charge for permits (training is not included in this fee) is proposed to be set at $15 for 3 years.Food handlers must obtain a permit before handling food and within 30 days of initial employment and with 7 days of the expiration of an existing permitHandlers may serve without restriction statewide with the permit.Approval of Food Handler Training Providers course and testThe Utah Department of Health in consultation with LHDs is responsible to approve food handler training programs.All food handler instructors must be registered with LHDs to be approved.The statute allows for food handler programs to use Department/LHD set of test questions or seek approval of their own set of questions. If they desire to use their own set of questions, they must have their exam evaluated by a Department (UDOH) approved independent instructional design and testing expert, and then receive a letter with a positive recommendation from this expert. The “expert” will look at question structure and if the course effectively measures applicant’s knowledge of learning objectives. Food handlers must complete a
training course within 14 days of beginning employment, and get the food handler permit within 30 days from that initial employment date. Food Handlers must pass exam with 75% score or higher.Courses must have 75 minutes of training time.Exams must have 40 multiple choice questions, have four content sections, and 10 questions chosen at random from each of the 4 content sections.After passing exam, food handlers will receive a certificate of completion which is valid for 30 days from date of issue towards getting food handler permit from the LHD. LHDs are responsible to issue the food handler permitFood handler individual information will be delivered to LHD electronically or by mail from the training provider.It is unlawful for any food handler training company to represent that their course will satisfy Utah requirements if they are not Department approved.Exams are approved for 3 years, and providers must pay a Department a fee for costs of review if they elect not to use the state provided bank of questions. No fee is charged to those providers who elect to use the state provided bank of questions. Provider test questions must be changed within 30 days if Department finds that questions are not (continued next page)
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Food Handler Changes (cont.)
meeting objectives or if new evidence is found that questions need to be changed due to public health reason.Exams may be offered on line, oral, or written. Courses may be on line, trainer led, or a combination of both.Providers must provide technical support to assist users taking the course and exam.The new rule must require providers to implement procedures to inhibit fraud. These may include:Providers shall routinely rotate test questionsTrack IP addresses or locationRotate exam questions, order of answers, etc.Provide a distinct online certificate with rule required information printed on the certificate that identifies a person taking an online course or exam. Providers are required to implement measures to inhibit duplication of a certificate or permitelectronic signature.Any fraud committed would invalidate a certificate of completion.Food handler training providers are subject to Department (UDOH) audit at any time to determine compliance with statute and rule.The rule will be out for public comment in June 1 to July 1 with the earliest anticipated enactment date in mid-July, 2013. You may access the proposed rule on the Utah Administrative Rules website after June 1.
Who Am I?
I grew up in Bountiful, UT, in a family consisting of five brothers and two sisters. I enjoyed spending much of my time playing sports especially basketball, soccer, and volleyball. I also grew up with a strange fascination with Africa after my grandmother introduced me to the John Wayne movie ‘Hatari.’ I set a goal to visit Africa after my senior year of high school where I literally put the word ‘senior’ in my ‘senior trip’ as I went on a safari to Kenya in a group that consisted of myself and about 8 older retired couples.
EH in the News
Contributed by Loren Allen
One Dead, 20 Sickened After Chinese Chef Mistakes Pesticides for SpicesApril 26, 2013 at 9:00AM by Kiri Tannenbaum
A Chinese cook is under arrest after one person died and 20 were sickened because of his fatal mistake. The cook reportedly mistook pesticide for spices when preparing food in China's Inner Mongolia region, according to The Huffington Post.
The police did not find any foul play and determined it was a case of negligence despite the fact that pesticide poisonings are on the rise in China. The diners were migrant workers employed by the Beijing-Tibet highway expansion project, a route that is know for major traffic congestion sometimes lasting up to 10 days, reports the Global Post. Unfortunately, two of the workers remain in critical condition. The cook was one of his own victims, falling ill after eating the same lunch he prepared on the construction site.
AWARD NOMINATIONS ARE NEEDED
Please make your award nomination for 2013!
Award Criteria and Nomination Forms can be found at UEHA.org
Methamphetamine and Local Health Department Involvement
Contributed by Karla Bartholomew & Kerry CramerSalt Lake Valley Health Department
As a disclaimer, there are 12 health departments/multi-county health districts in Utah. Each health department/multi-county health district sets their own priorities involving methamphetamine contaminated properties. Where the Salt Lake Valley Health Department (SLVHD) takes a different philosophy than other health departments/multi-county health districts, that difference will be noted.
Methamphetamine contaminated properties are regulated by a number of statues, administrative rules and local regulations. The SLVHD initially adopted regulations in 2001 dealing with chemically contaminated properties. On a state-wide basis, statues and administrative rules started to be adopted in 2004. Most of the authority for dealing with meth contaminated properties is contained in Title 19 Environmental Quality Code, Chapter 6 Hazardous Substances, Section 901-906, "Illegal Drug Operations Site Reporting and Decontamination Act."
The first question usually asked is what constitutes a contaminated property. As used in Title 19-6-902. Definitions.
(3) "Contaminated" or "contamination" means:
(a) polluted by hazardous materials that cause property to be unfit for human habitation or use due to immediate or long-term health hazards; or
(b) that a property is polluted by hazardous materials as a result of the use, production, or presence of methamphetamine in excess of decontamination standards adopted by the Department of Health under Section 26-51-201.
The definition of “contamination” has changed a number of times over the years as the meth problem has evolved. The initial definition related solely to labs. As labs became less common and properties were increasingly contaminated by use, a legislative change was made to include use. The original standard was 0.1 ug/100 cm2.
In 2008, the legislature appropriated money for the Utah Department of Health to establish a health protective standard. The standard is not a medical standard. Due to the adictive nature of meth, human studies will never be performed. (It wold not be a good idea to perform a study on meth and turn three-fourths of the participants into tweekers.) Animal studies are also unreliable. A rat on meth behaves differently than a human on a similar dose. The study was based on research of 30 years of legitimate meth use—bed-wetting in children, weight loss in pregnant women, attention deficiet hyper-activity disorder in children, etc. As a result, the current standard was set at 1.0 ug.100 cm2
In 2004, the legislature also passed a bill making it mandatory that law enforcement agencies report any meth activity to the local health department.
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Title 19-6-903. Law enforcement reporting and records -- Removal from list.
(1) (a) When any state or local law enforcement agency in the course of its official duties observes any paraphernalia of a clandestine drug laboratory operation, including chemicals or equipment used in the manufacture of unlawful drugs, the agency shall report the location where the items were observed to the local health department.
Additionally, under Title 19-6-903, local health departments are required to maintain a list of properties reported by law enforcement agencies that is available to the public. The list is required to contain only law enforcement agency reports. The SLVHD chose to expand the list of properties to include those that have been tested by a certified decontamination specialist and found to be in excess of the established standard.
(3) (b) The local health department shall place property considered to be contaminated on a contamination list.
(4) The local health departments shall maintain searchable records of the properties on their contamination lists and shall:
(a) make the records reasonably available to the public;
(b) provide written notification to persons requesting access to the records that the records are only advisory in determining if specific property has been contaminated by clandestine drug lab activity; and
(c) remove the contaminated property from the list when the following conditions have been met:
(i) the local health department has monitored the decontamination process and, after documenting that the test results meet decontamination standards, has authorized the removal of or purging of the contamination information from the department's records; or
(ii) a certified decontamination specialist submits a report to the local health department stating that the property is decontaminated.
A third component of 2004 legislation was, for the first time, required knowledge and certification of those involved in the decontamination of meth properties. The standards include knowledge of meth laws, decontamination standards and procedures, and HAZWOPR certification. Prior to this time, virtually anyone could represent themselves as competent to decontaminate properties. The legislation authorized Utah Division of Environmental Quality to develop specific standards that must be met for certification. R311-500. Illegal Drug Operations Site Reporting and Decontamination Act, Decontamination Specialist Certification Program.
A fourth component of 2004 legislations was to require certified decontamination specialists (CDS) to report their activities to the local health department. It was felt that local health department oversight was needed to assure decontamination procedures and standards were met.
Title 19-6-904. Decontamination specialist reporting to local health departments.
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(1) A certified decontamination specialist is required to report to the local health department the location of any property that is the subject of decontamination work by that decontamination specialist by Chapter 249, 2004 General Session19-6-906. Decontamination standards--Specialist certification standards-- Rulemaking.
As a final component of 2004 legislation, the Utah Department of Health was authorized to develop decontamination standards for meth contaminated properties .
Rule R392-600. Illegal Drug Operations Decontamination Standards.
(1) The Department of Health shall make rules under Title 63G, Chapter 3, Utah Administrative Rulemaking Act, in consultation with the local health departments and the Department of Environmental Quality, to establish:
(a) decontamination and sampling standards and best management practices for the inspection and decontamination of property and the disposal of contaminated debris under this part;
Now, what does this all mean? If a local health department receives a report from a law enforcement agency or a CDS, they will investigate the report and determine if a property is contaminated with meth. If the report is valid, The SLVHD will post the property “Closed to Entry.”
(Other local health departments may deal with this differently). The Closed to Entry placard is probably the most restrictive action the SLVHD can take. It means that the property is essentially sealed up—no one goes in, nothing comes out. Anyone in the property except a CDS or the property owner performing a preliminary assessment is guilty of a misdemeanor under UCA 76-6 et. al. Everything inside the house is considered contaminated and is usually taken to the landfill.
SLVHD had cases on 123 properties in 2011. There was a 35% increase in 2012 with 166 properties ranging from sheds to multi-million dollar homes. While the source of the contamination has changes, the levels have not. Lacking other evidence, in the late 1990s and early 2000s, if a property tested positive for meth above 10-20 ug/cm2, the contamination was assumed to be caused by a lab. Now, we have properties testing at 500 ug/cm2 solely from use. It is assumed that the higher levels are due to the meth imported from Mexico. Earlier methods of production—Biker (P2P), Red Phosphorous (Red, White, Blue, Bevis & Butthead), Anhydrous ammonia (Birch, Nazi, and now One-pot) produced meth ranging from 50-80% pure. Mexican meth can approach 100% pure allowing more contamination to be created by lower use.
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To have the Closed to Entry placard removed, decontamination must be performed in accordance with R392-600, Illegal Drug Operations Decontamination Standards and SLVHD Regulation #32, Chemically Contaminated Properties. The first step involves performing a preliminary assessment. The CDS or property owner (yes, the property owner is allowed to decontaminate his/her own property) will determine the levels and areas of contamination, usually through sampling.
After the initial assessment, the CDS or property owner must prepare a Work Plan delineating what will be done to decontaminate the property, who will do the work, when will the work be done, etc.. The Work Plan must be submitted to the local health department for review and approval.
Contrary to popular belief, it is not necessary to strip a house down to the studs in order to decontaminate it. In fact, this is seldom the case. All porous materials such as carpet, drapes, furniture and other items that cannot be decontaminated on-site must be removed and taken to the landfill. Such material is treated as “Special Waste.” This means that the material is buried immediately upon receipt. This prevents anyone from taking a contaminated couch from the landfill and re-using it.
The next step is to triple wash all nonporous surfaces in the house. This will remove the gross dirt and grease from surfaces as well as some of the meth. The CDS usually then applies a proprietary chemical to the surfaces to further neutralize any remaining meth.
The final step is to conduct confirmation sampling. This is done to validate the decontamination procedure. Confirmation sampling involves taking either discrete or composite samples of all contaminated surfaces, the HVAC system, any out-buildings, and a field blank for quality control. A 100 cm2 template is wiped in sample each area with a gauze pad containing methyl alcohol. The gauze pad is then placed in a vial for laboratory analysis.
If the lab results are below the decontamination standard, the Closed to Entry placard is removed and the property is removed from the list. If not, the decontamination process is repeated (and repeated and repeated….) until results below the decontamination standard are achieved.
Now, what does this all mean? The consequences of a contaminated property can be devastating, both emotionally as well as financially. As was stated, if a property is deemed contaminated it is closed to entry. This prevents a property owner from living or even being in a house. In all likelihood, most personal possessions will be lost. It is not uncommon for residents of contaminated properties to try and remove
Red P One Pot
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possessions. Sometime this can be as blatant as backing up a trailer at midnight and trying to remove everything from the house, to a mother trying to retrieve a stuffed toy (contaminated with meth) for her child, to someone trying to get their meds or false teeth (and remaining meth) from the house. For commercial properties—hotel rooms, apartments, businesses, etc. in addition to the decontamination costs, this represents a loss of income.
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Who Am I? (cont.)
I loved my first trip to Africa and when I arrived home I started looking for reasons to go back. I have now been to Africa seven times and visited eight different countries. The reasons have varied: I spent four months in Uganda doing research in the school systems, and while there I received a mission call for the LDS church to South Africa. I spent the following two years between South Africa and Botswana. During these experiences I realized all the great adventures Africa has to offer and have since climbed Mt. Kilimanjaro, went cage diving to see great white sharks, tracked gorillas in the jungles of Rwanda, flew in a helicopter over Victoria Falls, white water rafted on the Nile and Zambezi rivers, and been on countless safari’s and interacted with various animals. I loved the adventures I had in Africa, but it also opened my eyes to all the basic things we enjoy in the U.S. that are lacking in developing countries.
My experience in Africa created a desire in me to be involved in clean water projects. I began this process by attending BYU and studying for an undergraduate degree in geology with a minor in international development. However, after this experience I decided I enjoyed working from a health aspect more than the technical side of these projects and went back to school to pursue a Master in Public Health from the University of Utah. During this time I got married to my wife Nicole, and realized working with water in the U.S. isn’t such a bad idea either and was fortunate enough to be hired by the Bureau of Water Quality and Hazardous Waste in Salt Lake last July.
I’m Jay Clark, currently enjoying my first year with the Salt Lake County Health Department, and after having an eventful past year consisting of finishing school, starting a new job, building a house, and welcoming my first child into the world I’m looking forward to spending more time hiking, playing indoor soccer, basketball, volleyball, as well as traveling and just spending time with my family.
Who Am I? I’m Jay Clark!
UEHA APPRECIATES THE FOLLOWING ORGANIZATIONS FOR THEIR
SUPPORT!
Utah Festival Opera
The Lund Family
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UEHA would like to thank everyone for their participation in the Dutch Oven Dinner.
Keep posted for future social events!
Have some picture you’d like to share? Send them to Brian Cowan at;
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