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Manny Halpern, Ph.D., CPE visits as part of interdisciplinary research training...


More than 30 ERC students and faculty gathered on November 18th, for discussion with Dr. MannyHalpern, PhD, CPE, of the NYU School of Medicine and the Hospital for Joint Diseases regarding his experience in introducing ergonomics in Environment of Care .  He described the pilot project program which he discusses in his publication “From Research to practice: The application of NIOSH model ergonomic program in a healthcare setting” (Halpern, 2009). He spoke candidly about the challenges of promoting recommendations for improved ergonomics in the workplace. 
Dr. Halpern discussed process outcomes, facilitators, and potential barriers, including difficulty collecting relevant data and the limitations of OSHA logs, as opposed to lost work time data, to reflect the impact of an ergonomic program, potential employee concerns about their participation in the study, and perceived managerial constraints. He proposed incorporating recommended modifications into capital, rather than operating budgets, in order to sustain the program. Considering ergonomic recommendations in the planning and architectural phases of new and renovation construction of a healthcare facility, as a capital expenditure, results in cost savings for the organization, in reducing occupational musculoskeletal injuries and subsequent lost work time. He indicated that facility financial decision-makers would support “evidence-based architecture” as a cost-effective method of implementing ergonomic recommendations.
In addition, Dr. Halpern introduced an exciting new concept which could impact advancement of NIOSH recommendations in healthcare settings. By focusing on “healthy computing” in a pathology laboratory, he realized that an unexpected outcome of his study was the discovery that ergonomic issues impact patient safety, patient privacy, and Americans with Disabilities (ADA) compliance.   For example, the awkward and uncomfortable position in which lab technician had to enter data into the computer raised the potential for errors, which potentially impacts patient safety. He further discovered that the door to the lab was not wide enough to accommodate wheelchair access, necessitating phlebotomy being performed in the doorway of the lab blocking access to the lab and compromising patient privacy, as well as the musculoskeletal health of the lab technician, who had to perform the task in an awkward position since lighting in the doorway was poor. He concluded that conducting ergonomics in settings where the human being is the ‘work object’, such as healthcare and hospitality services, required a system approach to identify ergonomic problems. Considering the need for a systems approach, Dr. Halpern suggests that there is a need for more research to explore a potential link in healthcare work settings between ergonomic concerns related to employee safety and patient safety, patient privacy, and ADA compliance issues. Dr. Halpern further explained that, historically, NIOSH recommendations affecting patient safety elicit a more rapid response through JCAHO than OSHA enforcement of employee safety regulation. Therefore, an organization may map out those ergonomic concerns related to patient safety, which may affect also employee safety, as a strategy for more effective enforcement of ergonomic recommendations.
Dr. Halpern also toured laboratories and had discussions with students and faculty about on- going and collaborative research. He is a faculty member in the NY/NJ ERC.    
Halpern M. (2009). From research to practice: The application of NIOSH ergonomic model      
program in a healthcare setting.  Journal of the Association of Occupational Health
Professionals in Healthcare, 29, 21-24. 

Environmental Justice Tour

On September 15, University of Cincinnati students and faculty attended an Environmental Health and Justice Tour in Louisville, KY. 

Environmental justice is the union between the physical and the cultural environment.    It is the idea that all areas of our environment are important including wildlife and wetlands, urban habitats, industrial facility sites, and industrial development.  Environmental justice addresses the idea that all humans should be living in healthy environments free from pollution caused by industrial facilities. 

Participants of the tour met in West Louisville early for a welcoming speech and light breakfast.  During the opening session, speakers presented on environmental justice goals and how important it is for everyone in the community to work towards the improved health and well-being of others.  The focus of this tour was to educate all participants on the injustice occurring throughout the country involving low-income communities.  Low-income and minority communities have been a target for air, water, and land pollution.  Many industrial facilities, waste-sites, and incinerators have been built near low-income and minority communities.  These sites expose these populations to a multitude of pollutants.  The common opinion given by supporters of environmental justice is that industrial facilities build their waste-sites and incinerators in areas where the community doesn’t have a voice, meaning they are unable to make their appeal due to lack of funding and political support. 

After the opening session, participants loaded two school buses and toured industrial sites located throughout West Louisville.  A tour guide on each bus educated the participants on each site visited and the impact the sites have had on the environment and communities.  The following are some of the sites visited on the tour. Pictures of the tour can be viewed by going to the following webpage:

Gallagher Power Plant: This plant is located across the Ohio River in Indiana.  It produces enough energy for 200,000 homes.  Gallagher Power Plant predates the Clean Air Act, meaning it does not have to install scrubber systems to reduce air emissions on all of the old mechanical systems.   Because of the wind direction, most of the air emissions are blown into Kentucky.  The Jefferson County Air Pollution Control District has estimated that 8-9% of the county’s nitrogen oxides are coming from this power plant. 

Ford Automobile Assembly Plant:  This plant is no longer in production.  However, from 1925-1955 it produced over 1.6 million vehicles, including Model A’s and T’s.

Morris Forman Wastewater Treatment Plant: The plant started treating water is 1959 and is the district’s largest water treatment facility. It removes 97% of the solids from storm water and wastewater using activated sludge. Area residents have complained about the odors emitted from the plant.  Scrubbers have been installed to help reduce odors and aluminum covers are being installed over all open areas of the treatment process. 

Rubbertown began in 1918 with the construction of Standard Oil.  Two more oil refineries were constructed over the next 20 years.  It is in this area that Louisville became a center for the production of much needed rubber during World War II.  Rubber companies built in the 1940’s include National Carbide, B.F. Goodrich, Phillips Petroleum and DuPont.  This area is home to Carbide Industries, which produces acetylene (used to produce vinyl chloride), calcium carbide (an alternative energy source), and calcium hydroxide (waste by-product).  For years, the company piped the by-product, calcium hydroxide, under a small road, Bells Lane, from the plant to a 10-acre waste pile near the plant.  In 1963, the pile spilled over and covered Bells Lane and much of the company’s southern parking lot, contaminating over 75 acres of land.

 Carbide Industries

 Another chemical plant in the area, Lubrizol, has a partnership with three other companies, Zeon, OxyVinyls, and PolyOne.  All four companies share one plant and produce materials to manufacture rubber, vinyl house siding, PVC pipe, and cable insulation. Rohm and Haas has been a resident of Rubbertown since 1960.  The facility produces plastic additives used in PVC piping, house siding, and packaging. The plants in this area produce products that have been linked to fatal liver cancer in exposed workers.  This production also adds to air toxins that greatly exceed the recommendations set by the EPA.  DuPont Chemical produces Freon, vinyl chloride, and hydrochloric acid using ozone-safe, non-chlorofluorocarbon (CFC) products.  Hydrochloric acid is a by-product that the company, in the past, injected into underground wells.  Since 1992, the facility has found markets to sell their acid for beneficial use.

A combined release of over 3 million pounds of air toxins annually can be attributed to the industries in Rubbertown.  12 monitoring stations have been placed in the area and analysis has shown elevated concentrations of chemicals, which place residents at higher risk for cancer, including  1,3 Butadiene, Acroylonitrile, Formaldehyde, Perchloroethylene, Ethyl Acrylate and Benzene.

In the 1880’s African Americans in West Louisville first inhabited an area now called “Park DuValle”.  This community was built near the Rubbertown manufacturing facilities.  It is believed that African Americans were pushed into this area of Louisville because living near the manufacturing facilities was undesirable.  In the 1990’s this was a high crime area.  The city of Louisville, along with the US Department of Housing and Urban Development (HUD), rebuilt the area to make it a safer area to live.  The continued focus for Park Duvalle and the surrounding neighborhoods will be reduction in the chemical emissions and cleaner air.

Lake Dreamland, another stop on our tour, began as a community of small summer cottages on the Ohio River.  The property has a small lake created by damming a tributary of the river.  With the WWII construction of the chemical plants in Rubbertown, the area was abandoned by the wealthy.  Lack of available sewage wastewater treatment led to sewage being disposed of in pits filled with rock.  Groundwater flows through the rock and ends up in the lake and river.  Due to pollution issues, the city purchased the cottages in 1987.  The cottages were sold to residents for $1 with a stipulation that the current owners will, at death, allow the land to revert to the county.

Of particular interest on the tour was the Lee’s Lane Superfund Site.  From 1940 to 1975, the site was operated as an industrial and domestic waste landfill.  The site lies in the Ohio River flood plain, which floods every year, and the waste pit is in direct contact with area groundwater.  In 1975, residents living next to the site reported “blue sheets of flame” near their water heaters.  Explosive levels of methane gas were discovered and homes were evacuated.  The state later discovered 400 drums of hazardous waste materials with more than 50 chemicals, including benzene and heavy metals.  The EPA spent $2.2 million to clean up the surface, but toxic gas venting and monitoring continue today.

 Dr. Tracey Yap (back row, 3rd from left) and University of Cincinnati nursing (Diane Busch-front row, 1st from left), and Industrial Hygiene (Amy Turner-front row, 2nd from left) students.

Sadly, the area has many issues with soil, air and water contamination along a beautiful stretch of the Ohio River.  Only with continued vigilance, activism, and remediation will the problems begin to resolve.

This tour was sponsored through the Passionist Earth and Spirit Center.   The Earth and Spirit Center serves to educate others about the sacredness of the Earth and all its’ inhabitants through spiritual practices, transformative learning opportunities, and community action. 



Eastern Kentucky Coal Mine Trip--ICG and TECO


The ICG surface mine and restoration areas and the TECO wash plant were the sites of a student and faculty visit on September 21. Don Gibson, Director of Permitting and Regulatory Affairs for ICG in Kentucky organized the visit for 14 students and three faculty members. Paul Jackson of TECO facilitated the visit to the preparation plant.
During the bus trip to Hazard, KY, students reported on topics each selected as an introduction to the group to mining. These were:
     Mine Safety and Health Administration (MSHA)
        Job Task Analysis and Miner training     
        Training of Surface Miners
        Silica Exposure
        Accidents and Injuries   
    Mine environment
        Coal Preparation Plants
        Dust Control in Mining
        Occupational Exposure to Respirable Coal Dust
        Secretary of Labor's Advisory Committee report
        An Analysis of Job Stress in Mining
        An Oral History of Mine Emergency Response  
    Life in Coal Country
        Lost Mountain
        Coal and People
        Music of Coal 
We arrived in Hazard on Sunday, September 20, to attend the last hours of the Black Gold festival. The food and music were good. And it was nice to get off the bus!
After safety training and an introduction to wash plant technology on Monday, September 21, we toured the TECO wash plant near the center of Hazard. 13,500 tons of coal are processed hourly from the stockpile further up the mountain. The facility is operated 24/7, with one maintenance day weekly; the maintenance budget is $1.2M per month. Pictured is Shannon, one of the wash plant operators, providing details on the plant operations to the students. During our tour we learned just how important coal is to our country and Kentucky with 50% of the U.S. energy derived from coal and 92% of Kentucky energy from coal.
Long lines to get lunch indicated that we should have packed the TECO donuts! Finally we departed Hazard for the ICG Thunder Ridge surface mine in Leslie County. The trip gave a great view of hollows and steep mountain roads. Everyone agreed it would be a challenge to meet a coal truck coming down the road on a snowy day.
An ICG partnership with EKU faculty has resulted in a bee research project. The bees are healthy and the number of hives increasing. Tammy Horn, PhD, informed us that the hive population has already reached 150,000 bees! When we were there, lots of flowering plants were seen, and the bee smoke was appreciated as many came out to say ‘hello’.
Effort is devoted to introducing plants to be pollen sources for the majority of the year; the newest to be added is sour wood that blooms in the hot days of summer. In addition, evergreen, oak, and maple trees are planted during the reclamation efforts by the mine. These trees are important as they will serve as an economic product for the local population as the mining industry moves.
ICG is also a key partner in the elk restoration project. Our timing was poor, and the elk were napping in the woods. The herd has grown substantially faster than predicted in the habitat now being created through reseeding with trees and grasses. The history of regulatory requirements following mountain-top removal mining was reviewed. The difference between the autumn olive and scrub grass that could survive on the compacted surface was quite a contrast to the more natural surface that is now allowed. We tromped through the uneven surface, and found hard and softwood plantings taking root, and lots of wild flowers undoubtedly brought in by the birds.
The scale of surface mining was demonstrated as we watched operations at the face. One truck stopped so that we could stand near it, to better understand the scale, and be close to a tire that costs $30,000 each! Pictured with the students and faculty is Tyler Wright, the site’s engineer.
Comments from the trip included:
            I had no idea they are concerned with reclamation
            Before this trip, I had limited knowledge of where coal came from
            This company cares about what the community thinks
            I had not heard the positive side of mining
            Mountain top removal mining does drastically affect the landscape, but the land is returned in a more usable state 
            I was impressed with the bee and elk projects
We are indebted to Phyllis Campbell Trosper who works in the Department of Environmental Health business office for helping us contact ICG through her nephew Larry Baker who is an employee there. It was great to meet Shannon at the prep plant, and Tyler and Nate at the mine.
Some photos are shown below, and a full album can be viewed at

Cincinnati Health Department Plans Healthy Homes Program

            Occupational Health Nursing MS student, Diane Busch-James, spent the summer working with the City of Cincinnati Health Department to plan the implementation of a CDC funded Healthy Homes program for the low-income population of Lower Price Hill.  The program addresses home issues that affect health such as mold, rodent and cockroach infestation, pet dander, smoking, lead, sewer gas, mercury, formaldehyde and other VOC’s, child safety, fire safety and injury prevention in the elderly.

            The CDC estimates that there are more than 6 million substandard houses and apartments in the U.S.  These conditions place the residents at increased risk for asthma, injuries, falls, childhood lead poisoning and other toxin induced illnesses.  The Healthy Homes program takes a comprehensive approach and requires the Health Department to look at the entire home environment.  It is felt that education and remediation can significantly reduce the exposures and thereby reduce the costs and number of medical and emergency visits, and, overall, provide the residents with a higher quality of life. 

            The program incorporates concepts such as the use of Integrated Pest Management.  The use of pesticides and rodenticides has added to resident exposures to chemicals, particularly in multi-family housing units. IPM teaches residents elimination of sources of food, water and harborage and choice of the least toxic products to destroy the invading insects or vermin.  The program advocates resident uses of cleaning products that are less hazardous, particularly those that give off less VOC’s, but are still effective in the elimination of dust, allergens and infectious agents.

             Revisions were suggested for the Sanitation Code to incorporate Healthy Homes concepts.  The program will not depend on voluntary compliance. Owners will be cited for leaking structural and plumbing issues.  Ventilation will be required in all bathrooms to remove excessive moisture and with all gas appliances, dryers, stoves, and heaters.  Residents will be cited for excessive clutter and cleanliness issues that contribute to infestation. 

             Research was completed in locating successful existing programs throughout the U.S.  and in finding educational materials appropriate to the population. Development of understandable, population appropriate materials is essential to increasing the knowledge of the residents and to the overall success of the program.  Many cities have implemented the program with success and they are willing to share the details of their programs. With materials provided, the Health Department will be able to contact other health departments for information and easily develop the educational component of the program. 

            Theory-based interventions were also addressed, as the program will require both increased community awareness along with individual interventions.  The sanitarians were given a basic knowledge of Diffusion of Innovations Theory and the Transtheoretical Model.  These theories will help with dissemination of information into the community and with individual behavior changes.  Of particular concern in this program is the exposure to secondhand smoke in the home.  Interventions will include increasing the resident’s knowledge of the effects of secondhand smoke on children and referrals to smoking cessation programs.

            Overall, much was learned from the employees at the Health Department who are dedicated and committed to improving our health.  They spend many hours inspecting city restaurants, tattoo parlors, some very nasty residences, and even our own University dining facilities.  Many thanks to Assistant Health Commissioner, Dr. Camille Jones, who heads the Community Health and Environmental Services Division and who promotes collaborative efforts with the University Education and Research Center. 

Heat Stress Sensor Project: Occupational Medicine, Environmental and Occupational Hygiene learn new techniques

Two new sensor technologies are being added to the research capability of the ERC.

The first is an ingestible pill sensor which can transmit signal from within the subject to a remote monitoring device. The monitoring device can be jacked to a computer or can be wireless. The pill is of the size of a big capsule and transmits the core temperature of the subject who swallows it. A single receiving monitor can be used to record readings from multiple pills. The monitor can be used to either display real time data or record data that can be retrieved later. The pills are calibrated by the manufacturer. Each pill comes with a serial number and model number that identifies the calibration parameters for that pill. At use, the pill is registered in the monitor.  
The second research tool is a band heart rate sensor. It is much like the one used in sporting activities.  Data from this sensor is recorded in the same monitor as the heat pill. Data for a selected heat pill and heart rate sensor can be displayed on a screen in real-time.  
In August, Jessica Ramsey and Chad Dowell from NIOSH provided hands-on training to UC students Amy Turner, Ashutosh Mani and Joe Hoffman (EOH) and Dr. Kristen Musolin (OMR). The new tools are in Dr. Amit Bhattachary’s lab in Kettering. 

Interdisciplinary trip to West Virginia

Several ERC students and faculty participated in an interdisciplinary trip to scenic West-Virginia in June.  The destinations included NIOSH in Morgantown, Beckley Mine Health and Safety Academy, and Beckley demonstration coal mine. In Morgantown, the group was greeted by several former ERC students who currently work at NIOSH in Morgantown.



Students join NORA seminar, North Carolina ERC

Students from Occupational Health Nursing and Environmental and Occupational Hygiene participated in the presentation by Dr. John Howard, former director of NIOSH and currently a special consultant to the agency. He discussed the changing nature of work and workers.  There was lively discussion during the session, viewed in the Howard Ayer Computer Laboratory on August 26.


Interdisciplinary Team Accomplishments


Community-based information resource
Cincinnati Interfaith Workers Center
Industrial Hygiene Masters students, Joe Hoffman and Amy Turner, initiated a project with the Cincinnati Interfaith Worker’s Center, an organization that strives to educate and assist low-wage and immigrant workers. Workers that belong to the Center and Center leadership indicated that they would like health and safety information about workplace hazards. A bulletin board with OSHA information on subjects including amputations, electrical safety, portable generator safety, and the dangers of lead exposure was created and installed at the Center. All information was made available in English and Spanish.   A question/concern envelope was also placed on the board so that workers interested in receiving more information on specific topics or with a question about their workplace could get answers. Occupational Health Nursing MS student Diane Busch-James and hygiene MS student Don Goins provided support work on this project. Drs. Carol Rice and Sue Ross have provided faculty mentoring on this project.
During the coming year, we will keep the bulletin board restocked with information, attend monthly membership meetings and answer questions from the members.
Responsibility for answering questions is shared among the ERC disciplines: nursing, medicine, safety and hygiene. In response to request for medical resources, the occupational medicine residents are organizing a list of potential local health care resources, including health care providers, health care organizations and health information sources in the Greater Cincinnati area.  

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