- David Turcotte, Sc.D. – Academic-Community Partnerships Provide Tools to Address Environmental Health
- Beverly May, Dr.P.H. – Empowering Rural Communities in Central Appalachia
- Dwayne Porter, Ph.D. – Engaging Communities in Water Quality Data and Connection to Quality of Life
- Dana Haine – Mixing Research with Creativity to Appeal to Learners
- Laurel Schaider, Ph.D. – On the Frontlines of PFAS Research
David Turcotte, Sc.D. – Academic-Community Partnerships Provide Tools to Address Environmental Health
June 16, 2020
David Turcotte, Sc.D., helps families and workers reduce environmental health risks in their homes and workplaces. As a public health research professor at the University of Massachusetts (UMass) Lowell and NIEHS-funded principal investigator, he focuses on worker safety, sustainable housing, and innovative approaches to asthma education and intervention.
Turcotte has dedicated his career to community engagement work and mobilizing community partners around environmental health. He began community organizing around public health issues more than 35 years ago when he was president of the local Lowell Fair Share chapter, a grassroots community activism coalition.
“We would knock on doors and tell residents that there was a superfund site nearby and inform them of the potential health risks associated with exposure to harmful chemicals,” Turcotte recalled. “We were raising awareness so that residents could take action to protect their health and safety.”
Engaging Communities to Address Asthma in Massachusetts
Turcotte chairs the steering committee of the Massachusetts Asthma Action Partnership and leads the Healthy Homes Program at UMass Lowell, which works to reduce environmental risks that trigger asthma attacks among low-income seniors and families living in public and subsidized rental housing. According to Turcotte, asthma is an environmental justice issue as it disproportionately affects low-income and minority residents and vulnerable populations like older adults and children.
For more than a decade, he has organized UMass Lowell researchers and community health workers from the Lowell Community Health Center to assess rental housing for asthma triggers such as excess dust, mold and mildew, and pests.
“This program provides low-income families with the education and tools to better manage and improve their indoor environment,” shared Turcotte. “An impact evaluation of the program’s asthma interventions revealed fewer asthma-associated hospital emergency room and doctor visits and showed statistically significant improvements in quality of life and health indicators among hundreds of children in Lowell.”
Turcotte extends the longevity of the program’s effects by conducting training courses with Lowell Housing Authority managers and their maintenance staff on healthy housing practices. As a result, Lowell Housing Authority is a key partner in asthma intervention projects.
“It is important to recognize the value of community organizations and their knowledge and capabilities. My public health research involving community partners would not have been as successful without their contributions,” shared Turcotte. “Researchers should earn a community’s trust and foster a mutually-beneficial partnership that addresses the community’s needs and goals as well as the university’s.”
Promoting Environmental Health and Safety in the Workplace
Turcotte is also the principal investigator of The New England Consortium-Civil Service Employees Association (TNEC-CSEA), a partnership of UMass Lowell; New England coalitions for occupational safety and health (COSH groups) in Massachusetts, Rhode Island, Connecticut, and New Hampshire; and CSEA Local 1000 labor union in New York.
Through grant funding from the NIEHS Worker Training Program, TNEC-CSEA delivers health and safety training for workers engaged in hazardous waste cleanup and disaster response and preparedness. On the job, these workers may encounter environmental health hazards such as mold, chemicals, and radiation that could lead to asthma or other health problems. The training empowers workers to protect themselves and surrounding communities from potential disaster and emergency threats while reducing environmental contamination risks. TNEC-CSEA has developed and delivered this training since 1987, reaching about 3,000 workers annually.
“TNEC-CSEA’s partnership infrastructure and CSEA’s peer-to-peer training model allows the program to reach more workers than any of the member organizations could reach alone,” explained Turcotte. “Together, we’re able to use our community networks to reduce occupational health and safety risks, injuries, and negative health consequences, and save more workers’ lives.”
Turcotte shared that sometimes employers have concerns about the costs of providing worker safety and health training and updating workplace practices.
“It’s important to raise awareness among workers, unions, and employers that the return on investment is always greater than the potential costs of not taking action and not understanding occupational health and safety risk mitigating best practices in the workplace,” he said.
Going forward, Turcotte plans to continue to collaborate with community partners to provide worker health and safety training. He is also interested in updating TNEC-CSEA’s curriculum to incorporate new science and potential exposure risks on emerging chemicals and infectious diseases that could be harmful to workers.
Beverly May, Dr.P.H. – Empowering Rural Communities in Central Appalachia
May 28, 2020
Beverly May, Dr.P.H., strives to empower rural communities to address the environmental issues that concern their health. As a family nurse practitioner in Appalachian Kentucky, May witnessed firsthand the environmental health effects caused by coal mining and natural gas drilling in the region. When her rural valley was slated for mountain top removal, May was inspired to pursue a doctoral degree in public health at the University of Kentucky. Her hollow, a rural valley community, colloquially pronounced “holler,” organized to stop the planned removal, teaching May the value of community voice and participation.
May returned to the hollows in Eastern Kentucky to conduct a community-based participatory study as program manager of the Mountain Air Project (MAP). The project, funded by the NIEHS Research to Action Program, led by co-principal investigators Steven Browning, Ph.D., and Nancy Schoenberg, Ph.D., of the University of Kentucky, aims to reduce respiratory health disparities in Appalachian communities. This Research to Action grantee model has given May the opportunity to blend her expertise as a nurse practitioner working within the community and her skills as a trained epidemiologist evaluating data.
“Epidemiology gave me another layer to work with,” said May. “I am still able to see how the immediate environment affects individuals and families, but also able to take a step back to see the larger environmental exposures. It has given me more tools in the toolbox to understand what we are up against in my community.”
Hollows As Sampling Units
May engaged community members throughout the process, including selecting the project’s name. After identifying respiratory health as their main concern, the research team and community leaders decided to examine the environmental and behavioral factors contributing to the burden of asthma and chronic obstructive pulmonary disease. The second part of the study implements community health interventions based on their findings to improve control measures and reduce hospital visits.
The study focuses on Letcher and Harlan Counties. Residents of these two central Appalachian counties have respiratory health inequities resulting from occupational exposure to coal mine dust, tobacco use, and other harmful exposures. Using the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System data, MAP found that nearly a third of adults smoked tobacco and 18.9% suffered from asthma, which is more than double the national average.
May worked with her research team to explore those statistics further but ran into difficulties determining the correct sampling unit to assess the rural counties. Through community input, May realized the best way to study selected communities was by hollows. Each hollow corresponded to its own river, stream, or lake, also technically identified as a U.S. Geologic Survey 14-digit hydrologic unit code. Community participation made that realization possible.
“Community-based research works well when people are learning from each other,” said May. “Using hollows as a sampling unit is the perfect example. We did not know there was a scientific way to define hollows and the geographer on our team did not know that we define each hollow as a community. We could not have connected the dots alone.”
Community Involvement in Data Collection
To gather information, May and her team extensively trained selected hollow residents to serve as community health workers. They were trained in respiratory health and spirometry, research methodology and ethics, and interviewing approaches. The community health workers then engaged directly with the study participants at their homes, establishing trust throughout the process and reducing barriers to preventative health behaviors, such as smoking cessation.
This community-driven engagement approach led to an 82.1% participation rate of households, which May attributes to the community health workers’ personal connection. Community health workers often had extended family ties or attended the same community centers such as a church.
“For us, community-based research means that the community experiencing the exposure and who are concerned are working as collaborators with the academic team who want to address the research question,” said May. “We have made it a point to make this project a collaborative effort, which involves sharing power, listening, and accepting guidance throughout the process.”
Research Translated Into Action
The research team has finished collecting household data and is now using those findings to implement the most appropriate interventions. Among their results, they found participants in public housing had twice the risk of asthma, but not those in mobile homes. Additionally, residents who lived in greater proximity of highways showed higher prevalence. These findings led the researchers to test Healthy Homes interventions to keep homes dry, pest-free, contaminant-free, and more.
May’s leadership in guiding MAP to integrate community-based research is recognized by her alma mater. She is working with a community activist and close friend to develop a training for University of Kentucky researchers on effective community engagement, participatory research, mutual respect, and shared learning.
Dwayne Porter, Ph.D. – Engaging Communities in Water Quality Data and Connection to Quality of Life
May 4, 2020
Dwayne Porter, Ph.D., is committed to building collaborative partnerships to break down sector silos and coordinate efforts to advance environmental health research and promote community health. As a professor of environmental health sciences at the University of South Carolina (USC), Porter focuses on translating scientific research into public health benefits, and he stresses the importance of involving the public in decision-making processes.
“My focus is on community-based research and research-based learning to enhance the quality of life for communities,” Porter said. “At USC’s Arnold School of Public Health, our expectation is that our students should not be confined to the classroom and laboratory but should have learning opportunities in the communities of our state and beyond it.”
Addressing Community Concerns Through Research
Porter serves as co-director of the NIEHS-funded USC Center for Oceans and Human Health and Climate Change Interactions (OHHC2I) Community Engagement Core (CEC), where he fosters relationships between academic researchers, policy makers, and the community. The goal of the CEC is to translate results from research on how climate change may affect ocean health, particularly in consideration of harmful algal blooms, microplastics, and the aquatic Vibrio bacteria--all of which may in turn harm human health.
“People living in South Carolina’s coastal communities are concerned about how these growing issues affect their health, from infection resulting from contact with contaminated water, to illness or death from consuming contaminated seafood,” said Porter. “The CEC’s efforts are dedicated to disseminating translated science, resources, and expertise so engaged communities can begin to address environmental health issues.”
To explore further potential health threats and share key findings, Porter and the OHHC2I team have established research collaborations with the National Oceanic and Atmospheric Administration; the United States Geological Survey; the Center for Coastal Environmental and Human Health at the College of Charleston; the University of Maryland Center for Environmental Science; the Interstate Shellfish Sanitation Conference; and the Low Country Alliance for Model Communities. The researchers and graduate students are assessing the health effects of exposure to Vibrio bacteria, cyanobacteria, and microplastics, including specific health problems like non-alcoholic liver disease.
Porter uses a variety of techniques and diverse partners to translate scientific findings about environmental health concerns to the affected community and broader public.
“As scientists, we have to be thoughtful in how we are conducting our research and engaging communities,” said Porter. “We have to earn their trust and respect and we have to learn how to listen. Having a close working relationship is important to developing culturally appropriate messages to share information. We want to empower our communities with knowledge they can act on, not alarm them or sensationalize the problem.”
Building Partnerships to Address Water Quality
One of the CEC’s key achievements is addressing the increased occurrences of elevated bacteria levels in the rivers and waterways in South Carolina. Human contact with water containing high concentrations of bacteria can lead to gastrointestinal disorders, respiratory problems, rashes, and other health concerns.
Concerned about people using waterways recreationally, Porter and his team worked with the South Carolina Department of Health and Environmental Control (DHEC) to build a partnership of entities for adopting more cohesive water quality health monitoring practices. The partnership includes wastewater and drinking water utilities, nonprofit organizations, community alliances, industries, local government agencies, and other users of the waters.
“Historically, these groups only sat in the same room if it was a courtroom and they were at odds with each other,” explained Porter. “At the first meeting in 2017, everyone sat in clusters separated by their fields. But we were able to begin dialogue and reach a common realization. Everyone agreed that we wanted the best water quality and the best quality of life for our communities and the people within them.”
The groups went on to form the Lower Saluda River Coalition, which was awarded the DHEC 2017 Community Star Award, an award recognizing collaborative efforts to build community relationships, promote environmental sustainability and resiliency, and improve quality of life for communities. Shortly after receiving the award, the partners expanded their mission to be inclusive of all three Midlands rivers, thus creating the Midlands River Coalition.
Porter and his students also contribute to a citizen-science water-quality monitoring program in which residents collect test samples from South Carolina’s lakes and reservoirs to aid water quality research. They take the results and lead the water quality analysis, then develop educational outreach materials on what neighbors and businesses can do to mitigate harmful algal blooms and how they can make more informed decisions about their use of the waterways. One of the ways that students share their findings is by distributing educational materials and talking with community members and government officials at information booths during community events. Porter and his colleagues are currently exploring the use of this partnership model in other communities.
Unifying the Vision of Environmental Health in South Carolina
Porter attributes some of the OHHC2I CEC’s recent success to its work across three National Science Foundation and NIEHS-supported Centers for Oceans and Human Health: the Woods Hole Center for Oceans and Human Health at the Woods Hole Oceanographic Institution; Lake Erie Center for the Great Lakes and Human Health at Bowling Green State University; and the Greater Caribbean Center for Ciguatera Research at Florida Gulf Coast University.
Each center includes a CEC charged with working with communities to identify research needs, engage the communities in research, and support the translation of sound science into useable information to address quality of life issues.
“We’ve realized that if we work collaboratively, taking advantage of the strengths we each bring, we have the opportunity to further advance the quality of life and public health issues across all of the communities within our respective centers,” said Porter.
Moving forward, he aims to continue to collaborate with the CECs to identify and solve environmental health problems for communities in South Carolina and beyond.
Dana Haine – Mixing Research with Creativity to Appeal to Learners
March 12, 2020
Dana Haine works with researchers, K-12 teachers, and students to make the newest scientific research digestible for classrooms and communities. As the K-12 science education manager for the Center for Public Engagement with Science within the University of North Carolina Institute for the Environment, she delivers new and relevant environmental health research findings, such as the health effects of e-cigarettes and implications of climate change, to learners.
Her interest in science goes back to childhood, but it was while working toward a master’s degree in biology that she decided to pursue a career outside a laboratory. Following graduation, she began teaching biology at Central Piedmont Community College in Charlotte, North Carolina. Her classes consisted mostly of non-majors, which inspired her to make the course content as relevant and engaging as possible.
“I knew that for many of my students, my biology course might be the only one they would ever take,” Haine said. “To make the course relevant and useful, I incorporated human health topics as much as possible. When we talked about the cell cycle, we talked about cancer. When we talked about the brain, we talked about the effects of drugs and alcohol on the nervous system.”
Bringing New Research into Classrooms and Communities
Today, Haine works within the Community Engagement Core (CEC) in the UNC Center for Environmental Health and Susceptibility (CEHS), an NIEHS Environmental Health Science Core Center, to bring engaging environmental health science content to K-12 students and other learners.
Haine explained that she often sees a disconnect between K-12 curriculum standards and current research. This presents a challenge for science-minded students graduating from high school, as they may not be aware of the current scientific research and all of the opportunities available to them as undergraduate students.
As she became familiar with the work of CEHS scientists, Haine saw an opportunity to integrate their timely, cutting-edge research findings into learning modules for students.
“By connecting teachers with current research findings through development of classroom-ready activities, we play a valuable role not only in preparing the next generation of scientists but also in promoting their understanding of environmental health topics,” Haine said.
Haine’s work with CEHS has also involved creating lessons for members of the wider community such as public health professionals. In 2016, Haine collaborated with John Balbus, M.D., NIEHS senior advisor for public health, to update an interactive lesson plan about climate change and human health. The lesson has since been adapted for use with clinical and public health students and practitioners. Most recently, Haine developed an online training module for public health professionals titled Extreme Heat & Air Quality: Implications for Human Health that will be released this spring.
Bringing the Science of E-cigarettes to K-12 Students
Haine found relevant, timely material for one of her latest projects by listening to a talk on the health effects of e-cigarette liquids and aerosols, given by Ilona Jaspers, Ph.D., research director for cardiopulmonary disease at CEHS.
“She was a very dynamic and engaging speaker, and she was passionate about taking her research to K-12 audiences,” Haine said. “She talked about how teenagers start to vape because of the appealing flavors but often have no idea those flavors contain addictive nicotine and that the flavors themselves may be harmful.”
Haine teamed up with Jaspers, connecting the researcher with middle and high schools for speaking engagements. At these events, Haine paid attention to questions raised by students and teachers. This exploratory process revealed young people’s misconceptions about vaping and guided Haine in the creation of a high school lesson on the topic.
To create the lesson, Haine turned to Jasper’s recent research papers and to Elise Hickman, one of Jasper’s doctoral students. Together, they created a two-part lesson plan, in which students examine experimental data showing how e-cigarette flavorings affect immune cells and how cinnamaldehyde, a flavoring, impacts cilia movement in the lungs by impairing mitochondrial function.
The lesson was piloted in three classrooms, two in North Carolina and one in Texas, in spring 2019. After some fine-tuning, Haine and Hickman modeled the lesson for teachers attending the North Carolina Science Teachers Association and the National Association of Biology Teachers annual meetings.
“One thing I really enjoy doing with my work, especially federally funded work, is disseminating it to teachers beyond North Carolina,” Haine said. “Conference presentations are a great avenue for disseminating lessons, especially national conferences because they often attract K-12, community college, and four-year college faculty.”
Engaging with Students Outside the Classroom
Haine also designs and delivers extracurricular STEM learning opportunities to students outside the classroom. From 2009-2017, she led the Climate Leadership and Energy Awareness (Climate LEAP), a year-long STEM program, where students learn about changing weather patterns and how human health may be affected.
In 2017, with supplemental funding from NIEHS, the UNC CEHS partnered with Columbia University’s Environmental Health Science Core Center and its community partner WE ACT to collaborate on informal youth programming that ultimately enabled Haine to introduce Climate LEAP participants to new topics such as climate resilience and climate justice.
“I’m working to create a better planet for our children,” Haine said. “The more I’ve learned as a result of my work, the more aware I’ve become of how the environment impacts our health, and I want to help people understand that connection.”
Haine looks forward to continuing her work with the NIEHS-funded CEHS, where she is able to approach research translation, lesson development, and outreach efforts with freedom and creativity.
Laurel Schaider, Ph.D. – On the Frontlines of PFAS Research
February 3, 2020
When Laurel Schaider, Ph.D., joined Silent Spring Institute in 2009, she began studying contaminants of emerging concern in public and private drinking water wells on Cape Cod. The region’s porous sandy soils allow surface pollutants to easily percolate through the ground, seep into wells, and contaminate drinking water. Silent Spring scientists wanted to know if pharmaceuticals and other chemicals from consumer products were making their way into well water. Among the chemicals they found were per- and polyfluoroalkyl substances (PFAS), a complex class of manufactured chemicals. Since then, Schaider has focused her research on how PFAS move through the environment, how people can be exposed, and how they affect human health.
Widespread PFAS Contamination
In use since the 1950s, PFAS are found in many consumer products, from cosmetics and dental floss to tents and non-stick frying pans. They are known as “forever chemicals” because they do not break down in the environment. Exposure to PFAS is linked to a wide range of potential health effects, such as thyroid disease, high cholesterol, liver damage, low birth weight, decreased effectiveness of vaccines, and some types of cancer.
Because of these health concerns, EPA required large public water supplies in the U.S. to test for PFAS from 2013 to 2015. The testing showed that 6 million Americans were being served by public water supplies where PFAS exceeded EPA’s guideline. “That really got a lot of people’s attention,” said Schaider.
That 6 million figure was just the tip of the iceberg; current estimates put the number of Americans with PFAS in their drinking water at more than 100 million. People can be exposed to PFAS from other sources, such as crops grown in PFAS-contaminated soil; grease-resistant food wrappers, pizza boxes, and microwave popcorn bags; and stain-resistant carpeting.
As the lead investigator of Silent Spring’s PFAS-REACH (Research, Education, and Action for Community Health) project and the Community Engagement Core co-leader for the University of Rhode Island’s STEEP Superfund Research Program, Schaider has become a nationally recognized expert on PFAS.
Schaider and her team have studied the prevalence of PFAS chemicals in fast food packaging and the effects of dietary habits on PFAS exposures. For example, her research has found that people who eat more meals at home as opposed to eating out have lower levels of PFAS in their body, and people who eat more microwave popcorn have significantly higher PFAS levels. These results suggest that food packaging is an important source of exposure to PFAS.
As part of her work at Silent Spring, Schaider communicates PFAS research findings to communities involved in the studies.
“Part of our mission is to translate what we learn to improve people’s health and reduce their risk of disease,” said Schaider. “We provide information to consumers on how to reduce their exposure to potentially harmful chemicals in their daily lives.”
Schaider does much of her research in partnership with community groups, including the Massachusetts Breast Cancer Coalition, Testing for Pease, and Toxics Action Center. She first conducted research in a community setting when she was a postdoctoral fellow at the Harvard T.H. Chan School of Public Health as part of an NIEHS-funded project at the Tar Creek Superfund Site in northeastern Oklahoma. She studied the environmental trail of contaminant metals like zinc, lead, and cadmium in the Tar Creek community.
The goal was to detect and characterize the presence of heavy metals from mine waste in Tar Creek and to examine how the metals migrated into neighboring yards and homes. Project leaders worked with a community organization, the LEAD (Local Environmental Action Demanded) Agency, to develop a study and conduct the research. This included measuring levels of exposure in the community and evaluating the effects of contamination on community health.
During this period, Schaider also led a project investigating mercury exposure from eating fish caught in Grand Lake, which is downstream of Tar Creek. This project also involved significant community participation. Local fishermen and the Oklahoma Department of Wildlife Conservation provided the catch used for mercury analysis, residents of the Grand Lake area completed questionnaires about their fish consumption, and community advisors aided in study design and implementation.
“Community members have so much knowledge,” said Schaider. “It’s essential, especially for environmental public health research, to make sure we are capturing that knowledge and asking questions that community members really want answered so they can improve their health.”
Looking forward, Schaider is excited to start collaborating with the Agency for Toxic Substances and Disease Registry (ATSDR) on a multi-site PFAS health study. The federal study is investigating communities across the country that have experienced PFAS contamination in their drinking water supply. Leading one of seven projects funded through the ATSDR study, Silent Spring researchers will be testing children and adults for a range of known PFAS chemicals and correlating PFAS exposures with different biological markers of health effects. The team will also be collecting new information about previously unidentified PFAS chemicals to which communities may have been exposed.