Development of indicators for measuring outcomes of water safety plans.

Water safety plans (WSPs) are endorsed by the World Health Organization as the most effective method of protecting a water supply. With the increase in WSPs worldwide, several valuable resources have been developed to assist practitioners in the implementation of WSPs, yet there is still a need for a practical and standardized method of evaluating WSP effectiveness. In 2012, the Centers for Disease Control and Prevention (CDC) published a conceptual framework for the evaluation of WSPs, presenting four key outcomes of the WSP process: institutional, operational, financial and policy change. In this paper, we seek to operationalize this conceptual framework by providing a set of simple and practical indicators for assessing WSP outcomes. Using CDC's WSP framework as a foundation and incorporating various existing performance monitoring indicators for water utilities, we developed a set of approximately 25 indicators of institutional, operational, financial and policy change within the WSP context. These outcome indicators hold great potential for the continued implementation and expansion of WSPs worldwide. Having a defined framework for evaluating a WSP's effectiveness, along with a set of measurable indicators by which to carry out that evaluation, will help implementers assess key WSP outcomes internally, as well as benchmark their progress against other WSPs in their region and globally

Irrigation water issues potentially related to the 2006 multistate E. coli O157:H7 outbreak associated with spinach

A multistate Escherichia coli O157:H7 outbreak in August and September 2006 was found to be associated with consumption of fresh bagged spinach traced to California. The California Food Emergency Response Team (CALFERT), consisting of personnel from the California Department of Public Health Food and Drug Branch (FDB) and the U.S. Food and Drug Administration (FDA) undertook an environmental investigation to determine how and why the spinach became contaminated. At the invitation of FDA and FDB, the Centers for Disease Control and Prevention (CDC) also participated in the environmental investigation. This paper presents findings from the portion of the environmental investigation focusing on environmental factors related to irrigation water that may have contributed to contamination of the spinach and hence to the outbreak. Analysis of the available data suggests that depths to groundwater and groundwater-surface water interactions may pose risks to ready-to-eat crops. These risks should be further evaluated and quantified to understand and identify the factors that contributed to this and similar outbreaks. One implication of this analysis is the need to continue to conceptually broaden the scope of produce-related outbreak investigations. Where feasible, investigation strategies should integrate possible contamination sources beyond those actually found on the farms that are identified as sources of produce involved in outbreaks.California Agriculture Food safety Outbreak investigation Fresh produce Groundwater-surface water interactions

“Back to the Future”: Time for a Renaissance of Public Health Engineering

Public health has always been, and remains, an interdisciplinary field, and engineering was closely aligned with public health for many years. Indeed, the branch of engineering that has been known at various times as sanitary engineering, public health engineering, or environmental engineering was integral to the emergence of public health as a distinct discipline. However, in the United States (U.S.) during the 20th century, the academic preparation and practice of this branch of engineering became largely separated from public health. Various factors contributed to this separation, including an evolution in leadership roles within public health; increasing specialization within public health; and the emerging environmental movement, which led to the creation of the U.S. Environmental Protection Agency (EPA), with its emphasis on the natural environment. In this paper, we consider these factors in turn. We also present a case study example of public health engineering in current practice in the U.S. that has had large-scale positive health impacts through improving water and sanitation services in Native American and Alaska Native communities. We also consider briefly how to educate engineers to work in public health in the modern world, and the benefits and challenges associated with that process. We close by discussing the global implications of public health engineering and the need to re-integrate engineering into public health practice and strengthen the connection between the two fields