Environmental Public Health Commons^™

Assessing The Relationship Between The Incidence Of Campylobacteriosis And Ecological Risk Factors In Tennessee, Emmanuel Angmorteh Mensah

Electronic Theses and Dissertations

Background: Campylobacteriosis although is the leading causes of bacterial diarrheal illnesses, have not gained prominent awareness and there are gaps in the understanding of transmission routes for sporadic, non-outbreak cases and their risk factors at the communal level to humans. This study, therefore, aimed to identify the campylobacteriosis risk factors and risk perception from the existing literature in the United States, determine the incidence and ecological risk factors for campylobacteriosis zip code level in Tennessee, and to perform spatiotemporal analysis of campylobacteriosis incidence cases in Tennessee.

Method: To achieve the first aim, a scoping review was conducted to synthesize …

Emerging Tick-Borne Diseases In Northeast Tennessee, Jacob Schultz

Electronic Theses and Dissertations

Tick populations have been immigrating into northeast Tennessee from east Tennessee, Kentucky, Virginia, and North Carolina. Counties in states bordering northeast Tennessee harbor tick species associated with human illness. Human diseases transmitted by ticks include ehrlichiosis, spotted fever rickettsial group diseases, tularemia, anaplasmosis, babesiosis, Lyme disease, alpha-gal syndrome, Heartland virus, Powassan virus, and southern tick-associated rash illness (STARI). These diseases cause morbidity and mortality in human populations and may pose a high risk to individuals, wildlife, and livestock. The Cherokee National Forest covering the east Tennessee border provides a permissible environment for ticks to immigrate and thrive. Residents of northeast …

Species Data And Vector Modeling: Evaluating Datasets For Improved Models Of Ixodes Ricinus Tick Distribution In Europe Under A Changing Climate, Steven Jones

Electronic Theses and Dissertations

To increase capacity for monitoring and surveillance of tick-borne diseases, publicly available tick distribution and climate change datasets are required to create accurate predictive distribution models. It is difficult, however, to assess model accuracy and utility when using incomplete datasets.  The more recent development of comprehensive tick databases for Europe and availability of climate change scenarios from multiple IPCC Assessment Reports allows for improved modeling efforts. Multiple tick datasets were combined and three climate change projections were compared by predicting current and future distributions of Ixodes ricinus ticks in Europe using the MaxEnt species distribution model. Overall, much of Europe …

Comparing Heatwave Related Mortality Data From Distressed Counties To Affluent Counties In Central And Southern Central Appalachia, Miranda Taylor Pardue

Undergraduate Honors Theses

The Appalachian Mountains are home to some of the most culturally rich places in the United States, but also some of the most impoverished communities as well. Several recent events support climate change across the globe. It is expected that Appalachian communities may suffer more dire consequences, as many communities lack strategies to help relieve some of the worst effects of climate change. Heatwaves are predicted to increase in duration and frequency over time, and communities that are not well prepared for the damaging effects of heatwaves can suffer unduly. This study aims to quantify the likelihood that people living …

Association Of Perfluorinated Chemicals With Endocrino-Carcinogenetic, Obesogenic And Metabolic Health And With Markers Of Chronic Inflammation And Oxidative Stress, Ogbebor Enaholo Omoike

Electronic Theses and Dissertations

First, this study examined the association of perfluorinated chemicals with 1) cardio-metabolic health outcomes and 2) the association of phthalates with cardiometabolic health outcomes, and 3) cardio-metabolic health outcomes while assessing the possibility of additive interactions between perfluorinated chemicals (PFCs) and phthalates. Second, association with markers of chronic inflammation and oxidative stress were explored. Finally, this study examined the association of these chemicals with estrogenic cancers- Breast cancer, prostate cancer, uterine cancer and ovarian cancer.

Using data from the National Health and Nutrition Examination Survey (NHANES), logistic regression models were used to investigate the relationship between PFCs and the cardio-metabolic …

Determining How Temperature Affects The Survival Of Salmonella And E. Coli Species In Sinking Creek: A Meta-Evaluation, Miranda Liner

Undergraduate Honors Theses

In recreational waters, pathogen pollution is a major concern for the USEPA. The USEPA is responsible for initiating the National 303(d) List of Impaired Surface Waters. Pathogen pollution from E. coli is a common reason why recreational waters are placed on the 303(d) list. E. coli O157 H:7 and other enteric pathogens can cause serious illness and even death. Sinking Creek is a part of the Watauga River watershed which runs through Carter and Washington county. Sinking Creek is currently listed on the 303(d) as impaired due to the presence of E. coli. Because of the known presence of …

Assessing Heat-Related Mortality And Morbidity Risks In Rural Populations And Sub-Populations, Emmanuel A. Odame

Electronic Theses and Dissertations

Heat stress is an environmental and occupational hazard exacerbated by climate change. Rural populations and sub-populations continue to experience disproportionate risks of heat-related impacts due to their low adaptive capacities in terms of infrastructure, information and other resources which are critical in dealing with heat. The study goals were to determine heat-related mortality risks in rural populations globally, explore the contribution of the outdoor work environment and other factors in association with occupational heat-related illnesses (HRI), and assess the risk of heat stress among crop workers using the Wet Bulb Globe Temperature (WBGT). Published peer-reviewed scientific literature on heat-related mortality …

Heat Waves And Heat-Related Mortality In East Tennessee, Taiwo Adesoba

Electronic Theses and Dissertations

Heat waves represent a public health challenge that requires multiple responses and warnings to protect vulnerable populations. Although studies have reported an increasing trend of heat wave occurrence in many areas of the world, no clear trend exists in East Tennessee. Using data from Parameter-elevated Relationships on Independent Slope Models (PRISM), CDC WONDER and the United States Census Bureau, the relationship between mortality rates and year was estimated during heat wave events between 1999 and 2010. Five heat wave definitions were tested. Overall, 2007 and 2010 stand out as the years with the highest number of heat wave days in …

The Influence Of Immigrant Generation On Obesity Among Asian Americans In California From 2013 To 2014, Shaoqing Gong, Kesheng Wang, Ying Li, Arsham Alamian

ETSU Faculty Works

Objectives We aimed to examine the association between immigrant generation and obesity among Californian adults and Asian Americans. Results Overall, 23.3% of the Asian population was obese, and 40.0% was overweight. The percentage of 1st, 2nd, and 3rd generation were 72.7%, 22.6%, and 4.6%, respectively. Overall, 1st generation of Asians had lower odds of being obese compared to Whites (OR = 0.34, 95%CI = 0.26–0.45). Multiple logistic regression analyses showed that overall, 2nd generation (OR = 1.69, 95%CI = 1.10–2.60) and 3rd generation (OR = 2.33, 95%CI = 1.29–4.22) Asians had higher odds of being obese compared to 1st generation …

The Ecology Of Fecal Indicators, Dennis A. Gilfillan

Electronic Theses and Dissertations

Animal and human wastes introduce pathogens into rivers and streams, creating human health and economic burdens. While direct monitoring for pathogens is possible, it is impractical due to the sporadic distribution of pathogens, cost to identify, and health risks to laboratory workers. To overcome these issues, fecal indicator organisms are used to estimate the presence of pathogens. Although fecal indicators generally protect public health, they fall short in their utility because of difficulties in public health risk characterization, inconsistent correlations with pathogens, weak source identification, and their potential to persist in environments with no point sources of fecal pollution. This …

Maxent Estimation Of Aquatic Escherichia Coli Stream Impairment, Dennis Gilfillan, Timothy Andrew Joyner, Phillip R. Scheuerman

ETSU Faculty Works

Background: The leading cause of surface water impairment in United States’ rivers and streams is pathogen contamination. Although use of fecal indicators has reduced human health risk, current approaches to identify and reduce exposure can be improved. One important knowledge gap within exposure assessment is characterization of complex fate and transport processes of fecal pollution. Novel modeling processes can inform watershed decision-making to improve exposure assessment.

Methods: We used the ecological model, Maxent, and the fecal indicator bacterium Escherichia coli to identify environmental factors associated with surface water impairment. Samples were collected August, November, February, and May for 8 …

Maxent Estimation Of Aquatic Escherichia Coli Stream Impairment, Dennis Gilfillan, Timothy A. Joyner, Phillip Scheuerman

ETSU Faculty Works

Background.The leading cause of surface water impairment in United States’ rivers and streams is pathogen contamination. Although use of fecal indicators has reduced human health risk, current approaches to identify and reduce exposure can be improved. One important knowledge gap within exposure assessment is characterization of complex fate and transport processes of fecal pollution. Novel modeling processes can inform watershed decision-making to improve exposure assessment.

Evaluating And Improving The Effectiveness Of Vehicle Inspection And Maintenance Programs: A Cost-Benefit Analysis Framework, Ying Li

ETSU Faculty Works

Motor vehicle inspection and maintenance (I/M) programs are designed to identify high-emitting vehicles and mitigate their impacts on air quality and climate. I/M programs have been traditionally ranked superior among various vehicle emission control measures by the results of cost-benefit analysis, based on the assumption that these programs will achieve the targeted emission reduction outcomes. However, the actual effects of I/M programs may be greatly uncertain and when this uncertainty is taken into account, these programs may become suboptimal. This study develops a new a cost-benefit analysis framework that links various program design consideration, such as program participation rate, identification …

Effects Of Global Warming On Work-Rest Routines For Crop Workers In Appalachia, Ken Silver, Ying Li, Emmanuel Odame, Yuqiang Zhang

ETSU Faculty Works

Background: Workers in outdoor occupations are expected to be at high risk of increased morbidity and mortality, and diminished productivity, as a result of global warming in the 21st century. A previous modelling study of geographic variations in heat-related mortality risk in projected U.S. populations mid-century showed the states of Tennessee, Kentucky and North Carolina to be highly vulnerable. Methods: Under both the RCP4.5 and RCP8.5 emissions scenarios of IPCC AR5, we evaluate the effect of future warming on estimated Wet Bulb Globe Thermometer (WBGT) temperatures using model-simulated future climate variables that were dynamically downscaled by a regional meteorology model …

Comparing Urban And Rural Vulnerability To Heat-Related Mortality: A Systematic Review And Meta-Analysis, Ying Li, Emmanuel A. Odamne, Ken Silver, Shimin Zheng

ETSU Faculty Works

Studies of the adverse impacts of high temperature on human health have primarily focused on urban areas, due in part to urban centers generally having higher population density and often being warmer than surrounding rural areas (the “urban heat island” effect). As a result, urban areas are often considered to be more vulnerable to summer heat. However, heat vulnerability may not only be determined by heat exposure, but also by other population characteristics such as age, education, income, baseline health status, and social isolation. These factors are likely to increase vulnerability among rural populations compared to urban populations. In this …

Salmonella And Aeromonas Contamination In A 303(D) Listed Water Body Compared To Fecal Indicators & Water Quality Parameters, Elizabeth M. Morgan Ms.

Undergraduate Honors Theses

Since the passage of the Clean Water Act, concern about surface water quality has increased. Reducing exposure to pathogens and adverse impacts on human health because of contact with surface waters has become the focus of many regulatory agencies. Fecal pollution is often a cause of surface water impairment. Fecal indicators, such as fecal coliforms and Escherichia coli, are used as surrogates to evaluate the presence or absence of fecal pollution. However, a growing body of research has shown that these species lack key characteristics necessary to be adequate indicators. As such, explorations into the efficacy of indicator species …

Biosand Water Filter Evaluation: Meta-Evaluation And Pilot Study Of Field Use Indicators, Bethesda O'Connell

Electronic Theses and Dissertations

Diarrheal diseases are a global public health burden, killing 1.8 million people annually. Diarrhea disproportionately affects children and those in poverty. Most diarrheal cases can be prevented through safe drinking water, basic hygiene and/or sanitation measures, with drinking water interventions having the most impact on reducing diarrheal disease. A meta-evaluation was completed of studies evaluating a specific household water treatment method, the biosand water filter. Results from the meta-evaluation illustrate that biosand water filters improve drinking water quality and reduce diarrheal disease. However, there is no generally agreed upon field method for determining biosand water filter effectiveness that is useable …

Associations Of Perfluoroalkyl Substances (Pfass) With Lower Birth Weight: An Evaluation Of Potential Confounding By Glomerular Filtration Rate Using A Physiologically Based Pharmacokinetic Model (Pbpk), Marc-André Verner, Anne E. Loccisano, Nils-Halvdan Morken, Miyoung Yoon, Huali Wu, Robin Mcdougall, Mildred Maisonet, Michele Marcus, Reiko Kishi, Chihiro Miyashita, Mei-Huei Chen, Wu-Shiun Hsieh, Melvin E. Andersen, Harvey J. Clewell Iii, Matthew P. Longnecker

ETSU Faculty Works

Background: Prenatal exposure to perfluoroalkyl substances (PFAS) has been associated with lower birth weight in epidemiologic studies. This association could be attributable to glomerular filtration rate (GFR), which is related to PFAS concentration and birth weight.

Objectives: We used a physiologically based pharmacokinetic (PBPK) model of pregnancy to assess how much of the PFAS–birth weight association observed in epidemiologic studies might be attributable to GFR.

Methods: We modified a PBPK model to reflect the association of GFR with birth weight (estimated from three studies of GFR and birth weight) and used it to simulate PFAS concentrations in maternal and cord …

Prenatal Exposure To Perfluoroalkyl Acids And Serum Testosterone Concentrations At 15 Years Of Age In Female Alspac Study Participants, Mildred Maisonet, Antonia M. Calafat, Michele Marcus, Jouni J.K. Jaakkola, Hany Lashen

ETSU Faculty Works

Background: Exposure to perfluorooctane sulfonic acid (PFOS) or to perfluorooctanoic acid (PFOA) increases mouse and human peroxisome proliferator–activated receptor alpha (PPARα) subtype activity, which influences lipid metabolism. Because cholesterol is the substrate from which testosterone is synthesized, exposure to these substances has the potential to alter testosterone concentrations.

Objectives: We explored associations of total testosterone and sex hormone–binding globulin (SHBG) concentrations at age 15 years with prenatal exposures to PFOS, PFOA, perfluorohexane sulfonic acid (PFHxS), and perfluoronanoic acid (PFNA) in females.

Methods: Prenatal concentrations of the perfluoroalkyl acids (PFAAs) were measured in serum collected from pregnant mothers at enrollment (1991–1992) …

"Nursing Contamination: Wearing Scrubs In Public", Kemble Green

Undergraduate Honors Theses

Nurses are frequently seen in public in their “scrubs,” which could mean that contaminated clothing is being brought into the community, thereby posing an infection risk. The purpose of this study is to investigate if and which contaminants are present on the fabrics and the actions nurses are taking to eliminate contamination risks.

Eleven scrub tops were worn on hospital units over one twelve-hour shift. The contaminated scrubs and three control tops were then swabbed and used to inoculate agar plates. After incubation, colonies were counted, streaked onto nutrient and Mannitol-salt agar for isolation, and incubated. Using API Staph strips …

Comparison Study Of The Averaged Sediment Microbial Enzyme Activities In Four Fecally-Contaminated Streams In The Same Watershed In Northeast Tennessee To Biochemical Oxygen Demand, Nitrate Concentration, And Phosphate Concentration, Brian G. Evanshen, Kurt J. Maier, Phillip R. Scheuerman

ETSU Faculty Works

Microbial enzyme activities (MEA’s) are measurements of microbial metabolism. These activities are dependent on the need for nutrients and respiration. This extended study evaluated four streams in the same watershed that had an approved fecal coliform Total Maximum Daily Load. Sediment and water samples were collected monthly for the first year of each specific stream study, and then quarterly to the end of 2006. Dehydrogenase, a measure of microbial respiration, along with acid phosphatase, alkaline phosphatase, galactosidase and glucosidase activities were measured using colorimetric assays. Biochemical oxygen demand (BOD) was determined using the standard 5-day test (BOD₅). Nitrate …

Comparison Of Microbial Water Quality Parameters Of Four Geographically Similar Creeks In Northeast Tennessee, Kimberlee K. Hall, L. K. Gallagher, Brian G. Evanshen, Kurt J. Maier, Phillip R. Scheuerman

ETSU Faculty Works

Four creeks within the Watauga River watershed in Northeast Tennessee are routinely monitored for water quality assessments. To identify sources and monitor remediation, Sinking Creek, Cash Hollow Creek, Buffalo Creek and Boones Creek are monitored for chemical and microbial parameters. These parameters include phosphates, nitrates, BOD and fecal coliforms. Sinking Creek is a tributary of the Watauga River with 10 miles of impaired water. Cash Hollow Creek enters the Watauga River at river mile 11.4 with 3.4 miles of impaired water. Boones Creek contains 18.6 impaired miles while the status of water quality in Buffalo Creek is not yet determined. …

Comparison Study Of Sediment Microbial Enzyme Activities To Biochemical Oxygen Demand, Nitrate Concentration, Phosphate Concentration In The Sediments Of A Fecally-Contaminated Stream In Northeast Tennessee Relative To Season And Land Use, Brian G. Evanshen, Kurt J. Maier, Phillip R. Scheuerman

ETSU Faculty Works

Microbial metabolism reacts quickly to environmental conditions. These reactions are dependent on the need for nutrients and respiration and can be measured using an assay of individual microbial enzyme activities (MEA’s). In this study, we measured MEA’s in the sediments of a stream in northeast Tennessee that had an approved fecal coliform Total Maximum Daily Load (TMDL). These values were compared to biochemical oxygen demand (BOD), phosphate concentration and nitrate concentration in the water column of this stream. Comparisons were grouped by season and land use. Stream sediments and water were collected monthly for one year and then quarterly for …

Preliminary Epidemiological Interpretation Of The Intrinsic And Extrinsic Factors Contributing To The Coverage And Participation Rates Of The Vaccination Program In Arssi, Ethiopia, Muchie Kidanu

Electronic Theses and Dissertations

Many immunization programs in developing countries arr now undergoing a period of rapid utilization. Innovative strategies, such as immunization holidays, are being tried. Political commitment and enthusiasm are high. There is a strong desire by health professionals to protect the lives of many children from the untimely death and/or disability resulting from infectious diseases preventable by vaccination.

Evaluation of an immunization program can benefit other elements of the health system, particularly those that are not amenable to objective evaluation as immunization. In this case, immunization can serve as an indicator of the overall performance of the health system. The problems …