Environmental Public Health Journal 2017 | BCIT Institutional Repository

Environmental Public Health Journal 2017

Association between knowledge of the pneumococcal vaccine, vaccination status and recommendations for vaccination
BACKGROUND Pneumococcal disease caused by Streptococcus pneumoniae has a high morbidity rate in elderly individuals aged 65 or older. Previous studies have demonstrated that low vaccination rates with the 23-valent pneumococcal polysaccharide vaccine (pneumovax) are due to a lack of awareness and knowledge about the vaccine in the general population. This study measured the association between the public’s knowledge of the pneumococcal vaccine, vaccination status, the type and number of health care facility visits per participant in the past year and number of advertisements seen for the vaccine. METHODS This study used a survey to test the knowledge of its participants on the pneumococcal vaccine and associated the results with nominal data such as vaccination status and recommendation for vaccination by their primary health care providers. The survey tested the participants using 15 true or false questions that assessed their knowledge on the pneumococcal vaccine and pneumococcal disease. RESULTS No association was found between the knowledge individuals have on the pneumococcal vaccine and whether their health care provider recommended the vaccine (p=0.467). However, a statistical difference in knowledge between individuals who are vaccinated and individuals who are not vaccinated was found (p=0.039 (CHI), p=0.011 (ANOVA)). There was also a positive association found between vaccination status and primary health care provider recommendation for the pneumococcal vaccine (p=0.001). No association was found between vaccination status and number of visits to a primary health care provider in the past year (p=0.149). Using an ANOVA analysis, it was found that there was a difference in number of advertising types seen for each vaccination status group (p=0.011). CONCLUSION Based on the results, it can be concluded that individuals who are vaccinated have more knowledge on the pneumococcal vaccine, but their knowledge is not affected by a recommendation to receive the vaccine from their primary health care provider. This suggests that health care providers are not providing sufficient information about the vaccine to their patients when they recommend it. Despite this knowledge gap, the association between vaccination status and primary health care provider recommendation for the vaccine indicates that individuals are more likely to get vaccinated when their primary health care provider recommends it. However, more visits to the provider annually did not influence the vaccination status of the patient. In addition, results from the ANOVA analysis suggest that participants who saw more vaccine advertisements were more likely to be vaccinated., Peer-reviewed article, Published., Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2017., Peer reviewed, Streptococcus pneumoniae, Pneumococcal disease, Pneumovax, Vaccination, Knowledge, Advertisements, Health care provider recommendation
Determining the accuracy of colorimetric pH testing compared to potentiometric methods
Background: Bacterial growth in foods can be prevented by applying various controls to the food product, including adjusting the acidity of the food. Research has indicated that a pH level of 4.6 or lower will be effective to prevent most bacterial growth. In order to verify this level has been achieved pH test strips (colorimetric) or a digital calibrated pH meter (potentiometric) can be used. This study attempted to quantify the degree of accuracy that pH test strips have compared to the calibrated pH meter. Method: MColorpHastTM pH indicator strips with a pH range of 0-14 were tested against a calibrated Extech pH100 meter. In this study 40 samples of rice were acidified to varying levels. Each sample was measured with both colorimetric and potentiometric method. Results were compared to determine the level of accuracy of the pH test strips. As well, test strips were used to measure pH in a variety of different coloured preserves. Results: A two-tailed test showed that there was a statistically significant difference between the readings from the pH test strips and the digital pH meter (P=0.0003). Conclusion: Based on the results, it can be concluded that both methods of measurement are not equally accurate. A calibrated pH meter will give more accurate readings of pH levels and should be used in most cases to confirm food safety with a high degree of confidence. In testing dark coloured jellies and preserves, pH test strips should not be relied on as they will be stained by the food, making the colorimetric reading difficult to determine accurately., Peer-reviewed article, Published., Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2017., Peer reviewed, pH, Test strips, Calibrated pH meter, Food safety, Acidity, Accuracy, Colorimetric, Potentiometric, Comparison
Electronic cigarettes
Background: Electronic cigarettes are a widely-used, yet still emerging technology. As such, there is relatively little data regarding the reasons why people take up their use. Many claim to use them as a smoking-cessation method. Concern exists that experimentation in non-smokers may lead to nicotine addiction and subsequent smoking. The purpose of this study was to determine the primary reasons for the commencement of electronic cigarette use, and to suggest way in which these findings could affect current policies and regulations pertaining to electronic cigarettes. Methods: A survey examining electronic cigarette use was prepared. The survey contained questions respecting primary motivation for use, frequency of use, present and former smoking status as well as agreement with common perception about electronic cigarettes. Basic demographic information was also collected. The survey was posted to “www.reddit.com” and was accessible to users who used electronic cigarettes themselves via the “/r/electronic_cigarettes” sub-Reddit for a period of five days. Once responses were collected, Chi-square tests of independence were run to determine if any associations existed. Responses were also compared to previous studies of a similar nature to see if any similarities existed. Results: In total, 155 responses were received. The majority of the respondents were males (89.7%) between the ages of 19 and 28 (47.7%). 30.32% listed their occupation as “student”, and almost three-quarters of the respondents had some post-secondary experience. 78.1% of respondents were former smokers, and 61.3% identified their primary reason for electronic cigarette use as “to quit smoking.” Chi-squared tests for association between responses yielded statistically-significant associations between being a previous smoker and believing that electronic-cigarettes are healthier than conventional cigarettes, and between gender (specifically being male) and reasons for electronic cigarette use (specifically “to quit smoking”). However, the latter result was possibly skewed by a higher response rate from males as opposed to females. Conclusion: The high proportion of previous smokers among electronic cigarette users suggested that quitting smoking was the most common reason individuals take up electronic cigarette usage. It is therefore suggested that studies be done to determine if their use is less harmful than that of conventional cigarettes, and that existing legislation regarding their use in public be modified in light of this evidence. It is also suggested that they be given consideration as a legitimate means of smoking cessation., Peer-reviewed article, Published., Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2017., Peer reviewed
Evaluating the cleaning procedures of meat slicers at retail delis in Metro Vancouver
Background: Ready-to-eat deli meats are widely consumed by the public; however they are also a high risk food for carrying Listeria monocytogenes. Listeriosis, an infection that can result from consumption of Listeria monocytogenes contaminated food, is the leading cause of deaths related to foodborne illness in Canada. Due to structural constraints and inadequate cleaning, mechanical slicers used to process deli meats have been implicated as a major source of Listeria monocytogenes contamination of deli meats. Several governing bodies, including local health authorities have published recommendations on the proper method of cleaning and sanitizing meat slicers to prevent the risk of contamination of deli meats. This study evaluated the compliancy of retail delis in Metro Vancouver to these recommendations and also assessed their knowledge of the risk associated with deli meats. Methods: An in-person, self-administered paper survey was conducted at several retail delis and supermarkets. The survey questions determined the cleaning and sanitation procedures of meat slicers at the establishments and also assed knowledge of the risk associated with deli meats. Both nominal and numerical data was collected and analyzed using a Chi-squre test and a t-test. Results: Based on the data collected, a statistically significant difference was identified between the cleaning procedures practiced by the establishments and those recommended to prevent pathogen transmission through meat slicers. The chi-square test revealed that there is a statistically significant association between the size of the establishment and the adequacy of cleaning procedures, with small-scale delis being less likely to comply with the cleaning practices that are recommended by governing bodies. Conclusion: Cleaning procedures practiced at retail delis and supermarkets are not consistent with those recommended by regulatory agencies to prevent the transmission of pathogens such as Listeria monocytogenes from meat slicers to deli meats. Smaller retail delis are less likely to follow proper cleaning methods than larger supermarket delis. Educational intervention by health authorities may be needed to ensure that food establishments are informed of proper and timely cleaning procedures., Peer-reviewed article, Published., Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2017., Peer reviewed, Deli, Meat slicers, Cleaning and sanitation, Listeria monocytogenes
Follow-up study of private well users affected by groundwater arsenic in the Surrey-Langley area
Background: Arsenic is a potent toxicant and Group 1 human carcinogen which occurs naturally in certain sediments and can contaminate groundwater. In the Surrey-Langley area of British Columbia, a 2007 study of private wells found that 43% of wells tested contained arsenic concentrations above the maximum acceptable concentration (MAC) prescribed in Health Canada’s Guidelines for Canadian Drinking Water Quality. The well owners who participated in the 2007 study were informed of the results and of effective treatment methods that would remove the arsenic contamination. This is a follow-up study that surveyed affected well users approximately 10 years later in order to identify whether the well users had subsequently made any water treatment or behavioral changes to improve the quality of their drinking water, and also to determine whether knowledge translation of the arsenic risk had been effective. Methodology: This study contacted and enrolled private well users who were living at properties which had previously been included in the 2007 study and, in 2007, were found to have arsenic levels above the MAC in the groundwater. Respondents who agreed to participate completed a questionnaire designed to identify what treatment methods or behavioral methods they use to mitigate the risk posed by arsenic contamination. Pre-treatment and post-treatment samples of their drinking water were collected and the arsenic concentrations were analyzed. The effectiveness of treatment devices for arsenic removal was evaluated. The groundwater arsenic concentrations from approximately 10 years apart were compared to identify if arsenic levels had changed. Results: Of the 42 properties that participated in the 2007 study and had groundwater arsenic levels above the MAC, 17 participated in this follow-up study. 14 of the participants also took part in the 2007 study 10 years ago. 79% of participants had not known prior to taking part in the 2007 study that their drinking water contained arsenic levels above the MAC. All 79% then either installed reverse osmosis treatment devices to remove arsenic from their drinking water, or switched to using bottled water for drinking. This indicates that knowledge translation of the health risk was effective. Of the 8 properties using treatment devices rather than bottled water, to mitigate the arsenic risk, 2/8 (25%) were ineffective at reducing arsenic. In addition, arsenic groundwater concentrations were not found to have changed significantly in 10 years (p = 0.11). Conclusion: Participation in the 2007 study was viewed as useful and informative by participants. Knowledge translation of the health risk and the need for risk mitigation was effective, but 25% of treatment devices were found to be ineffective at removing arsenic from drinking water. These results suggests that further knowledge translation of the need for routine testing for arsenic in post-treated drinking water may be beneficial to affected private well users., Peer-reviewed article, Published., Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2017., Peer reviewed, Arsenic, Groundwater, Knowledge translation, Private well users, Surrey, Langley
Heterotrophic bacteria in botte refill stations
Background: Heterotrophic bacteria are commonly found in water supplies where there is inadequate or non-existent disinfection. Water coolers are known to have high HPC levels due to the filtered, non-chlorinated water provided. Water bottle refill stations utilize a carbon filter which can act as a food source for HPC. This study measured HPC levels in water samples from bottle refill stations to determine whether there is a difference compared to tap water at BCIT. Method: Standard Method 9060 A was used to collect water from bottle refill stations to compare to non-filtered tap water. Samples were plated using R2A Agar and incubated for 7 days before enumerating HPC from water samples. Samples were collected from specific drinking water fountains that contained Carbon Filters and compared to the nearest tap water source. Results: Mean HPC levels in bottle refill stations were found at 95 cfu/mL while mean HPC levels in tap water were 55 cfu/mL. A two-sample T-test confirmed that the mean HPC levels of bottle refill stations and tap water are statistically significantly different (P= 0.000124). Although the findings were statistically significant, the study’s power was low at 11%. Conclusion: Based on the results, drinking water obtained from bottle-refill stations at BCIT contained on an average higher level of HPC compared to tap water. Overall, HPC levels were below recommended levels in drinking water and not considered to have any harmful effects. To continue the safe use of bottle refill stations, facilities should develop and follow written procedures to maintain stations and ensure regular changing of filters., Peer-reviewed article, Published., Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2017., Peer reviewed, Heterotrophic, HPC, Carbon filter, Drinking water
Potential risks and user preferences of helmet-sharing program provided by Vancouver’s Mobi bike-share program
Background: Mobi is a bike-sharing program in Vancouver, BC that provides helmets for use with each bike. There is little research documenting risks associated with helmet-sharing, but an evidence review has shown that there is the potential for transmission of diseases that are known or presumed to be transmitted via fomites. This study attempted to ascertain public opinion of helmet-sharing and whether concern over the cleanliness of shared helmets affected likelihood of wearing them. Method: A survey was conducted to determine if there is a relationship between concern with helmet cleanliness and likelihood of wearing shared helmets. The researcher conducted surveys in-person at randomly chosen Mobi docking stations. An online (SurveyMonkey) survey was also distributed using Facebook, Twitter, Reddit and email. Results: Chi-square tests performed using NCSS determined that there was a statistically significant association between helmet use on personal bikes and use of Mobi helmet when riding Mobi bikes (p=0.00029). There was also an association between whether users found cleanliness the most important factor in their decision to wear the Mobi helmet (of cleanliness, aesthetics, legal requirement, safety and comfort/fit) and likelihood of wearing the Mobi helmet (p=0.02038). There was no association found between level of concern for cleanliness of the helmet and likelihood of wearing it (p=0.54995). Conclusions: Based on the results, there is an association between concern with the cleanliness of shared helmets are and how likely users are to wear them. Users that were most concerned about safety were more likely to use the Mobi helmet during every ride. Those that were most concerned about cleanliness were least likely to wear the Mobi helmet. However, this study also concluded that some users chose not to wear the provided helmets for reasons other than concern for cleanliness. Further research is required to determine how this will affect the health and safety of Mobi Bike users., Peer-reviewed article, Published., Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2017., Peer reviewed, Helmet, Bike-share, Helmet-share, Bicycle
The practicality of using a smartphone as a sound level meter
Background & Purpose: Sound is of vital importance for human life, it is one of the main forms of communication between people. However, sound that is a nuisance to others is considered noise. Too much noise can be disruptive and affects one’s enjoyment of life and can lead to ill health effects. In some municipalities, bylaw officers or Environmental Health Officers (EHOs) are tasked with enforcing the local noise bylaw. “Sound Level Meters” (SLM) are certified instruments enforcement officers use to accurately measure sound. However, accurate SLMs can be bulky and expensive. In this technological society, almost everyone has some type of smart phone capable of installing applications (apps) that mimic SLMs. The purpose of this project was to determine the accuracy of phone SLM apps compared to real SLMs. Method: Three Android & three iOS SLM apps were downloaded from the internet and installed on two Android and one iOS smartphone. The sound source was computer generated white noise. A type 1 SLM was used to set the white noise to three different sound levels, 80db, 65 dB, & 50 dB. Each Android and iOS smartphone measured the white noise at each sound level utilizing the three different SLM apps. Results were analyzed between the different apps and smartphones. The MANOVA and ANOVA statistical tests were used to analyze the data. Results: All MANOVA and ANOVA tests showed statistically differences between the apps and the SLM (p=0.00000). The power for all MANOVA tests was 100%, therefore there is confidence that the findings reflect the truth and there really is a difference between the different applications, smartphones, and interaction of applications and smartphones. Therefore, the smartphone/app combination tested were not able to replicate the noise level as measured by the SLM. Conclusion: It can be concluded that any individual Android SLM application can have significantly different mean decibels values across different Android smartphones. Different Android smartphones can also have significantly different means decibels across different Android applications. Results for iOS smartphones can only indicate significant mean decibels across the different SLM applications. Therefore, it is not recommended that smartphones with sound level measuring apps be used in place of SLMs., Peer-reviewed article, Published., Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2017., Peer reviewed, Sound Level Meter, Smartphone, Applications, Android, iOS
Presence of nicotine in marketed nicotine-free e-liquids for electronic cigarettes
Background and Purpose: Ever since the electronic cigarette made its debut in the market, it has been garnering great popularity due to public perception of it being a safer alternative to conventional cigarette. As a result, aside from being utilized in tobacco cessation programs, susceptible populations such as teenagers are slowly adopting this new trend of recreational E-cigarette smoking or “vaping”. The literature review conducted suggests that not only do different E-cigarette models exhibit different delivery efficiencies regarding percentage nicotine vapourization, there are discrepancies between what is labelled by the manufacturer and the actual nicotine content in the electronic cigarette liquids. This has serious public health implications because nicotine is the active chemical component in inducing addiction in cigarettes. As a result, recreational electronic cigarette users such as teenagers, may unknowingly become exposed to improper levels of nicotine, leading to a higher probability of nicotine dependence or switching to conventional smoking. The purpose of this study was to determine whether presence of nicotine can be detected in marketed nicotine-free electronic cigarette liquids. Methods: The nicotine content in electronic cigarette liquids was isolated and determined using Gas Chromatography Mass Spectrometry. Descriptive and inferential statistics was conducted using NCSS11 to see if there was a statistically significant difference between the labelled concentration of 0 mg in marketed “nicotine-free” electronic cigarettes from two popular brands, VapeWild and Mt Baker Vapour, to determine whether one brand has better quality control for nicotine content in nicotine-free E-liquids compared to the other brand. Results: Based on the analyzed E-liquid samples from the two brands, no nicotine was detected. Conclusion: E-cigarettes can be putatively considered as a safer alternative to conventional cigarettes because nicotine levels can be pre-determined and limited with a high degree of confidence., Peer-reviewed article, Published., Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2017., Peer reviewed, Electronic cigarette, E-liquids, Nicotine, Accurate labelling, Addiction
Quantification of temperature fluctuations in restaurant coolers and modelled Listeria monocytogenes growth
Background: Coolers in food service establishments should ideally operate at 4°C or less. However in restaurant environments cooler doors are continually being opened and closed as food workers gather and store items. These actions may lead to temperature fluctuations in coolers which may pose a health risk towards the storage of potentially hazardous foods. This study measured and analyzed temperature fluctuations in coolers and quantified the risk they presented by modelling Listeria monocytogenes growth in response to these temperatures. Method: ACR Systems Inc. Smart Buttons were placed near the opening of restaurant coolers and recorded temperatures over a 1-week span. Food Spoilage and Safety Predictor (FSSP) was used to model L. monocytogenes growth in response to the collected cooler temperatures. Results: Coolers spend significantly less than 50% of the time above 4°C. The magnitude of temperature fluctuations during open business hours was found to be insignificant in comparison to fluctuations during closed business hours. However, fluctuations were significantly greater in reach-in coolers than in walk-in coolers. With respect to modeled L. monocytogenes growth, it was inconclusive on whether growth would be more or less than Health Canada’s 100cfu/g policy in smoked salmon. However growth was significantly less than this limit in ready-to-eat ham. Conclusions: More restaurant coolers need to be analyzed to confirm whether the defrost cycles of coolers have a greater impact on temperature fluctuations above 4°C than the daily activities of staff members. In addition, more coolers need to be analyzed to determine whether L. monocytogenes growth in smoked salmon stored in coolers for a week grow significantly more than 100cfu/g. However, it can be concluded L. monocytogenes growth will be significantly less than 100cfu/g in ready-to-eat ham and will pose a lower risk for listeriosis than smoked salmon., Peer-reviewed article, Published., Project submitted in partial fulfillment of the requirement for the degree of Bachelor of Technology in Environmental Health, British Columbia Institute of Technology, 2017., Peer reviewed, Restaurant, Coolers, Temperature, Fluctuation, Listeria monocytogenes, Growth, Smoked salmon, Ready-to-eat ham