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Your Environment. Your Health.

2018 Grantee Highlights

Katy May, M.E.M. – Promoting Community Engagement in Environmental Health

December 17, 2018

Katy May

Katy May strives to effectively address the environmental health needs of communities throughout North Carolina.
(Photo courtesy of NCSU)

Katy May, M.E.M., co-director of the Community Engagement Core (CEC) of North Carolina State University’s Center for Human Health and the Environment, is dedicated to enhancing environmental health literacy while facilitating meaningful partnerships between researchers and community groups. After college internships working with communities affected by environmental health issues, May grew to appreciate the integral role of community engagement in environmental protection. This realization motivated her to earn a master’s degree in community-based environmental management from Duke University. Since graduating in 2014, she has applied her knowledge and skills toward connecting science and the public.

Generating a Spectrum of Community Engagement

May has worked to promote a spectrum of community engagement, ranging from intimate community-based research activities to online resources available to the public. One program she created, Beer-Reviewed Science, fosters a dialogue between environmental health scientists and the public, who gather in a local brewery to discuss why research matters to the community. She also has found social media platforms to be invaluable for enhancing interaction with communities because they allow her to engage with those not connected to the local science and environmental scene.

May strives to be creative and to think of a variety of ways to make environmental health science relevant to the public and to create different access points for different audiences. “Not everybody wants the same thing and providing a range or a menu of different ways that people can be involved has been useful,” said May.

Leveraging Partnerships to Address Community Concerns

As CEC co-director, May has found team science to be integral to the Core’s success. According to May, “environmental health problems are inherently interdisciplinary, so having a group of scientists from diverse backgrounds related to environmental health helps to more robustly address community concerns.”

The CEC partnership with the N.C. Cooperative Extension, run by NC State and North Carolina Agricultural & Technical State University, exemplifies the importance of one partner helping to make a difference. Extension has offices in all 100 counties of North Carolina and, through these connections, May has been able to quickly gauge the needs of communities throughout the state. When GenX, a perfluorinated compound currently being researched for its potentially adverse health effects, was found in the Cape Fear River Basin, May reached out to Cooperative Extension agents in the area to assess the concerns of the affected communities. From there, she collaborated with stakeholders to determine appropriate paths forward, including community-engaged research opportunities.

May works to engage community members in protecting their environmental health.

May works to engage community members in protecting their environmental health.
(Photo courtesy of NCSU)

Another way May has worked to address community needs is through the Community Mini Grant program, a resource for non-profits and community-based organizations to secure funding to address local environmental health issues. “We look for not only the strength of the proposals but also how do they relate to NIEHS’s goals and the Center for Human Health and the Environment’s research goals. So far, we’ve been lucky that there has been really good synergy between the proposals we get and the issues that community groups want to address, and the research coming out of the Center,” she said.

The program, led by May since it began three years ago, has supported various projects, including training community members to clean up homes after Hurricane Matthew, measuring for emerging contaminants in the Haw River watershed, and citizen science air quality monitoring in low-income, high-minority neighborhoods in Charlotte, NC. Even when groups do not obtain funding through the program, May provides them with resources and technical support and refers them to other institutions, when possible. For example, when Duke’s Superfund Research Center was looking for community partners who were worried about contaminated soil, May connected the Duke researchers with relevant Mini Grant applicants. She values the capacity building and community partnership opportunities the program enables.

Improving Research Dissemination to Enhance Environmental Health Literacy

One of the biggest challenges May has seen in her work is the differing perspectives scientists and affected communities bring to the table, with major difficulties being timeliness and uncertainty. Communities facing harmful environmental exposures understandably want information on what this means for their health as quickly as possible. However, there are limitations to how quickly research can be conducted and how definitive the results can be.

May works to bridge this gap by facilitating effective communication of the science and its inherent limitations, in order to maintain public trust. She seeks to take educating the public about the importance of environmental health issues a step further by building their environmental health literacy, so they can make informed decisions that improve their health outcomes and quality of life.

To further pursue her passion for improving the public’s environmental health literacy, May is pursuing a Ph.D. in science education while maintaining her role as the CEC co-director. Her goal is to master how to communicate effectively while still maintaining the public’s trust, keeping them engaged, and building their overall knowledge of environmental health. “In this day and age there is a need for people to understand why science matters, why it’s important to us as voting citizens, and why funding it is important.”

Victoria Persky, M.D. – Environmental Research Rooted in Community Concerns

November 15, 2018

Victoria Persky, M.D.

Persky is a professor of epidemiology and biostatistics at the UIC School of Public Health.
(Photo courtesy of UIC)

Victoria Persky, M.D., is passionate about creating healthier communities in Chicago by addressing exposures and health disparities. A professor at the University of Illinois at Chicago (UIC), Persky’s involvement in environmental health research over the years has been driven by community needs.

Persky currently co-leads the Community Outreach and Engagement Core within the NIEHS-funded Chicago Center for Health and Environment (CACHET), a partnership between UIC and the University of Chicago. In that role, she engages with underserved minority communities in Chicago to identify and address potential environmental hazards of concern.

She also engages with Chicago communities through her research, which focuses on both asthma and hormonal effects of environmental factors. “It is important to listen to people in the community to understand what the big issues are,” said Persky. “Then it’s my job, as a researcher, to try to find ways to address those issues.”

Community-Driven Research

In response to community concerns about asthma, Persky and her team have documented wide racial disparities in the incidence and severity of the disease in Chicago. Her group has linked increased asthma to prenatal polychlorinated biphenyl exposure and stressful life events among other factors.

In addition to her research, Persky worked part-time at a community health center in West Chicago for most of her career. “That gave me a unique insight into the problems in underserved communities and how it could be integrated with the kind of research I was doing,” said Persky.

Through that experience, she learned that community members themselves were an important part of community outreach and engagement. She developed one of the earliest community-based peer educator programs in Chicago, aimed at decreasing environmental risk factors for asthma. This Community Asthma Prevention Program focuses on reducing the high rate of asthma hospitalization and mortality in low-income and African-American Chicago neighborhoods.

Linking Pollutants to Hormone Effects

Her community-based research has also focused on the effects of persistent organic pollutants (POPs) on the endocrine system, the series of glands in the body that produce and secrete hormones. She has worked with a variety of populations to examine these effects. Among these groups, she found that exposure to POPs impacted hormones in employees at a capacitor manufacturing plant and in adults consuming high levels of Great Lakes fish contaminated with POPs.

Persky now leads a research project to examine the effects of POP exposure on hormones and diabetes in a diverse Latino adult population. The study builds on the Hispanic Community Health Study/Study of Latinos, an ongoing cohort of 16,415 multi-ethnic Hispanics in Chicago, San Diego, New York, and Miami. The team is measuring biological markers in blood to examine whether exposure to a range of POPs could be affecting hormone and immune pathways, which may be linked to changes in glucose regulation associated with diabetes.

Addressing Disparities in Southeast Chicago

Waste in Chicago

CACHET aims to reduce health inequities within Chicago communities.
(Photo courtesy of CACHET)

Through the CACHET Community Engagement Core, Persky works with community members and organizations in Southeast Chicago to identify environmental concerns and communicate research findings. She also serves as a liaison between CACHET researchers and the community.

The Southeast Chicago industrial corridor has a history of environmental concerns including dumping of petroleum coke (a byproduct of oil refining), high levels of manganese, and metal recycling

Persky is partnering with the Southeast Environmental Task Force, a community-based organization in Chicago, and NPR’s StoryCorps to collect stories that give a sense of the history of the area with respect to residents’ experiences with community and environmental health issues.

“Collective storytelling can be a way of building a sense of community and shared vision that can strengthen collaborative efforts like those of interest to the CACHET Community Engagement Core,” said Persky.

They also plan to develop a mobile app in response to community requests. “If they identify a problem in their community, such as a dumped pile of industrial waste, they will be able to log it with the app,” Perskey added. “We plan to aggregate that information so people can see what others are concerned about throughout their communities.”

Joseph Hoover, Ph.D. – Using GIS to Share Scientific Findings with Tribal Communities

October 15, 2018

Joeseph Hover
Hoover is also part of the University of New Mexico Superfund Research Program (SRP) Research Translation Core and, with the EHD Center the Research Translation Core, is working with Native communities to develop methods for risk communication regarding environmental exposures.

NIEHS grantee Joseph Hoover, Ph.D., uses Geographical Information Systems (GIS) to communicate research into easily understandable graphics. As part of the University of New Mexico Center for Native American Environmental Health Equity Research (Native EH Equity Center) Hoover is the co-lead of the Community Engagement Core and uses interactive tools to help tribal communities understand potential health risks posed by abandoned mines.

Hoover began using his background in geography to study environmental exposures and vulnerable communities as part of his doctoral research at the University of Denver. He assessed how GIS can be used to improve water quality knowledge and perceptions of GIS to convey water quality information to consumers. He found that interactive Internet-based GIS tools make it easier for community members to visualize water quality data in relation to where they live and increase their environmental health literacy.

“Geography has a very technical side with creating the maps and visualizations, but I’m also really interested in understanding how communities use this information and how we can make it more useful for them,” said Hoover.

Understanding Heavy Metal Contaminants and Multiple Routes of Exposure

UNM’s Native EH Equity Center works closely with tribal communities in Arizona, New Mexico, Utah, Montana, and South Dakota to investigate environmental health issues that disproportionately affect Native American populations. For example, in the 13 western states where the Native American population is most concentrated, there are an estimated 161,000 abandoned heavy metal mine sites, including uranium, cadmium, zinc, and others. Exposure to these metals through soil and water has been linked to chronic diseases such as cancer, kidney disease, hypertension, and neurocognitive disorders.

In 2015, the Gold King Mine Spill leaked heavy metal waste into the San Juan River. When contaminants enter a moving body of water, they can become difficult to track, and so can their health impacts. Fortunately, Hoover was able to use samples taken from the San Juan to create a series of maps illustrating how the Gold King Mine contaminant plume traveled downstream. These maps were crucial to understanding the flow of contaminants and where health impacts could emerge in nearby communities.

In a new health disparities study, the Native EH Equity Center is collaborating with Diné College and Northern Arizona University to examine potential exposure to metals through food. Animals that are part of traditional tribal diets, such as sheep and cattle, graze near and consume water from a watershed with abandoned uranium mine sites. Tribal members expressed concern about secondary exposure through consumption of the livestock and the Native EH Equity Center decided to test this exposure route as a compliment to data from the watershed.

map of geospatial imaging
Above is an example of geospatial imaging created by Hoover. Darker areas represent a higher concentration of abandoned mines in that area. He and his colleagues estimate that 600,000 Native Americans live within 10km (6.25 miles) of an abandoned mine site.

Hoover will use GIS and GPS technology to map where the cattle graze and how long they stay in certain areas. Then, researchers from other institutions will take tissue samples from the cattle and test for uranium and other heavy metals. “Understanding where the animals spend their time and what their movement patterns are will help us make sound recommendations to the community regarding grazing and cattle consumption,” explained Hoover.

Guiding Effective Research Relationships Through Collaboration

In June 2018, Hoover attended the Tribal Environmental Health Summit hosted by Oregon State University in Corvallis, OR. Researchers, Native community members, and students from across the country were in attendance. Tribal members and other scientists were able to share their strategies for effective research communication and relationship-building with Native communities.

Community-driven events, like the summit, give Hoover and the Native EH Equity Center the opportunity to discuss research with tribal members. On its own, the Native EH Equity Center uses workshops and community meetings to facilitate these conversations. Tribal members are given an opportunity to give feedback on the tools used to communicate findings to community members, such as graphics, artwork and newsletters. “It is so important to understand how the community wants to see the information, because if it’s not given in a way that is digestible to them, it’s not effective,” said Hoover.

Read more

Jonathan London, Ph.D. – Working with California Communities to Address Environmental Justice Concerns

September 17, 2018

Jonathan London, Ph.D.

London uses community-based participatory research to improve the rigor, relevance, and reach of science.
(Photo courtesy of UC Davis)

NIEHS grantee Jonathan London, Ph.D., is committed to building healthy, equitable, and sustainable communities in California. As an educator, researcher, and community builder at the University of California, Davis (UC Davis), London’s work is focused on addressing environmental concerns in rural communities, including those in the Imperial, Coachella, and San Joaquin Valleys.

London first became interested in community-engaged research through his undergraduate work with indigenous communities in Brazil, who were concerned about the impacts of deforestation, hydropower development, and other environmental issues. He went on to found and co-direct a non-profit organization dedicated to engaging young people in participatory-action research both in the U.S. and around the world.

“I’ve always held a strong interest in helping disadvantaged, historically marginalized communities,” says London. “These experiences taught me about the power of community voice and the importance of people being able to play an active role in addressing the conditions that are affecting them,” said London.

In his current role at UC Davis, London serves as co-director of the Community Engagement Core (CEC) of the NIEHS-funded Environmental Health Sciences Center (EHSC) and director of the Center for Regional Change.

Addressing Community Concerns about Asthma through Research

In his work with the CEC, London links researchers and community partners to address regional environmental health needs of vulnerable populations in California. To achieve this, he works with a diverse set of community partners through the Community Stakeholder Advisory Committee (CSTAC). The committee, comprised of non-profit organizations, government agencies, and academic partners, informs research questions by providing a unique window into the community’s needs.

The CSTAC helped identify environmental health priorities for the region, including understanding the relationship between particulate matter (PM) from the Salton Sea and the area’s high asthma rates. The Salton Sea, California’s largest lake, has been heavily polluted from pesticide runoff. The lake has also been drying up, sending dust into the surrounding area that compromises the health of low-income, largely Latino farmworker communities.

Research Trailer

While using the UC Davis mobile research trailer, Calipatria high school students help with sample collection and measurements to examine air quality around the Salton Sea, while also learning about air sampling.
(Photo courtesy of Keith Bein, UC Davis)

In a pilot study led by Kent Pinkerton, Ph.D., and funded by the UC Davis EHSC, London and CEC colleagues are assisting the research team connect with community leaders to for a collaborative study of how PM from the Salton Sea compares to PM from other air pollution sources in the Imperial Valley. Although only in the preliminary phases of the study, the objective is to determine if there are local sources of airborne PM in the Valley that have the potential to explain the increased rates of asthma observed among the young people of Imperial County.

Working in collaboration with Comite Civico del Valle (CCV), the research team has hosted town hall meetings with local communities to inform their research endeavors to collect and analyze airborne PM samples from the Valley. In collaboration with a newly formed Imperial County Advisory Committee, the CCV and students at Calipatira High School, the researchers are using air samples collected in Calipatria with a unique mobile research trailer to determine whether PM-specific sources from the Valley can help to explain increased susceptibility to asthma within the region.

“Throughout the study and data collection process, the communities will be in a decisive, highly influential role,” said London. “The overarching goal is to empower residents with information about their environment and encourage them to get involved to find solutions.”

Working to Improve Access to Clean Water

high school students

Calipatria High School students from the Imperial Valley learn about lung anatomy, while working with UC Davis professor Kent Pinkerton this summer. Ultimately, these students will share what they learn about the relationship between air quality and asthma, as well as the results of the Salton Sea project, with residents of the Imperial Valley.
(Photo courtesy of Savannah Mack, UC Davis)

Another area of London’s work looks at improving access to clean water, especially for low-income communities in the San Joaquin Valley. In these communities, drinking water is often polluted by an array of contaminants, including pesticides, heavy metals, nitrates, and wastewater from treatment and disposal systems that are poorly maintained. Frequent droughts further limit access to safe drinking water.

To raise awareness about these water supply challenges, London and colleagues recently published a report describing how lack of access to clean, safe, and affordable water is a threat to public health. London and colleagues have used this report to improve public awareness, help community members understand their water supply challenges, and encourage community engagement. In part owing to their work, broad public support was garnered for the California Clean Water and Safe Parks Act. The measure, which passed on June 5, 2018, will provide significant funding to support drinking water programs in disadvantaged communities.

“Hundreds of thousands of people in California are regularly forced to rely on drinking water that is unsafe, inaccessible, and unaffordable,” said London. “But our research has helped raise awareness of the scale and urgency of the problems with drinking water access in disadvantaged communities. Our hope is that this momentum will lead to future improvements in clean water availability for the region.”

Moving forward, London will continue leveraging community partnerships to transform environmental health science and improve public health. “My goal is to maximize university resources as tools for social justice, and to help underserved communities get access to information to empower themselves,” said London.

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Shawn Gibbs, Ph.D. – Advancing Infectious Disease Preparedness Beyond Healthcare

August 8, 2018

Gibbs Main Image

Along with his passion to protect workers from infectious or hazardous exposures, Gibbs is also dedicated to mentoring the next generation of industrial hygienists to help them become more adept in protocols related to occupational and environmental health.
(Photo courtesy of Shawn Gibbs)

NIEHS grantee Shawn Gibbs, Ph.D., is a certified industrial hygienist and professor of environmental and occupational health at the Indiana University School of Public Health, Bloomington. Building on his research experience in environmental microbiology, his current efforts are focused on preventing the spread of highly infectious diseases both in the workplace and within communities.

From 2009 to 2015, Gibbs served as the research director for the University of Nebraska Medical Center, Nebraska Containment Unit (NBU). While there, Gibbs worked with John Lowe, Ph.D., and other colleagues to develop safety protocols for healthcare professionals to use while caring for patients, including American patients treated for Ebola virus disease in 2014. Gibbs and Lowe also worked to examine the effectiveness of technologies, such as gaseous chlorine dioxide, and ultraviolet germicidal irradiation, to disinfect surfaces in hospital and ambulance environments.

Establishing a biosafety training initiative

Gibbs bidti image

BIDTI trainer leads operations-level training with the Omaha Fire Department.
(Photo courtesy of Shawn Gibbs)

Gibbs and Lowe established the Biosafety and Infectious Disease Training Initiative (BIDTI), a consortium funded by the NIEHS Worker Training Program (WTP). This consortium reaches an extensive population of U.S. workers and vulnerable communities who face risk of exposure to infectious disease. BIDTI partners include the Indiana University School of Public Health, Bloomington; the University of Nebraska Medical Center, NBU; the UT School of Public Health at Houston; and the Harvard T. H. Chan School of Public Health.

“The partnerships that have been formed between consortium members, and the professional organizations and industries that we serve, has provided us with the ability to make long-lasting, positive impacts towards improving worker safety,” Gibbs said.

BIDTI provides hands-on infection control and preparedness training, that is grouped into three levels – community, awareness, and operations – to positively impact the health of workers and communities. Awareness and operations-level training typically focus on demonstrating safety protocols, such as putting on and removing personal protective equipment (PPE). BIDTI also offers train-the-trainer courses within these levels, where participants are given an opportunity to learn how to effectively teach and deliver infectious disease training to others.

“One of the strongest facets of our program is our faculty trainers,” Gibbs said. “BIDTI trainers are extremely knowledgeable and have real-world, first-hand experience with highly infectious diseases.”

Preparedness beyond healthcare

Gibbs training image

Gibbs (pictured in front of podium) leads an infectious disease awareness training course for students in the Cincinnati College of Mortuary Science. "The death care and mortuary sector is an area that has been over-looked in preparedness and training," Gibbs said. "These workers face a high risk of exposure to infectious diseases by handling human bodies and remains, so we wanted to offer training to raise their awareness and capacity to protect themselves from exposure."
(Photo courtesy of Shawn Gibbs)

Learning from challenges

In addition to their successes, BIDTI learned many important lessons while addressing challenges. “One of our greatest challenges this past year was motivating industries and organizations to participate in our training, despite it being offered at no cost,” Gibbs said. “Since there is currently very little media attention on Ebola or other infectious diseases, many employers don’t see the value in training.”

Time was another significant barrier BIDTI experienced, as many workers didn’t have time to participate in training due to on-the-job demands or other priorities. Moving forward, Gibbs and colleagues plan to explore the value of offering incentives, such as continuing education credits, to encourage workers to participate in training courses. They also plan to improve outreach for workers in the waste handling and transportation industries by establishing more partnerships and leveraging connections with BIDTI advisory board members.

One of BIDTI’s primary goals is to address infectious disease preparedness needs for workers in non-healthcare professions. Gibbs and colleagues performed a series of gap analyses and surveys among U.S. workers in the mortuary, waste handling, and transportation sectors to identify specific needs for training in these populations. Other BIDTI target populations include vulnerable communities, custodial and environmental service workers, first responders, law enforcement, occupational health and safety activists.

During its first year, BIDTI trained over 2,000 workers – an accomplishment that can be attributed to numerous collaborations with consortium members, as well as professional organizations and schools. For example, a partnership with the Cincinnati College of Mortuary Science and professional organizations provided BIDTI with the necessary connections to train hundreds of workers in the death care sector. In another effort, Aurora Le, BIDTI project coordinator, established and led a private-public collaboration with the Sodexo North American Environmental Services Division which allowed BIDTI to reach and train roughly 1,000 custodial and environmental service workers.

Gibbs emphasized that BIDTI’s engagement with their target populations is key to the success of training objectives. “It doesn’t matter how good our safety protocols are, they won’t achieve their desired impact if the workers don’t use them. It’s important for us to better align our goals and objectives with their specific needs by engaging with the workers and communities we serve.”

Addressing risks associated with the opioid epidemic

New occupational health concerns have emerged in the wake of the growing U.S. opioid epidemic. Accidental exposure to needles potentially infected with diseases such as HIV or hepatitis C virus has become a mounting area of concern, especially among first responders, law enforcement officials, and vulnerable communities, such as the homeless and minorities.

In response to this emerging issue, BIDTI spear-headed infectious disease training for homeless communities and homeless coalitions who often encounter individuals with injection drug use problems and associated diseases in Indianapolis, IN.

In January 2018, BIDTI hosted an awareness-level training for law enforcement officials in Indiana, where trainers shared information about PPE protocols to prevent exposure to infectious diseases and highlighted similarities in safety protocols for highly potent opioids.

Moving forward, BIDTI will continue working to raise awareness on health and safety issues related to the opioids epidemic. These efforts will help workers and vulnerable populations better implement precautionary measures to protect themselves and others.

Relevant links and publications

  • Examples of BIDTI training resources: Canadian Pathogen Safety Data Sheets and the National Library of Medicine WISER application
  • Le AB, Herron R, Herstein JJ, Jelden KC, Beam EL, Gibbs SG, Lowe JJ, Smith TD. A Gap Analysis of United States Aircraft Rescue and Fire Fighting (ARFF) Members to Determine Training and Education Needs Pertaining to Highly Infectious Disease Management and Mitigation. [Abstract]
  • Le AB, Hoboy S, Germain A, Miller H, Thompson R, Herstain JJ, Jelden KC, Beam EL, Gibbs SG, Lowe JJ. A Pilot Survey of the United States Medical Waste Industry to Determine Training Needs for Safely Handling Highly Infectious Waste. American Journal of Infection Control, 46: 133-138. [Abstract]

Chris Cain – Promoting Training and Career Opportunities for Construction Workers

Chris Cain

Cain is an industrial hygienist who advocates for the safety and health of workers in the construction industry.
(Photo courtesy of Chris Cain)

July 9, 2018

NIEHS grantee Chris Trahan Cain is passionate about improving the health and safety of workers in the construction, trade, and energy industries.

Shortly after earning her bachelor’s degree in industrial hygiene, Cain began her career as a compliance officer for the New York State Public Employee Safety and Health Bureau. In this position, she enforced protective regulations for public employees at the state and local level according to the Occupational Health and Safety Administration (OSHA).

In 1998, Cain joined CPWR – The Center for Construction Research and Training, a nonprofit organization that is dedicated to reducing and eliminating conditions that pose risks to the health and safety of workers in the U.S. construction industry. This includes pipe fitters, brick layers, ironworkers, roofers, heavy equipment operating engineers, and laborers, among others.

Cain became executive director at CPWR in 2017. One of her primary roles is to oversee, manage, and develop training programs that target various levels of skilled construction workers and tradesmen from underrepresented, minority populations. These training programs are funded in part by a cooperative agreement with the NIEHS Environmental Career Worker Training Program (ECWTP), a special program under the NIEHS Worker Training Program (WTP).

ECWTP trainees practice their carpentry skills building small houses.

ECWTP trainees practice their carpentry skills building small houses.
(Photo courtesy of Steve Surtees, CPWR)

Building a sustainable workforce using apprenticeships

With NIEHS ECWTP funding, CPWR delivers long-term, comprehensive trainings that prepare workers for employment and readiness to enter a building trades apprenticeship program. This apprenticeship model ensures a more sustainable workforce in the construction industry and offers a unique advantage for workers who may not have previously found a steady career path.

“It offers new, inexperienced workers opportunities for mentorship, education at no cost, and income from on-the-job training,” Cain says. “It also helps those who are unemployed or under-employed gain better access to long-term careers and provides them with the necessary skills to ensure their success and safety in these careers.”

Between 2015 and 2017, CPWR used the apprenticeship model to train workers in four cities through partnerships with 4 local or community-based organizations across the nation, placing 117 workers into new construction careers.

A key to the long-term success of the model and its associated training is partnership with local employers and nationwide construction organizations. By integrating feedback from local employers, CPWR ensures that they provide the most relevant and effective training to participants whose goal is to become part of the local workforce upon completion of their apprenticeship.

“In the end, it is not CPWR who is running the show, but the work community itself,” Cain explains. “We come in to support and provide technical assistance, but it is really about the trades and employers bringing people into the workforce.”

Decontamination Line

Flint ECWTP trainees run through a simulation of a decontamination line.
(Photo courtesy of Steve Surtees, CPWR)

Creating jobs to respond to a public health emergency in Flint

After the 2014 Flint water crisis, CPWR implemented a training program for workers in Flint, MI. The discovery of unsafe lead levels in the community’s drinking water, required the replacement of all outdated and unsafe lead pipes, likely impacting thousands of water lines.

CPWR seized this as an opportunity to both build skills in the workforce and provide additional workers for the local initiative to improve Flint’s water system. Compared to the duration of other training programs offered by CPWR, the one in Flint is expedited to meet the urgent need for workers to replace unsafe pipelines.

In 2015, CPWR began a partnership with GST Michigan Works and the Michigan Building and Construction Trades Council to deliver hazardous waste, lead awareness, confined space, and OSHA training to 25 under- and unemployed workers in the Flint area. By the second year of the program, 20 participants had been placed into a formal apprenticeship program in one of the trades participating in the rebuild of Flint’s water system.

Now moving into its fourth year, Cain acknowledges that the program has had a very positive impact on the Flint community. Although there have been some changes to the training curriculum to accommodate growth, CPWR’s mission in Flint remains the same. “We, along with our local and state partners, share a common goal – we want to provide meaningful training opportunities for under- and unemployed locals in Flint, so that they can improve both their livelihood and community,” she explains.

Developing leadership and communication skills for workers

To develop a safe work environment, it is important that all levels of workers – senior management and on-the-ground personnel – communicate with each other. This ensures that workers develop an understanding and appreciation for safety requirements and protocol.

In January 2017, CPWR released a new training curriculum that focuses on developing workers’ soft skills, such as active listening and three-way communication. As part of this curriculum, CPWR released their Foundations for Safety Leadership (FSL) course module, which was created to improve the overall principles of leadership and communication in the construction industry. More specifically, this course aims to bridge communication gaps between management and craft workers in the industry. FSL course participants learn these skills through interactive, hands-on activities, such as role-play scenarios.

“It may not be natural for someone who is an excellent construction worker, to also have the soft-skills needed to make them a great leader and communicator,” Cain says. “That is why this curriculum is so important.” Many small and large employers have incorporated the FSL course into their ongoing safety training efforts. Cain estimates that at least 5,000 workers nationwide took the FSL course in 2017, which was offered through pre-existing OSHA 30-hour courses. Adoption of the curriculum has since gone much farther, having recently been modified for workers on Department of Energy nuclear sites. Construction companies have also adopted the curriculum as part of their internal leadership training programs, all of which aim to improve worksite safety.

“I am very proud of this program and how it has allowed participants to begin leading by example to empower other workers,” Cain says. “I think it provides an opportunity to influence positive changes throughout the construction industry.” Moving forward, Cain and her colleagues at CPWR will continue to refine the FSL course based on the needs of workers in the construction industry, in hopes to better improve the industry’s culture of safety.

Related Links

Melissa Gonzales, Ph.D. – Integrating Native Culture in Research and Translation

April 30, 2018

Gonzales, a native of New Mexico, is passionate about community engagement and research translation to reduce the exposures and health disparities that impact tribal communities.
Gonzales, a native of New Mexico, is passionate about community engagement and research translation to reduce the exposures and health disparities that impact tribal communities.

Melissa Gonzales, Ph.D., is an associate professor at the University of New Mexico (UNM), where she leads many community engagement and research efforts to address exposures and health disparities experienced by Native American communities in the western United States.

Gonzales co-directs the Center for Native American Environmental Health Equity Research, a Center jointly funded by NIEHS and the National Institute for Minority Health and Health Disparities. She also conducts research as part of the UNM Superfund Research Program (SRP) Center, where she is working to understand how different metals from mining waste in soil can become airborne and pose health risks to nearby tribal communities.

As part of the UNM SRP Center, Gonzales leads the Community Engagement Core and mentors Center trainees in the Environmental Monitoring and Interpretation Core. She also leads the Research Translation Core where her team is developing and applying a unique multi-directional research translation framework to make the Center's research understandable to community partners and other stakeholders.

Land-based and Cultural Perspectives for Research

Promoting Transdisciplinary Training

Because her research is holistic and transdisciplinary, Gonzales asks her students and trainees to think about how their work is part of the entire exposure paradigm, rather than being limited to a particular research area. "It's important for students to learn to work across disciplines and understand how their work fits into the bigger picture of environmental health," she said.

"Personally, one of the most rewarding parts of my work is watching trainees develop into independent researchers. Several of our trainees have moved on to faculty positions, and that has been exciting to be a part of," she noted. By combining human health, environmental science, and research translation, Gonzales is helping to prepare the next generation of investigators to tackle complex environmental health research questions in the future.

Born into a rural, agricultural family from northern New Mexico, Gonzales brings a unique perspective to her research. "My family has lived on the land for generations. Those of us from land-based cultures have a particular reverence for the interrelatedness between people, their environment, their health, and overall wellbeing," she said.

Gonzales understands the need to protect the land to protect people's health, and this perspective is shared with many of the tribal and rural communities she works with. "Having the same perspective has been really valuable in engaging with communities," she said. "They appreciate having researchers come in understanding how reliant they are on the integrity of the land for their way of life."

Gonzales and her team work with multiple tribal communities, including the Navajo Nation, Laguna Pueblo, the Cheyenne River Sioux Tribe in South Dakota, and the Crow community in Montana. While each community has unique perspectives and traditions, Gonzales says that their research has identified important similarities that can be generalized across these groups. For example, many of the communities have a traditional ceremony that involves burning wood, which is often contaminated by metals from nearby mining sites. Rather than looking at how each community specifically conducts their ceremony, Gonzales and her team looked at the similarities between cultures in how long, frequently, and intensely individuals were exposed to smoke.

"This approach is not only more inclusive of diverse practices, it is also more generalizable to other communities we were not able to study directly," Gonzales said. "We also found that by generalizing similar practices and exposure conditions, the research was more respectful of the community's cultural practices."

Research Translation through Art

The artwork above portrays DNA repair. The intricacy of DNA repair can be compared to the creation of beaded items in Native American culture. When a beaded necklace comes undone, the stones/beads are restrung by using what is already there. The design used is from the Crow Nation. The use of the flower design symbolizes the idea of regrowth.

The artwork above portrays DNA repair. The intricacy of DNA repair can be compared to the creation of beaded items in Native American culture. When a beaded necklace comes undone, the stones/beads are restrung by using what is already there. The design used is from the Crow Nation. The use of the flower design symbolizes the idea of regrowth.
(Photo courtesy of Mallery Quetawki-Zuni Pueblo)

Gonzales says that an important part of her research is making sure that it is communicated in a way that is meaningful to impacted communities. One of the unique approaches her team has used included bringing in a Native American artist-in-residence, Mallery Quetawki, to translate complex scientific concepts using cultural symbols that had meaning for the tribal communities.

For example, Quetawki created paintings to communicate the concept of DNA damage. "This is an abstract concept, and we heard from communities that it was difficult to understand because it is an internal biological process that can't be seen," noted Gonzales. The paintings show how the process of DNA repair is like restringing a traditional beaded necklace.

The research-artist team has also been successful in developing intricate paintings to translate messages about the immune system, and how it protects the body from outside influences. "The immune system is essentially there to protect you," Gonzales said. "To communicate this, we used tribal cultural symbols that represent protection and immunity."

Engaging with the Community

Gonzales and her team have built meaningful relationships with tribal communities over time, and this has enabled fruitful collaboration for research. "We're focused on building capacity within the tribes to understand their exposures to mining waste, to speak for themselves, and to conduct their own risk assessments," she noted. "We're from here, so they know we're invested in making sure they get the information they need," Gonzales said.

Maintaining active participation with the communities and being receptive to their concerns is integral to Gonzales" research efforts. One community activity Gonzales has particularly enjoyed is being involved with a research symposium on the Cheyenne Sioux reservation in Eagle Butte, South Dakota. During this annual event, local high school students present posters as part of their science curriculum, and UNM researchers present their work as well.

"This is a very unique opportunity to be able to engage with the community, from young students to tribal elders, to hear about what each other is doing," Gonzales said. "We explain our research and how it contributes to their health and wellbeing, and we also get to hear back from them about their questions and their concerns."

Jennifer Horney, Ph.D. – Understanding the Health Impacts of Disasters through Community Engagement

February 20, 2018

portrait of Jennifer Horney, Ph.D.
Jennifer Horney, Ph.D., uses community engaged research to help communities deal with natural disasters. (Photo courtesy of Texas A&M School of Public Health)

Jennifer Horney, Ph.D., an associate professor and department head of epidemiology and biostatistics at Texas A&M University (TAMU), studies the health impacts of disasters such as hurricanes.

Horney’s research looks at linkages between disaster planning and household actions related to preparedness, response, and recovery. As the project leader of the TAMU Superfund Research Program (SRP) Center Community Engagement Core (CEC), she is currently working with impacted communities in Texas to study the health impacts of Hurricane Harvey. Horney’s background and previous involvement as a member of a team of public health practitioners who responded to Hurricanes Isabel, Charley, Katrina, Wilma, and Irene give her the experience necessary to address community health concerns following disasters.

Hitting the ground running after Harvey

Just days after Hurricane Harvey struck, TAMU received funding as an NIEHS SRP Center. As a result, they were able to hit the ground running and collect household survey data and environmental samples in the Manchester neighborhood, a Houston community that is burdened by exposures due to adjacent refineries, freeways, water treatment facilities, and a rail yard.

One year prior to the hurricane, Horney and her team had the opportunity to work with a local community group called the Texas Environmental Justice Advocacy Services (TEJAS) to begin collecting data and samples in and around Manchester households along the Houston Ship Channel in December 2016. The team also collaborated with researchers from the Oregon State University SRP Center who were using silicone wristbands to collect personal exposure information from residents in the Manchester neighborhood.

These efforts uniquely positioned the team with baseline data for characterization of environmental contaminant exposure both before and after Hurricane Harvey hit the Houston area. Although residents were suspicious of outsiders coming into their neighborhood after the hurricane, Horney noted that partnership with TEJAS was vital to earn the community’s trust and conduct research. “The fact that our team had already built a relationship of trust with the community before the disaster was crucial for being able to follow up after the Hurricane,” she said.

Moving forward, household survey data, along with the environmental and personal sampling data, will help Horney and her team determine if there are any differences in exposures before and after the hurricane. “By comparing data after the storm with baseline levels, were able to demonstrate that Hurricane Harvey redistributed PAHs in Manchester and to determine that the sources of the PAHs were similar before and after the hurricane. We’re also collaborating with Texas A&M’s Institute for Sustainable Communities to develop tools to help community members understand what these exposures could mean for their health.” The results of her team’s research are published in PLOS|ONE and are also discussed on the Texas A&M website.

“Residents who live in communities that have been affected by disasters should have a say in the type of research that can make their communities more resilient in the future.”
—Jennifer Horney, Ph.D.

Engaging communities and working across disciplines

Horney is dedicated to working with community members to understand how social factors influence evacuation decision-making during disasters and the public health impact of disasters.

“Local knowledge from an engaged community has the power to improve models and predictions, and to help neighborhoods anticipate future threats and prepare for and recover from adverse events.”

In addition to engaging the community, Horney stresses that collaborating across disciplines is critical to building adaptive capacity in communities and achieving research goals. “To fully respond to community needs, sometimes it means we must learn from collaborators on how to look at research through a different lens, whether it is civil engineering or landscape architecture, to improve community resilience to disasters.”

By combining diverse perspectives, researchers like Horney can create better tools, develop better strategies, and make research better suited to address community needs.

For example, at a recent NIEHS Partnerships for Environmental Public Health (PEPH) meeting, Horney found that individuals from different programs could build on one another’s work and learn from each other. “Together we were able to develop a more comprehensive GIS tool than any of us could develop on our own.,” said Horney.

Student volunteers posing infront of a home
Students volunteering with EpiAssist to gain field experience in the community. (Photo courtesy of Jennifer Horney)

Fueling the pipeline for tomorrow’s scientists

Horney also created EpiAssist, a service-learning program that offers field experiences to undergraduate and graduate students at the TAMU School of Public Health. EpiAssist addresses the critical shortage of trained public health professionals by providing support to local, regional, and state health departments and agencies.

“Programs like EpiAssist emphasize reciprocity, ensuring a balance between meeting the needs of the community and our students,” said Horney. “Students are eager for real-life experiences outside of the classroom, and health departments and agencies often need extra assistance, especially when emergencies or disease outbreaks occur.”

In a different project, Horney and her team trained high school students in the Houston area to collect citizen science data to assess the quality of their neighborhood storm water infrastructure. They were then able to validate the students’ data with data collected by doctoral students.

“This is really important because citizen science data has frequently been questioned or ignored as not scientifically valid. Being able to validate the data collected by the high school students and show that it is equivalent to data collected by researchers will empower folks to assess their own vulnerabilities and risks,” Horney said.

Paloma Beamer, Ph.D. – Understanding How Culture and Behavior Affect Environmental Exposures

January 4, 2018

Paloma Beamer and Karletta Chief

Paloma Beamer and Karletta Chief lead a study examining the long-term effects of the Gold King Mine spill on Navajo communities. Findings from the study will ultimately be used to develop risk assessment methods that incorporate how tribes actually use water and the land.
(Photo courtesy of University of Arizona)

NIEHS grantee Paloma Beamer, Ph.D., an associate professor at the University of Arizona (UA) Mel and Enid Zuckerman College of Public Health, is passionate about building partnerships and trust with the communities in which she works. Her research is helping reveal the importance of culture and behavior in determining exposure risks for specific communities. This knowledge could help inform interventions that reduce, or even eliminate, adverse health effects from environmental exposures experienced in these communities.

Responding to the Gold King Mine Spill

Ruby Sierra, Paloma Beamer and Arnold Clifford

Ruby Sierra of the Environmental Health Sciences Transformative Research Undergraduate Experience program, Paloma Beamer and Arnold Clifford take a core sample in an agricultural field.
(Photo courtesy of University of Arizona)

On August 5, 2015, the Gold King Mine leaked three million gallons of polluted water into a tributary of the Animas River in Colorado. The water traveled into the San Juan and Colorado rivers, flowing along the borders of 12 Native American Tribes. Immediately after the spill, Beamer worked with Karletta Chief, Ph.D., and other UA Superfund Research Program (SRP) researchers to quickly create a fact sheet to help affected communities understand the spill and its immediate effects.

In addition to concerns about short-term effects of the spill, Navajo communities wanted to know how water contaminated from the spill might affect their long-term health. With NIEHS funding, Beamer and Chief began the research necessary to address these concerns.

The researchers worked with the Navajo Department of Health and colleagues at Northern Arizona University to design a study that included testing for lead and arsenic exposure in people living in the three Navajo communities downstream of the Gold King Mine spill. The researchers also measured these contaminants in the sediment, agricultural soil, river, and well water around these communities and will examine how the communities’ perception of health risks from the spill compared with the actual health risks.

Rachelle Begay, Yoshira Ornelas Van Horne and graduate student Corinna Sabaque

Rachelle Begay, project coordinator for Center for Indigenous Environmental Health Research, doctoral student Yoshira Ornelas Van Horne, and graduate student Corinna Sabaque prep field kits for Navajo Nation community health workers to use for household sampling. 
(Photo courtesy of University of Arizona)

So far, the project has involved community members from 20 different organizations and academic partners from seven institutions. It Is also supported by several NIEHS-funded Centers at UA, including the SRP Center, Southwest Environmental Health Sciences Center, and Center for Indigenous Environmental Health Research, part of the Centers of Excellence on Environmental Health Disparities Research program. Study support also comes from the Northern Arizona University Center for American Indian Resilience, which is funded by the National Institute of Minority Health and Health Disparities.

Understanding Routes of Exposure

Tommy Rock and Janene Yazzie

Northern Arizona University doctoral student Tommy Rock and Janene Yazzie, an intern with the Bureau of Indian Affairs, sample sediment along the San Juan River. More than 70 students from ten academic intuitions were trained to work on various parts of the project.
(Photo courtesy of University of Arizona)

The researchers began by using focus groups to determine how Navajo communities use the San Juan river. "We have now identified almost 50 different activities that could lead to potential exposures if there was a concern about contaminants in the river water or in the sediment," said Beamer. "Because the communities use the river for much more than recreational activities, risk assessments need to take this into account when determining that the river was safe for use after a spill."

Throughout the study, the researchers focused on using approaches that build trust with the community. For example, they enlisted Navajo Department of Health community health workers who were already known by the community, to collect urine samples and reported back data to each household that provided samples.

The researchers have also received funding from the Agnese Nelms Haury Program in Environment and Social Justice to leverage the partnerships and findings of the NIEHS project to create broader and longer-term capabilities. They will be working with the Navajo community and leaders to identify tools and skills that might help them better respond to future spills or other environmental disasters.

Making Workplaces Healthier

Beamer, who began a term as president-elect of the International Society of Exposure Science in January 2018, is now planning a new study that will train community health workers to identify hazardous exposures in workplaces around Tucson, Arizona, and to work with the businesses to reduce those exposures. "Although preventable by definition, occupational disease and injuries are leading causes of death in the U.S.," said Beamer. "Unfortunately, low-income or low-wage minority workers bear most of the burden of occupational disease."

Beamer and her team will focus the study on auto repair shops and beauty salons. These types of workplaces, which have not been well-studied in terms of exposures, will allow the researchers to test their approach in two very different work cultures with different predominant genders. After gathering information about the businesses and exposures, the researchers will work with the businesses owners, trade groups, workers, and the community health workers to design an intervention focused on reducing the sources of dangerous workplace exposures. They will then implement the intervention in a formal clinical trial, evaluate its effectiveness, and identify factors that led the businesses to use exposure control strategies.

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