YOUR ASSOCIATION
Open Access
PRESIDENT’S MESSAGE
Rule #1 in Environmental Health: Expect the Unexpected!
Scott E. Holmes, MS, REHS
H ave you ever returned from conduct- ing a “routine” inspection and ex- claimed, “You won’t believe what I saw today!” Here are just a few unexpected things my staff found while doing “routine” inspections: • Unrefrigerated seafood stored for days in a van in the summer (ick). • A self-installed septic system with a single “lateral” discharging to a nearby creek. • A pool with 0 ppm chlorine and a broken chlorination system. The pool operator knew the chlorinator had failed a few days ago and was “waiting for parts.” • Very old, potentially explosive and toxic chemicals discovered during a food inspec- tion in the basement of a grocery store that was once a compounding pharmacy. Pic- ture in your mind crystallized picric acid, arsenic, and mercury compounds. The response involved environmental health and fire hazardous materials (hazmat) teams, police to evacuate adjacent build- ings and close off streets, and the bomb squad, who had a very cool robot that, unfortunately, could not do stairs. • A directional sound-generating device used by neighbor A to intentionally aggra- vate neighbor B. Neighbor B sold their property, sued neighbor A, and won. • Snakes in a well. (Really? Yes, really!) (Photo 1). Unexpected events in environmental health often seem so random. Can you pre- pare for them? I believe you can by building, sustaining, and empowering yourself, but more on that after a couple of real-life envi- ronmental health stories of the unexpected.
• Overall, four of the five ill children were in the same grade, and the other child was a sibling. • The ill teacher taught three of the five ill children. • Staff who became ill worked in or near the health office. • No pesticides or chemicals had been used in the school or on the grounds. The external environmental health rapid assessment did not identify anything unusual. The internal assessment, however, was a dif- ferent story. As we walked down the hallway near the affected students’ classrooms, we noticed a very slight odor. To me, the faint floral fragrance smelled like perfume. Mike, our experienced indoor air quality specialist who had a bloodhound-like nose for iden- tifying chemical odors, turned to me with a twinkle in his eye and said, “Pyrethrins!” Peering into a classroom, we saw children working on a special art project—making a beautiful bouquet of daisies to take home to their family. Students were handling the flow- ers, cutting and plucking leaves off the stems, and creating their own unique bouquet. Most appeared to be having great fun. We heard a couple of sneezes, and a few students had runny noses and watery eyes. Mike quickly explained that some varieties of daisies have natural pyrethrin in their stems. Handling the flowers, plucking leaves, and cutting stems would expose hands directly and release pyrethrin into the air, where it could be inhaled. Children and adults allergic to pyre- thrin would have an immediate IgE immune response (Type I hypersensitivity). The health aide was likely exposed while examining chil-
Flower Power One Friday afternoon before Mother’s Day, a school nurse called the environmental health department. Her voice was strained. Within minutes of each other, five students and two staff came to her health office with similar symptoms: itching, stinging skin, difficulty breathing, and dizziness. Her health aide quickly developed similar symptoms, but the nurse was not affected. She thought it must be an allergic reaction. With a single phone call, our TGIF mood switched to emergency response (ER) mode. Our ER Team met STAT (don’t you love acronyms!). We suspected a chemical expo- sure, perhaps a pesticide. The risk was high. Children were affected. Could this wave be the first of more illnesses? We quickly drove to the school. When we arrived, we formed two strike teams. One team interviewed those affected, and the other conducted a rapid environmental health assessment of the school. We found several clues to unlocking this environmental health mystery: Unexpected events in environmental health often seem so random. Can you prepare for them? I believe you can.
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Volume 89 • Number 3
https://doi.org/10.70387/001c.171783
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