Public Water Specialist; Sanitarian, Environmental Health Specialist, Industrial Hygiene Environmental Health Scientist, Safety, Bioterrorism, Emer. Mgt. Specialist, Injury Cntrl, Asbestos Specialist, Lead Specialist, Vector Control Specialist, Radon Specialist, Institutional Environments Specialist, Health Physicist Infection Cntrl, Housing Specialist Pool and Spas Specialist, including cruise vessel sanitation Consumer Safety Officer, Environmental Health Officer (e.g. U. S. Public Health Service, serving in a broad array of federal agencies) Ergonomics Specialist Food Safety Specialist On-site Waste Specialist OTHERS hazardous waste cleanup, pollution prevention specialist, urban growth planning and policy specialist, etc.

Florence Nightingale taught it, but she was reported to not believe in the germ theory!

Creating the Professional Practice Academic “Nexus” in Environmental Health American Public Health Association 131st Annual Meeting, San Francisco, CA Presented by: Dr. Steve Konkel, AICP Dublin Institute of Technology Environmental Health Science Course March 4, 2010

Who Are We?— As Environmental Health Scientists: We are problem solvers, educators, scientists, inspection & enforcement officers, advisors, and environmental engineers, and we play many more roles in our society as well!

What is the Value of Environmental Health? We make the difference between civilizations of the first order and civilizations of lesser orders! We are the difference between life and early death for the majority of people living in our communities! We work in the background of key decisions that safeguard the young and the old, the poor and the wealthy. Throughout the ages countries and their armies have achieved victory with our help.

Environmental Health The protection of populations and individuals from chemical, biological, radiological, and physical threats to their health and well being. Joe Beck, 1976 QUESTION: How does this compare with your definition of Homeland Security?

Knowledge Pyramid Information Facts Knowledge Personal Values Experience Prof.Values Decisions How We Make Decisions in Environmental Health

Knowledge Pyramid Information Facts Knowledge Personal Values Experience Prof.Values Decisions Note: We make decisions based on values, not based on facts. This has very important implications for strategic planning!

Part of the Employment Scope of Environmental Health

Job Opportunities Are Boundless in Env.Health If! You know the right questions to ask! You know where to look - 50,000 on the worldwide web (www. ) if you search the right Key Words! Environmental Health and Safety (and the other nearly 100 titles in use) Therein lies the threat to our identity, as well as our existence!

Why are we not sitting at the table of the U.S. Department of Homeland Security and why are we not playmakers in preventing bioterrorism and emergency preparedness efforts? Where was the call for our assistance during the anthrax episodes? Why did we not warn folks about the obvious air health hazards present from the 9/11 events? What Is the Health of Our Profession?

When was the last time you read about the shortage of Nurses in the United States? Have you ever heard about the Environmental Health Professional shortage? We believe that we are critical to National Security and essential to preventive measures to improve human health as well as the quality of life. It is ironic that while DHHS (Health Resources and Services Administration-HRSA), State and county health departments may not yet realize our appropriate roles, the military does!

ENVIRONMENTAL HEALTH “Our Apparent Irrelevance” Are the political folks who have never heard of us the ones we should attribute our profession’s irrelevance? What about the physician who does not know our professional capabilities,and thinks his or her profession is the best educated, most well positioned, and most competent in all areas affecting the health of individuals AND communities? Is the nurse who feels they have had a stake in environmental health since Florence Nightingale taught sanitary practice an asset to EH professionals or a competitor?

Symptoms of Problems Facing the EH Profession In excess of 50,000 new EHS jobs in the public and private sector of environmental health are going unfilled by qualified professionals. The Schools of Public Health and the National Environmental Health Protection and Accreditation Council (EHAC)- accredited environmental health programs graduate fewer than 1000 adequately prepared graduates each year. There is an apparent inability of both graduate and undergraduate programs in Environmental Health to recruit and graduate students.

Symptoms of Problems Facing the Profession The role of environmental health in Homeland Security is not recognized by the Federal government. Environmental Health currently has a lower profile and less professional identity than it had in the 1970’s. The division of the field by the creation of the federal EPA and OSHA, as well as missions for the CDC agencies, CPSC, and ATSDR (to cite only a few) has resulted in no visible EH counter parts at the county level. A lack of Ph.D.s in Environmental Health and/or with professional practice experience qualified to teach has limited the growth, visibility, and attractiveness of the field.

Symptoms of Problems Facing the Profession The lack of training or emphasis in using environmental health professionals in first responder roles. The current practice of Federal and state entities in cross training of nurses in environmental health in the face of a national nursing shortage. This shortage is so severe that hospitals are recruiting nurses from third world countries (sends quite a confusing message). The continual subdivision of the profession without the maintenance of a “common core body of knowledge.” The non-recognition of environmental health as an occupational specialty by the Peace Corps (it does recognize environmental science, however).

So What Do We Do? We learn to plan on a different scale! We become relevant to homeland security! We prepare for emergencies and disasters! We allow our leaders to know our capabilities! We think of our selves as indispensable professionals!

The Six States of Planning that Should Exist for All Environmental Health Programs and Disaster Preparedness Recognition of potential problem - This requires recognition of the scope and impact of potential problems. Developing a baseline for the current state of problems. Developing a first line of defense of prevention (pre-event). Developing the second line that mitigates the damage of the event in process. (intra-event) Developing the post-event response. Re-evaluation and refinement of plans.

The Six States of Planning that Should Exist for All Environmental Health Programs - Continued This should replace the older concept of planning that only dealt with: Pre disaster or event planning Reaction to the ongoing disaster or event Dealing with the post event or disaster

If we Accept this Planning Hierarchy…Then Where do We Start - Where is our profession’s plan to deal with SARS? What have we learned? Are we waiting on the Medical profession and researchers to do our work for us? What other profession has the responsibility to develop a proactive plan based in the sanitary sciences that we can use to represent our profession?

If we Accept this Planning Hierarchy “Then” - Where was our proactive plan in dealing with West Nile Fever? Have we updated our vector control plans since the 1960s? If so, how many mosquitoes breed in pool covers prior to opening each season? What are the true risks of DEET use (pre West Nile)? Do the new adult mosquito killing devices work?

How many gallons of water does it take to keep a population under stress alive? Is evacuation from disaster sites the best option for the public? How have you considered in-shelter protection and quarantine processes in your plans? Under what circumstances should they be used? What are the various ways you can use refrigerated trucks? Basic Decisions Require Essential Knowledge

Basic Decisions Require Essential Knowledge - Cont. Can you use stabilized chlorine for disinfecting drinking water? How would you handle and dispose of bodies of victims as a result of a class 4 pathogen? In the event of a massive summer power outage that requires weeks to repair, how would you keep heat deaths from occurring?

Basic Decisions Require Essential Knowledge - Cont. How can fire trucks deliver emergency drinking water? How many of you have practiced wearing a protective suit? How many professionals have their hazardous worker certification? Have you attended any meetings of your combined emergency reaction teams? Can a garden hose serve as temporary drinking water service?

This is not intended to be a quiz or make you feel uncomfortable but only to illustrate some basic knowledge and capabilities that each member of our profession should possess!

Step 1 -Achieving Relevance Know the definition of environmental health - then call your political representatives. Do not worry about the politician, talk to their staff (they are an undervalued resource) Tell them what you do and offer to advise them behind the scenes!

Step 2 -Achieving Relevance Become the expert in at least one area that impacts community health and survival. Go meet the staff of your emergency response group and tell them what you do--and offer your assistance as a volunteer! Publish what you have learned in your local paper or professional journals, and state professional newsletters.

Step 3 -Achieving Relevance Form state or national groups to develop an ascending set of recommended steps to safeguard individuals and communities from communicable disease threats. Publish these in the NEHA journal and ask for peer review from the readers. Ask to present these measures to the local boards of health and the Centers for Disease Control (CDC).

Step 4 -Achieving Relevance Participate in your National and State Organizations. Recommend a standard “common core of knowledge” for all new hires and support efforts with time and money to increase the profession’s visibility. Recommend a “Base Name” for all environmental health professionals, then worry about specialization. When in the public eye use the “environmental health base name.”

Step 5 -Achieving Relevance Develop local, state and professional organization Strategic Plans! If you do not know where you are going, how can you get there? Make sure the mission covers EH and that the vision is exciting. Include all internal and external stakeholders that want to be involved! Make sure the Goals of the plan achieve the vision. Provide time lines and responsibilities!

If we do not know who we are, if we do not know where we are going, and we do not know where we started, nor have a common base of knowledge - then - Do we truly exist as a profession?

Examples of Our Activities at Eastern Kentucky University to Achieve Key Goals & Form Linkages CDC Strategic Plan Goals & EKU Planning Efforts

An Example of a Vision We view the development of a “Nexus” (a crossroads, a connection, a partnership, a focus or an interface) between education and field practice as an essential first step in the survival of environmental health as a profession. Such a Nexus must return ownership of the profession to the best and brightest of the practicing environmental health professionals who are responsible for safeguarding and serving the public. It must further assist these leaders into filling oversight positions that provide effective and efficient roles in guiding the development of both the education and training of future environmental health professionals. We feel that this is intrinsic to the protection of future generations.

Creating the EH Academic / Professional Practice Nexus By: Joe Beck Steve Konkel & Darryl Barnett

Goal Six: “Create Strategic Partnerships” Partnerships currently exist with both the public sector (the Dept. of Defense-DOD, and the Dept. of Energy-DOE) and the private sector (Darden Foods, and several environmental consulting companies). These partnerships, in addition to our close relationship with the KY Dept. for Public Health, provide excellent opportunities to develop reality-based EH marketing, communication, research and training-program initiatives with the full participation of important EH stakeholders

EKU Investment Goal One of our Tactical Mission Goals is to - Develop and “grow” a model that will achieve racial and ethnic diversity in the recruitment and education of future Environmental Public Health Professionals

Goal Three: “Foster Leadership” Future leadership in EH will be impacted by the presence of a USPHS Commissioned Officer on the faculty; in turn, the development and future recruitment of well qualified individuals into the Public Health Service will be strengthened. The strength of the EKU program would lend itself to participation in CDC “fellowship” programs for both students and faculty.

We have not choice but to succeed! If we do not succeed then - we become Irrelevant to Public Health Practice

Conclusion Environmental Health is at a crossroad: We can protect individuals and communities from biological, chemical, physical and radiological health as innovators in developing policies and programs to protect public health. We can gain trust and credibility in the practice of environmental health, serving as one of the more influential professions in society. Doing nothing means that environmental health will become less relevant, ensuring that the medical and other allied health professionals will become overextended and governmental agencies who purport to serve community and individuals needs will be more reactionary in responding to events, rather than prevention-oriented. Environmental Health professionals should recognize the breadth of core competencies required for effective field practice and foster lifelong learning & education

Conclusion Environmental health professionals should strive to become systems thinkers and be able to integrate knowledge of various sub-specialties (some previewed herein), yet not fall short by acting as warlike,disparate factions. There is a natural alliance with the medical profession to encourage preventive efforts affecting environmental health. The Environmental Health mission must materialize both in times of war and crisis and in a proactive state to build the infrastructure which enhances our quality of life and health outcomes. It is our choice to be proactive. Reflection should lead us to integrate theory with practice, rather than divide into theory versus practice “camps.” The role of teams, partnerships, and relationships, based on compatibility of values, will bring us together. We are more alike in our aspirations than we are different. This transcends geography, professions, and cultures.. .

Conclusion The role of teams, partnerships, and relationships, based on compatibility of values, will bring us together. We are more alike in our aspirations than we are different. This transcends geography, professions, and cultures. .

Thank You for Your Attention! Comments, Questions? Dr. Steve Konkel, Program Coordinator and Associate Professor the Graduate Program_Environmental Health Science Eastern Kentucky University Dizney Building, Room 210 521 Lancaster Avenue Richmond, KY 40475 steve.konkel@eku.edu (859) 622-6343