Learning Objectives:

• Understand the DSHEA regulation and amendments
• Discuss contamination and quality issues with herbal supplements
• Know the herbs most likely to cause Type I allergic reactions
• Describe the liver toxicity from pennyroyal and kava kava
• Describe the CNS toxicity from alpha lipoic acid
• Explain several toxicological problems with Ginkgo biloba

Director

New Mexico Poison & Drug Information Center

PEHSU Region 6

Learning Objectives:

• Understand the descriptive epidemiology of the major neurodegenerative diseases
• Describe the primary mechanistic processes thought to underly Alzheimer’s disease and Parkinson’s disease
• Identify at least one environmental risk factor for Alzheimer’s disease and Parkinson’s disease
• Recognize the long prodromes in neurodegenerative diseases, and how these relate to both causation and potential therapeutic interventions

By the end of this presentation, participants should be able to:

Presenters: Perry Sheffield, MD, MPH, FAAP; Frances Morales Ramos, MPH; and Teresa Herrera, MPH

Learning Objectives:

• Describe the scope and trends in global temperature and regional microclimates.
• Identify the physiologic health effects of extreme heat to different at-risk populations.
• Outline support systems and public health programs regionally and nationally to assist with support in extreme heat events.
• Understand the treatment considerations and evaluation of pregnant and pediatric patients with core temperature elevation.

Learning Objectives:

• List health hazards of volcanic emergencies
• Discuss toxicological hazards of volcanic emergencies
• Discuss personal protective measures
• Discuss patient assessment and management of related toxicological health complaints

Ziad Kazzi, MD
Associate Professor Emergency Medicine and Medical Toxicology
Emory University
PEHSU Region 4

John Balmes, MD
Core Consultant in Occupational and Environmental Medicine
Professor of Medicine, University of California San Francisco
Professor of Environmental Health Sciences, School of Public Health University of California, Berkeley
PEHSU Region 9

Robert J. Geller, MD 
Professor of Pediatrics, Emory University
Medical Director GA Poison Center
PEHSU Region 4

Fuyuen Y. Yip, PhD, MPH
Section Chief (acting), Environmental Health Tracking Section
Lead Poisoning Prevention and Environmental Health Tracking Branch 
National Center for Environmental Health | Centers for Disease Control and Prevention

Kanta Sircar, MPH, PhD, PMP
CDR, US Public Health Service
Epidemiologist, Asthma and Community Health
Division of Environmental Health Science and Practice
National Center for Environmental Health | Centers for Disease Control and Prevention 

 

By the end of this module, participants should be able to:

1. Understand the importance of early environmental health intervention.
2. Identify types of existing early intervention (EI) services at federal and state level.
3. Describe potential impact of synergistic partnerships among existing public health services to amplify the reach of regional PEHSUs while enhancing existing EI services.

Presenter:

Research Scientist

Harvard T.H. Chan School of Public Health

 

 

 

By the end of this module, participants should be able to:

1. Define the chemical family of perfluoroalkyl substances (PFAS) and where they can be found.
2. Outline the scope of potential exposure across the United States. 
3. Describe potential health impacts in children.
4. Discuss implications for clinicians.

• Describe three health behavior change approaches
• Employ techniques in health messaging that will increase likelihood of behavior change
• List examples of health behavior change messages that may decrease exposure to environmental contaminants

Presented By:

Learning Objectives:

• Describe at least one way that climate impacts the health of children.
• Define climate-smart healthcare.
• Identify two climate-smart approaches that healthcare systems can adopt to reduce contributions to greenhouse gases.
• List two core co-benefits of climate-smart healthcare.

Laura Anderko, PhD, RN
Director, Mid-Atlantic Center for Children's Health & the Environment 
Georgetown University
Region 3 PEHSU

 

 

 

 

 

 

Learning Objectives:

• Describe environmental injustice issues related to children living in poverty where they live, learn and play.
• Develop strategies to address environmental injustice issues related to children seen in the pediatric setting.

Jennifer A. Lowry, MD

Learning Objectives

• Define epigenetics in one simple sentence
• Recount three ways that genes can be “turned off”
• Recommend 3 ways for pregnant women to decrease their exposure to environmental toxins

Learning Objectives

• Describe current permissible exposure limits for uranium in drinking water
• Describe the absorption, distribution, and elimination of ingested uranium
• Review the potential effects, if any, of ingested uranium on the renal system
• Review the potential for development of renal or bladder malignancies after long-term exposure to uranium in drinking water
• Describe current testing options and recommendations for patients who may have
• been exposed to uranium in drinking water
• Briefly discuss possible treatment options for uranium exposure

Learning Objectives

• Review health reasons to spend time in Nature
• Learn how DC Park Rx was planned, developed and implemented at a "doctor's office"
• Review recently published data on DC Park Rx
• Summarize next steps for expansion and research of Park Rx

• Learn how chemical in consumer products are regulated in Washington State
• Be able to discuss the benefits and shortcomings of this approach
• Become familiar with the Children’s Safe Product Act and the types of data required to be reported
• Be able to discuss the toxicity and exposure related concerns relevant to prioritizing chemicals in consumer products
• Learn how Toxic Substances Control Act Reform is expected to impact children’s consumer product regulation

Presented By: Elaine Faustman, PhD and Marissa Smith

• Review impact of adverse environmental effects of poverty on children's health and development
• Understand ecology of environmental health disparities in the context of a cycle
• Explore strategies to reduce environmental health disparities and promote children's health and development
• Examine the Break the Cycle Program as a leadership development model to reduce children's environmental health disparities

Presented By:

At the conclusion of this activity, attendees should be able to:

• Increase participants’ knowledge of how development and use of the built environment affects population health
• Describe national statistics on health outcomes and disparities
• Discuss successful community development projects regarding the built environment
• Recognize role of environmental public health advocates in Health Impact Assessment plans 

Presented by:

• Explain how a chemical can act like a hormone
• Recount 3 chemicals with strong evidence for harm in humans
• Recommend 5 ways to personally decrease exposure to environmental toxins

• Provide an overview of a multi-faceted PEHSU response to a community-level exposure.
• Review key principles of pediatric environmental health that were central to PEHSU response.
• Review 3 common clinical inquiries to PEHSUs regarding the community-level exposure and response to local providers:
  • Increased asthma symptoms
  • Request for chemical biomonitoring
  • Management of possible asbestos exposure 

Maida Galvez, MD, MPH, FAAP

Associate Professor in the Departments of Preventive Medicine and Pediatrics; Co-director of the Mount Sinai Transdisciplinary Center for Early Environmental Exposures Community Outreach and Engagement Core

New York, NY
Region 2 PEHSU 

 

 

Lauren Zajac, MD, MPH

Fellow - Pediatrician at Icahn School of Medicine at Mount Sinai 

New York, NY

Region 2 PEHSU

 

 

 

 

At the conclusion of this activity, attendees should be able to:

The presenter will begin by describing the study methodologies used in the journal articles to be discussed. This will be followed by a discussion of the results of the studies under consideration and implications for current clinical and public health practice. The presenter will conclude by discussing preventive steps that can be taken to decrease exposure to endocrine disruptors as evidenced in the journal articles.

 

Articles discussed:

1. Evidence for hormesis in mutagenicity dose-response relationships.
Calabrese EJ, Stanek EJ 3rd, and Nascarella MA
Mutation Research 2011; 726(2): 91-97

2. An illusion of hormesis in the Ames test: Statistical significance is not equivalent to biological significance.
Zeiger E and Hoffmann GR
Mutation Research 2012; 746(1): 89-93

3. The Frequency of U-Shaped Dose Responses in the Toxicological Literature. 
Calabrese EJ and Baldwin LA 
Toxicological Sciences 2001; 62: 330-338

4. Natural Variability and the Influence of Concurrent Control Values on the Detection and Interpretation of Low-Dose or Weak Endocrine Toxicities.
Ashby J, Tinwell H, Odum J, and Lefevre P

Presented by:

• Identify data available at EPA. 
• Describe the purpose of the Toxics Release Inventory (TRI) Program.
• List potential uses of TRI data.
• Describe limitations of TRI data.
• Identify a tool to access TRI data.

 

Jocelyn Hospital, MS 

Toxicologist

Toxics Release Inventory (TRI) Program

US Environmental Protection Agency (EPA)

Washington, DC

 

 

Kara Koehrn, MEM, BS 

Toxicologist and Data Analyst

Toxics Release Inventory (TRI) Program

US Environmental Protection Agency (EPA)

Washington, DC