Environmental Public Health Journal 2017 | BCIT Institutional Repository

Environmental Public Health Journal 2017

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Are absorbent pads suitable alternatives for tattoo dressing?
Background: Tattoo is a form of body modification that involves injecting ink underneath the epidermis using a needle. According to BC’s Guidelines for Personal Services Establishments this kind of invasive procedure will require wound dressing but the kind and sterility of the wound dressing has not been specified. During a tattoo convention an Environmental Health Officer (EHO) noticed that some tattoo artists were using absorbent pads for wound dressing. Absorbent pads are not sterile; therefore there is a concern of microbial infections at the tattoo wounds. This study examined the viability of using absorbent pads, which are non-sterile, as tattoo wound dressings. Method: 3M Quick Swabs were used to swab absorbent pads to collect the microorganisms present on the surface. 3M Petrifilm E. coli/Coliform Count Plates were used to culture E. coli and Coliform which could be present on the SanidermTM sterile tattoo dressing and absorbent pads. The presence of E. coli colonies on the petrifilm would show up as blue dots, while coliform colonies would be red dots. The total colony forming units (CFU), which include both E. coli and coliform colonies, were counted to assess the general sanitation conditions of both types of dressing. Results: Zero CFU were found from sampling the SanidermTM dressings and absorbent pads purchased from tattoo supply shops within Metro Vancouver. Conclusions: In the field of Environmental Health, coliform is often used as an indicator for the degree of sanitary quality; while E. coli is used as an indicator for fecal contamination. Therefore, the results of this study, indicated that the absorbent pads have high degree sanitation and are free from fecal contamination., 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, Absorbent pads, Meat pads, Tattoo, Dressing, Wound dressing, Sterile dressing
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
Efficacy of chlorine sanitizer spray bottles exposed to various temperatures and ambient light
Background: Gastroenteritis is largely under reported across Canada. It is estimated that one reported case represents on average 313 cases. In addition, improper cleaning is one of the top ten reported causes of food borne illness. Sanitization is important to reduce the number of pathogenic microorganisms present on food contact surfaces to a safe level. Correct concentrations of sodium hypochlorite are to be prepared and used within the range of 100ppm – 200ppm on food contact surfaces. The purpose of this study was to evaluate the rate of degradation of sodium hypochlorite in spray bottles to assess if these solutions need to be prepared fresh daily to achieve efficacy. Two variables seen within a food service establishment were chosen to evaluate the rate of degradation, temperature and ambient light. Method: Room temperature (20˚C), 35˚C and ambient light exposure were tested to evaluate their effect on the degradation of free chlorine in spray bottles over time in days. The experiment was preformed by setting up 3 individual spray bottles at 20˚C with no light, 20˚C with ambient light and 35˚C with no light. The sodium hypochlorite was then sampled and recorded periodically three times a week over a 15-day period to determine the stability of the chorine solutions prepared at around 200ppm. Results: In the order of spray bottles tested, 20˚C no light, 20˚C ambient light and 35˚C no light, a correlation coefficient of -0.3027, -0.8235 and -0.8169 were recorded. In addition, the following test spray bottles held a r-squared value of 0.0916, 0.6781 and 0.6674. A p-value of 0.5094, 0.0249 and 0.0249 were also assessed, with a corresponding power of 8.99%, 73.74% and 71.75%. Conclusions: By calculating the linear regression formula, it was concluded that chlorine solution in spray bottles do not need to be prepared fresh daily. For 200ppm 20˚C no light, 200ppm 20˚C ambient light and 200ppm 35˚C no light, at days 128, 67 and 45, the estimated concentration of sodium hypochlorite will be at the minimum requirement of 100ppm respectively., 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, Chlorine, Sodium hypochlorite, Sanitizer, Spray bottle, Temperature, Ambient light
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
Environmental health officers and climate change adaptation in British Columbia
Background: The average annual temperatures in British Columbia have been steadily increasing in recent history and are expected to continue to rise. Climate change impacts have a significant effect on public health, and adaptation to these changes is necessary. Environmental health officers (EHOs) are in a position to deliver climate change adaptation programs in public health. The purpose of this study was to assess EHO perception of climate change adaption and identify knowledge or policy gaps. Methods: A self-administered online survey created used Google Forms was distributed through e-mail and social media to EHOs in BC. The survey asked for demographics information, beliefs about climate change, adaption, and public health. Chi-square tests and descriptive statistics were used to analyze results. Results: There was a significant association found between working in a mixed urban and rural environment and the incorporation of climate change adaptation into practice and the belief that climate change has impacted public health in BC. No association was found between years of experience and incorporation of adaptation. Conclusion: While EHOs generally recognize the public health impacts of climate change, there are many barriers preventing EHO involvement in climate change adaptation., 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, Climate change adaptation, Environmental health officers, EHOs, Public health
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
Evaluating two methods of testing residual sanitizer concentrations in food service establishments
Objective: Utensils and tableware are food contact surfaces that have the potential to transmit disease-causing microorganisms if not washed, cleaned and sanitized correctly in a food service establishment. To prevent utensils and tableware from becoming vectors of disease, it is essential that operators and staff are able to adequately sanitize them and accurately test for it in a quick and convenient manner. It is also essential that Environmental Health officers are able to test whether adequate sanitization is occurring during their routine inspections. Currently there are no guidelines indicating the correct method of testing. Therefore, this study investigated two methods used to test residual sanitation concentration in a dishwasher. The purpose of this research was to determine if there is any difference in the two methods currently being used, and if so, which method is the more reliable one. Methods: LaMotte Chlorine Test Strips were used to detect the levels of chlorine in a commercial dishwasher. The chemically treated strips were dipped onto a freshly wet and washed utensil and directly in the rinse water of a dishwasher. Results: The difference in the mean of 60 samples from two independent groups was analyzed. Thirty samples were obtained from location one, the dishware l, and thirty samples were obtained from location two, the rinse water of the commercial dishwasher. The mean residual concentration was calculated and compared. The means demonstrated there is a significant difference (p = 0.035)between the two groups; the average residual concentration was lower for the dishware compared to the rinse water. Conclusion: Dishware is a vector capable of transmitting disease causing microorganisms if not sanitized adequately. Thus, it is important to ensure that dishes in a food service establishment have been thoroughly sanitized. The testing of that requires a consistent and reliable method. It is safe to assume that testing on the dishware is the best course of action to err on the side of caution., 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, Test strip, Chemical dispenser, Chlorine, Low temperature dishwashers, Sanitation, Tableware, Rinse water
Evaluation of public health interventions in shellfish tag compliance rates
Background: The recent Vibrio parahaemolyticus outbreak in the summer of 2015 highlighted that shellfish tags are one of the key pieces of information used to trace back and determine the source of a foodborne outbreak or illness associated with raw or uncooked shellfish. According to the Canadian Food Inspection Agency, all shellfish tags must meet the requirements stated in the Section 7.3 of the Canadian Shellfish Sanitation Program (CSSP). Non-compliant tags may hinder national and regional regulatory agencies from identifying problems in harvest locations and at the processors, and further impede provincial control measures. As a result of the national outbreak, the BC Center for Disease Control (BCCDC), Ministry of Agriculture and the Canadian Food Inspection Agency (CFIA), as well as health authorities and Environmental Health Officers (EHO) have been involved in a variety of actions and interventions to improve compliance. These include efforts to promote education and to improve control and surveillance of V. parahaemolyticus and other shellfish associated illnesses. This study examined the effectiveness of health agencies’ interventions to improve shellfish tag compliance rates to Section 7.3 of the CSSP by comparing the numbers of shellfish tags in compliance before and after the interventions that were implemented in 2016. Methods: 120 randomly selected shellfish tags were grouped into “Before” and “After” interventions. By assessing the date of processing, 60 tags collected before September 2016 were placed into the “Before” group. Another 60 tags collected after September 2016 were placed into the “After” group. Within each group, shellfish tags were individually analyzed to determine whether the tag met or exceeded the required quality, information, and type and quantity criteria. Shellfish tags were considered “Compliant” if they completely fulfill 10 components embodied in the criteria, whereas shellfish tags that failed to meet all the components were labeled “Non-compliant”. Results: Based on the statistical analysis conducted on the data, there was a greater proportion of compliant shellfish tags post-intervention compared to pre-intervention. The Pearson’s Chi-square test confirmed that there was a statically significant association (p-value = 0.000) between the numbers of shellfish tags in compliance and the interventions that were implemented after the outbreak. Conclusion: The results have demonstrated that the interventions implemented by numerous regulatory authorities resulted in greater compliance to Section 7.3 of the CSSP. Public health regulators including the Ministry of Agriculture and the CFIA, as well as BCCDC and EHOs should continuously be involved in a variety of actions, such as promoting education at the processor and retail level and also implementing interventions to improve compliance. By doing so, successful interventions and increased compliance rates will lead to rapid identification of shellfish-related illnesses or outbreaks and facilitate control measures that can expeditiously remediate public health issues., 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, Shellfish tag, Food traceability, Seafood traceability, Shellfish processing facility, Shellfish biotoxin, Food safety, Public health
Evaluation of the daycare mangers’ knowledge, attitude, and practice on lead in drinking water at daycares licensed by the Fraser Health Authority
Background: Daycares in BC fall under the Community Care and Assisted Living Act which require all daycare facilities to provide a safe environment, including drinking water. Young children who have been exposed to lead in drinking water at schools and daycares can incur serious health effects, including damage to cognitive development. Previous research has demonstrated that even low levels of blood lead concentration are associated with intellectual disability, slowed growth and development, lowered ability to concentrate, decreased academic achievement and behavioural problems. Individuals’ knowledge, attitude and practice (KAP) on drinking water can influence on how the children consume drinking water and potentially cause adverse health effects. This study evaluated daycare managers’ knowledge, attitude, and practice (KAP) on lead in drinking water related to this issue. Method: This study was conducted by collecting 106 responses from a KAP survey to evaluate the knowledge, attitude, and practices regarding drinking water contaminants. The survey was distributed to daycare managers in Fraser Health region. The responses were analyzed with regression and correlation, one-way ANOVA, and chi-square tests. Results: There was a statistically significant correlation between the age of daycare manger and their knowledge (t-test = 0.0309). All other tests showed no statistical correlation, difference, and/or association (p-value greater than significance level of 0.05 on all parameters) between managerial experiences, age of managers, types of daycares in their knowledge, attitude, and practice regarding lead in drinking water in daycare facilities. The data of KAP questionnaires indicated that most daycare mangers do not fully understand and not are sufficiently educated regarding lead toxicity in drinking water. Conclusions: The results of KAP surveys showed that an educational intervention by the government or local health authorities is highly recommended and needed to improve the daycare managers’ knowledge, attitude, and practice regarding lead in drinking water. Additional research is required to confirm this., 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, Lead, Water contaminants, Drinking water, Daycares, Knowledge, Attitude, Practice, Perception
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
Knowledge comparison between group childcare centres and family childcares on sanitation of toys
Background: Childcare facilities (CCFs) are known to have a high potential risk of exposure and transmission of infectious diseases through contact surfaces, such as toys. Research to date suggests that toys are a potential source of cross-infections in CCFs, especially when childcare providers do not practice proper hygiene. Currently, there is a lack of knowledge on the differences in sanitation methods of toys between group and family CCFs. This study compared knowledge of group and family CCFs regarding how to sanitize toys. Methods: Self-administered surveys were distributed to group and family CCFs in Surrey, BC via e-mail. The survey was used to assess the knowledge of childcare providers on sanitation of toys. The survey was evaluated using a scoring system. In addition, each participant answered descriptive questions, such as the existence of sanitation plans and toy cleaning and sanitizing schedules. Results: Group and family CCFs showed no statistically significant differences in knowledge levels on sanitation of toys. The mean score of the knowledge level of group and family CCFs was 65% and 55% respectively. Conclusion: Childcare providers in CCFs play a key role in properly sanitizing toys and preventing transmission of infectious diseases between children. Recognizing knowledge gaps in sanitation can lead to policy development as well as improved educational programs., 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, Childcare, Group, Family, Children, Toys, Sanitation, Public health, Knowledge
Mean difference of coliform counts in relation to sanitation frequencies at the Simon Fraser University Childcare Society
Background: Young children in child care facilities are more likely to contract communicable diseases than if they are cared for at home. The relationship between pathogen presence and frequency of toy sanitation at these facilities is not well studied. Thus, the discrepancies currently seen in the hygiene guidelines between health authorities in British Columbia, Canada. Most childcare facility studies in the current literature focus on gastrointestinal outbreak situations or the sanitation of multiple surfaces. The focus of this project is on toys only. Toys made out of wood were selected because research shows that this material is more susceptible to harboring bacteria on it. Microbiological swabbing was performed to measure the effectiveness of the sanitation schedule of a child care facility in Burnaby. Method: Twenty-four wooden blocks were randomly selected for surface sampling. The 3M™ Quick Swabs were used to collect the bacterial coliforms before and after sanitizing the blocks, whereas, the 3M™ Petrifilm™ E. coli/Coliform Count Plates were used to enumerate the bacteria. The last time the facility had cleaned the blocks was 1.5 weeks prior to sampling. Results: There were 0 CFU/cm2 for before and after sanitizing the blocks, therefore, the mean difference was also 0 CFU/cm2. Inferential statistics could not be conducted. Conclusion: The results can be interpreted several ways. One interpretation is that the current toy sanitation frequency at the facility is good. It could also mean that, the methodology used was not able to detect any coliforms. In combination with the conclusions from the different studies discussed in the evidence review, the development of a prescriptive toy sanitation schedule for child care facilities would not be a high priority for health authorities., 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, Child care facility, Sanitation, Frequency, Colony-forming unit (CFU), Coliforms, E. coli gastroenteritis

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