Skills and abilities needed by environmental health science and protection professionals in the public sector. (Features).

Introduction

Environmental health graduates who pursue careers in the public sector have many opportunities at all levels of government. At the federal level, they can find employment with one of several public-health agencies, including the Food and Drug Administration (FDA), the U.S. Environmental Protection Agency (U.S. EPA), and the Centers for Disease Control and Prevention (CDC). At the state level, environmental health job opportunities exist within state departments of health, environment, and transportation.

Nevertheless, entry-level environmental health professionals are likely to find the greatest opportunities at the local-government level. Local health departments are eager to hire entry-level personnel who have completed bachelor degrees in environmental health. For this reason, this examination of the skills and abilities of environmental health professionals in the public sector is especially relevant to local government agencies.

There are several reasons for seeking to understand what skills and abilities are necessary for environmental health professionals. One reason is to contribute to the field by graduating students who can fill existing jobs in public-health agencies. Academic programs in environmental health can be accredited by the National Environmental Health Science and Protection Accreditation Council (EHAC). EHAC uses curriculum guidelines in accrediting programs, and these guidelines include both general and specific courses that students must take. The research presented here was designed to contribute to a review of the guidelines with the goal of ensuring that the curricula offered by accredited programs meet the needs of the profession, including future priorities for environmental health.

Environmental Public-Health Priorities for the Future

According to a consortium of public-health professionals that includes the American Public Health Association, the Association of Schools of Public Health (ASPH), the Association of State and Territorial Health Officials, the Environmental Council of the States, the National Association of County and City Health Officials, the National Association of State Alcohol and Drug Abuse Directors, the National Association of State Mental Health Program Directors, the Public Health Foundation, and the U.S. Public Health Service, there are 10 essential public-health services (ASPH, 1994):

1. monitor health status to identify community health problems;

2. diagnose and investigate health problems and health hazards in the community;

3. inform, educate, and empower people about health issues;

4. mobilize community partnerships to identify and solve health problems;

5. develop policies and plans that support individual and community health efforts;

6. enforce laws and regulations that protect health and ensure safety;

7. link people to needed personal health services and assure the provision of health when otherwise unavailable;

8. assure a competent public-health and personal health care workforce;

9. evaluate effectiveness, accessibility, and quality of personal and population-based health services; and

10. research for new insights and innovative solutions to health problems.

These 10 services can serve as a basis for determining appropriate undergraduate curricula for environmental health students. The services require professionals who are skilled in observation, evaluation, and communication. Both interpersonal and public communication skills are encompassed by the 10 essential services. In addition, the fact that research and inquiry skills are noted in the list of services means that public-health professionals must be able to think critically and solve problems.

Aside from these general skills, knowledge about some environmental health issues may be more important than knowledge about others. For example, drinking-water quality remains one of the most important environmental issues to the American public (Hearne et al., 2000). In an assessment of environmental issues that will remain important to the American Journal of Public Health, Greenberg (2001) notes that the environment has been a public-health issue for more than 30 years. He predicts that the environmental health issues of the future will include environmental justice, market-based incentives, technology, globalization, global warming, and weapons of mass destruction. These issues are not emphasized in the current accreditation guidelines for the undergraduate environmental health curriculum.

Environmental justice and equity in public health are noted by Koplan and Fleming (2000) as a future public-health challenge. One solution to eliminating disparities in public health is to focus on "community-based strategies tailored to different racial and ethnic groups." This challenge implies that public-health professionals should have an awareness of diversity--an awareness that is especially important considering the apparent lack of diversity in the environmental health profession. Additional notable environmental public-health challenges include protecting the environment from increasing urbanization and population growth. Land use change and associated environmental health impacts will be increasingly important subjects for the profession.

Emerging infectious diseases, such as West Nile Virus, have brought some focus on how local environmental health practitioners are increasingly taxed with environmental health issues of global dimensions. As Koplan and Fleming note, public-health practice is becoming increasingly complex, and local governments are often the most critical component in protecting the public.

Science and technology will continue to offer opportunities to enhance public-health practice, but there are weaknesses in the scientific endeavors that apply specifically to environmental health. The major weakness, according to the Pew Environmental Health Commission (PEHC), is an "environmental health gap" that is hindering the use of preventive approaches to eliminate disease (PEHC, 2000). The commission has called for the creation of a National Health Tracking Network that will include five components:

1. a national baseline tracking network for diseases and exposure;

2. a nationwide early-warning system for critical environmental health threats;

3. state pilot tracking programs to test diseases, exposures, and approaches to national tracking;

4. federal investigative-response capability; and

5. tracking links to communities and research.

The major purpose of the national initiative would be to gain a better understanding of the relationship between environmental exposures and human health effects. According to PEHC, the network would require public-health professionals who are "adequately trained to collect and interpret the data at the local, state and national levels." These professionals would also be required to communicate their findings to the public and to policy makers. So, in order for a national tracking network to work effectively, public-health professionals must be skilled in observation, interpretation, and communication. These skills are noted repeatedly when the future of public health is discussed and were found to be important in the examination of skills and abilities that follows.

Methods

The research used a three-pronged approach to determining the skills necessary for environmental health professionals in the public sector. The first prong was an examination of public- and environmental health priorities as set by governmental agencies. Particular attention was paid to Healthy People 2010, which is a strategic plan for improving the nation's health. Environmental health is a prominent component of Healthy People 2010.

The second prong was a cursory review of current entry-level positions suitable for environmental health graduates. In addition to the results of previous research, current job postings from a number of agencies at various governmental levels were examined. A career guide specifically targeted toward environmental professionals was another source of data for the second component.

The third prong was a survey of public-health professionals in government agencies at all levels. An online survey was developed on the basis of current accreditation guidelines. The survey consists of four sections: 1) job skills, 2) subject knowledge, 3) technical areas, and 4) agency information. For the job-skills and subject-knowledge sections, respondents were asked to rate the importance of each attribute on a scale of 1 to 5. The technical-areas section asked respondents to identify all areas that would be important for environmental health professionals in their organization.

The survey was disseminated online to individuals with national public-health professional organizations, state affiliates of NEHA, and state government agencies. In addition, representatives of federal agencies were contacted through the Environmental Health Policy Committee of the U.S. Public Health Service. This committee includes CDC, the Agency for Toxic Substances and Disease Registry (ATSDR), FDA, the Indian Health Service, the National Institutes of Health, and the Office of Chief Counsel of the Public Health Service. Table 1 gives a breakdown of agencies and organizations contacted for the survey.

Personal e-mail messages were sent to individuals responsible for environmental health programs as identified on the Web sites. When an environmental health administrator or professional could not be identified in a government agency, the director of the agency was contacted. In several instances, no information about staff was available online, so e-mails were sent to site webmasters. As a result of this step, several groups posted the link to the survey on their home pages and asked their constituents to participate.

While this electronic approach to contacting survey participants and conducting the survey was time- and cost-efficient, it did have some limitations. First, selection of the sample did not adhere to standard qualitative survey methods--that is, it was not a random sample that would be representative of the population of public-health agencies. Second, there was self-selection bias as the request to participate was forwarded from one individual to the next and people accessed the link on home pages. The survey results discussed below must be interpreted with these limitations in mind.

Results

Public-Health Priorities

The most prominent source of information related to future public-health priorities is found in the Healthy People 2010 planning documents (Department of Health and Human Services, 2000). Healthy People 2010 is a national planning agenda that identifies priorities and objectives with the overall goal of creating a healthy America. The two overarching goals of Healthy People 2010 are 1) to increase quality and years of life and 2) to reduce health disparities. These two goals are inherent in 20 focus areas with numerous objectives. Although environmental health can be considered a component of many of the objectives, two focus area chapters specifically identify environmental health issues that are important for planning environmental health curricula--Chapter 8, "Environmental Health," and Chapter 10, "Food Safety."

In examining the environmental health objectives in Healthy People 2010, we can gain some insight into the knowledge that environmental health professionals need. Table 2 summarizes the important environmental health issues from Healthy People 2010. These issues are linked to specific knowledge areas, all of which are considered technical areas in the accreditation guidelines.

Healthy People 2010 emphasizes that public awareness of environmental health is the "key" to achieving environmental health goals. If public awareness is the key, then environmental health professionals should focus on educating the public about the field and about ways in which citizens can contribute to obtaining environmental health goals. Consequently, a basic understanding of public perception and appropriate educational approaches to reaching the public is a critical knowledge area for environmental health professionals.

CDC and ATSDR have developed a "shared vision for environmental public health" (CDC/ATSDR, 2000). This vision comprises four elements, stressing coordination, improvements in environmental health practice, cooperation, and leadership. CDC and ATSDR emphasize three skills as important in achieving the vision: 1) identifying problems, 2) solving problems, and 3) evaluating solutions to problems. In the context of the shared vision, these skills are critical and therefore should be part of the environmental health curriculum.

CDC and ATSDR specify the expertise necessary in the problem-based approach to environmental health. In the realm of problem identification, they note that professionals will need to be skilled in laboratory science, epidemiology/biostatistics, genetics, surveillance/tracking, toxicology, and medical sciences. To solve problems, environmental health professionals also must understand community and tribal involvement, public-health ethics, health education for communities, risk communication, advice/guidelines for regulators, advice/guidelines for health care professionals, genetics, behavioral change research, and medical screening/treatment facilitation. Finally, to adequately assess the effectiveness of environmental health programs, professionals must possess knowledge and skills in program-effectiveness evaluation, cost-benefit analysis, and capacity building.

The National Association of City and County Health Officials (NACCHO) is promoting a community environmental health assessment process known as the Protocol for Assessing Community Excellence in Environmental Health (PACE EH). PACE EH is a planning process that requires professionals to identify problems, develop indicators, and set priorities. Individuals undertake these activities as members of a team, so teamwork is critical to the success of the effort.

Community-based or place-based efforts at improving environmental quality are noted as an important factor in the future of the job market for environmental professionals. In The Complete Guide to Environmental Careers in the 21st Century (Environmental Careers Organization, 1999), 10 "mega-challenges" for the future are noted as follows:

1. pollution prevention,

2. global climate change,

3. integrating environmental costs and benefits into the global market economy,

4. biodiversity,

5. creating sustainable communities,

6. environmental justice,

7. ecological literacy,

8. monitoring the earth,

9. access to potable water, and

10. place-based approaches.

As with Healthy People 2010, these challenges suggest relevant environmental public-health knowledge areas that can be part of the environmental health curriculum. It is interesting to note, however, that in this "complete guide" to environmental careers, the job title "sanitarian" never shows up. "Environmental health specialist" is mentioned as a key job title only in the context of hazardous waste. "Public health officer" is noted as a key job title only in the context of water quality management.

Current Environmental Health Job Openings

In previous research examining the knowledge, skills, and attributes needed by environmental health professionals in the public sector, Treser et al. (1998) focused on evaluating the applicability of environmental health curricula in schools of public health to professional practice. An in-depth review of job classifications from six states found job requirements in five general categories: 1) knowledge skills, 2) job process skills, 3) job tools, 4) communications skills, and 5) leadership/interpersonal skills.

According to Treser et al., the greatest need in the public-health sector in the six participating states was for environmental health professionals with knowledge about drinking water, water resources, air quality, and hazardous and liquid wastes. In terms of job process skills, the 1998 study noted sampling and educational/training skills as being the most prominent requirements for environmental health jobs in the six states. Interpretive skills and problem-solving abilities were determined to be important job tools. Oral and written communications skills, including preparing reports, were found to be prominent requirements in the job classifications. Finally, public relations and teamwork skills were noted as important leadership/interpersonal skills.

Since this earlier, systematic research had been completed, the research presented here did not comprehensively evaluate job classifications. Rather, current environmental health job postings were accessed for a more general review of job requirements. Using a variety of online resources for searching for environmental jobs, the research found 14 entry-level positions to be suitable for further interpretation. In terms of geography and level of government, the positions can be broken down as follows:

1. six postings were for state government jobs in New Hampshire, Missouri, Florida, California, Virginia, and Connecticut;

2. seven postings were for local jobs, in county agencies, in Idaho, New Jersey, Arizona, California (two postings), Illinois, and New Mexico; and

3. one posting was for a job with the federal government in FDA.

Although only 14 job postings were reviewed, 38 job duties were noted in these postings. Table 3 groups these duties by the associated skills of communication, interpretation, critical thinking/problem solving, and enforcement/compliance. It is clear from this sample of current job postings that entry-level environmental health professionals are mainly involved in compliance activities, including conducting inspections and issuing permits. Furthermore, duties related to conducting inspections were noted in 10 of the 14 job postings.

Certain skills are necessary for conducting inspections and ensuring compliance with laws and regulations. As Table 3 shows, the job duties noted in these postings emphasize communication, critical thinking, and interpretation skills. According to these postings, the most desirable entry-level professionals in the public sector include individuals who have well-developed communication and interpretation skills and the ability to apply those skills in the compliance setting. This finding is consistent with the work by Treser et al. noted above.

Entry-level environmental health professionals will be involved in a variety of activities that require a breadth of knowledge about many issues. The technical areas noted in the 14 job postings are listed in the sidebar on page 12. It is worth noting that one important item on this list is application of knowledge; it is valuable for the employee to be able to apply what he or she has learned about chemistry and biology in the field.

Survey of Public-Health Professionals

Using the approach described earlier, this research obtained survey responses from 127 public-health professionals in 32 states. Figure 1 shows a breakdown of survey participants' locations of employment. State and county professionals participated the most in the survey, making up a combined 76 percent of the responses. City and regional professionals make up 16 percent of the responses; only 3 percent of the responses were from individuals who work in the federal government. As Table 4 shows, Florida, Iowa, Minnesota, and Ohio dominated the responses with 18, 16, 16, and 11 responses, respectively.

Sixty-two percent of the respondents identified themselves as working in some management capacity, that is, as a director of environmental health, a supervising sanitarian, an environmental administrator, a secretary of the department, or a deputy director of environmental services. As Figure 2 shows, 35 percent of the respondents function in a staff capacity at their places of employment. This group includes respondents who gave their job title as sanitarian, environmental health specialist, or health educator.

participants in the survey were asked to rank the job skills in the accreditation guidelines on a scale of 1 to 5, with 1 being "not important at all" and 5 being "very important." Figure 3 shows the mean scores of the five job skills in the accreditation guidelines. Critical thinking and problem-solving skills are the most important skills to this group of public-health professionals. Computer skills appear to be the least important of the skills noted on the survey.

Respondents were asked to identify additional job skills that were not listed, and Figure 4 groups these open-ended responses into nine categories. Interpersonal communication skills, including listening skills, appear to be critical for environmental health professionals in the public sector. Several respondents wanted to be sure to distinguish between public-speaking skills and interpersonal skills.

In terms of subject knowledge, as Figure 5 illustrates, risk communication and risk assessment are the most important subjects to this group of public environmental health professionals. Environmental economics and statistical methods posted the lowest mean responses.

In interpreting the important technical areas for the accreditation guidelines, it is possible to identify how many times the participants noted that a technical area is important. Table 5 ranks the technical areas according to how many survey participants checked these areas on the survey. It is clear that water quality, food protection, and wastewater are critical technical areas for environmental health professionals in the public sector; these three categories were checked in more than 80 percent of the survey responses. Noise control, global environmental health, occupational health and safety, and industrial hygiene are among the technical areas least often identified as important.

An open-ended question allowed for participants to identify additional subject areas that are important for environmental health professionals. Subjects noted in response include body art, rabies control, land use and urban sprawl, children's health issues, bioterrorism, geographic information systems, emergency response, and grant writing.

Participants in the survey were asked to identify characteristics that make an environmental health applicant most attractive as a potential employee. The answers to this open-ended question made it clear that the survey participants are looking for well-rounded individuals who have a technical background and the ability to communicate one-on-one. The personal characteristics that were brought up in the responses indicate that candidates should have energy, integrity enthusiasm, flexibility, honesty and trustworthiness. Comments included the following:

* "A candidate would preferably have a broad base of knowledge."

* "Knowledge of how government operates: council, court, police intervention, etc."

* "Some sort of real work experience outside of academia."

* "To students I would say, join a club, learn how to work with people."

* "You might say the perfect person."

* "We very rarely hire those from EH programs, they tend to be the least prepared for real-world responsibilities."

* "I could write a book on this topic since September 11."

Discussion

Data gathered from the examination of public-health priorities, environmental health job postings, and opinions of practicing environmental health professionals should be an important element in discussions about revising environmental health accreditation guidelines. All three sets of data point to specific knowledge and job skills that are important for environmental health professionals in the public sector. More importantly, these data reinforce each other; certain knowledge and job skills surface repeatedly. This is true even though it may seem that environmental health professionals in the public sector are required to know everything about the environment and to have mastered a variety of job skills.

According to the respondents in the survey and the analysis of future public-health priorities, some environmental issues are becoming more important than others. These include emerging infectious diseases, bioterrorism, and land use change. Furthermore, other environmental issues, such as drinking water, wastewater, and food safety, continue to be priorities in environmental health. It would be wise for undergraduate environmental health programs to revise curricula to ensure that graduates possess knowledge about basic and emerging environmental health issues. This suggestion entails that coordinators of environmental health programs must stay current in the field and offer students opportunities to explore the issues that are most salient in society today. One way to provide such an opportunity would be to require that a seminar on current environmental health issues become part of the curriculum.

It is not enough for environmental health curricula to focus on developing knowledge about environmental issues in their graduates--skills are perhaps even more important. Undergraduates have unprecedented opportunities to hone their communication skills. The environmental health professionals surveyed in this research emphasize that public speaking is not the most important communication skill. They are more interested in interpersonal skills that include the ability of practitioners to work in teams and communicate effectively with individuals and small groups at all levels of government.

Environmental health professionals in the public sector will be increasingly called upon to provide educational opportunities for the public. The ability to develop an effective educational program will make a graduate very attractive to potential employers in the public sector.

As important as communication skills are, problem solving and the ability to think critically are also imperative for environmental health professionals in the public sector. This imperative requires that students gain an understanding of how to define problems, determine solutions, implement solutions, and evaluate their work. Although problem solving and critical thinking are not a specific knowledge component of environmental health curricula, undergraduate programs that provide these types of experiences for their students will graduate the most competitive professionals.

Acknowledgement: This research was funded by grant R13/CCR020362-01 from the Centers of Disease of Control and Prevention.

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FIGURE 1

Geographic Representation of Survey Respondents

Federal    3%
State     41%
Country   35%
Regional   8%
City       8%
Other      5%

Note: Table made from pie chart

FIGURE 2

Job Categories of Survey Respondents

Management  62%
Staff       35%
Other        3%

Note: Table made from pie chart

TABLE 1

Groups Contacted to Participate in Online Survey


National          National Environmental Health
professional       Association
organizations     American Public Health Association
                  Association of State Drinking Water
                   Administrators
                  Environmental Council of States
                  Association of State and
                   Territorial Directors of Health
                   Promotion and Health Education
                  National Association of Local
                   Boards of Health
                  Association of State and
                   Territorial Health Officials
                  National Association of City and
                   County Health Officials
State affiliates  California                           North Dakota
of NEHA           Connecticut                          Ohio
                  Florida                              Oregon
                  Georgia                              Pennsylvania
                  Indiana                              Tennessee
                  Illinois                             Texas
                  Louisiana                            Virginia
                  Michigan                             Washington
                  Minnesota                            Wisconsin
                  New Jersey                           Wyoming
                  National Capital area
State health      All state health departments were
departments        contacted except Pennsylvania (an
                   e-mail address for an individual
                   was not available at the
                   Pennsylvania site).
State             State environmental agencies were
environmental      contacted through the
agencies           Environmental Council of States
                   (see above).
Federal           The Environmental Health Policy
government         Committee of the U.S. Public
agencies           Health Service

TABLE 2

Environmenal Health Priorities from Healthy People 2010

Issue                        Knowledge

Water quality                safe drinking water
                             waterborne-disease outbreaks
                             water conservation
                             surface-water health risks
                             beach closings
                             fish contamination
Toxic/waste                  elevated blood lead levels in
                              children
                             risks posed by hazardous waste
                              sites
                             pesticide exposures
                             toxic pollutants
                             recycled municipal solid waste
Global environmental health  global burden of disease
                             water quality in the U.S.-Mexico
                              border region
Infrastructure surveillance  exposure to pesticides
                             exposure to heavy metals and other
                              toxic chemicals
                             information systems used for
                              environmental health
                             monitoring environment-related
                              diseases
                             local agencies using surveillance
                              data for vector control
Outdoor air quality          harmful air pollutants
                             alternative modes of transportation
                             cleaner alternative fuels
                             airborne toxins
Food safety                  foodborne infections
                             outbreaks of foodborne infections
                             antimicrobial resistance of
                              Salmonella species
                             food allergy deaths
                             consumer food safety practices
                             safe food preparation practices in
                              retail establishments
                             organophosphate pesticide exposure
Healthy homes & communities  indoor allergens
                             office building air quality
                             homes tested for radon
                             radon-resistant new-home
                              construction
                             school policies to protect against
                              environmental hazards
                             disaster preparedness plans and
                              protocols
                             lead-based paint testing
                             substandard housing

TABLE 3

Job Duties and Skills Noted in 14 Entry-Level Environmental
Health Job Postings

Skill                              Examples

Compliance/enforcement             collects amples coordinates
                                   inspections ensures compliance
                                   issues permits
Interpretation                     conducts health risk
                                   assessments reviews floor
                                   plans
Communication                      advises local health officials
                                   prepares reports teaches local
                                   health officials
Critical thinking/problem solving  assists in planning
                                   participates in program
                                   evaluation

Skill                              Frequency

Compliance/enforcement                14


Interpretation                        10


Communication                          9


Critical thinking/problem solving      5

TABLE 4

Breakdown by State of Respondents to Online Survey

State           Frequency  Percent

Unknown             2        1.6
Alabama             4        3.1
California          1        0.8
Colorado            1        0.8
Connecticut         1        0.8
DC                  2        1.6
Delaware            1        0.8
Florida            18       14.2
Georgia             4        3.1
Hawaii              2        1.6
Illinois            1        0.8
Indiana             3        2.4
Iowa               16       12.6
Michigan            6        4.7
Minnesota          16       12.6
Mississippi         1        0.8
Montana             2        1.6
New Hampshire       2        1.6
New Jersey          1        0.8
North Carolina      1        0.8
North Dakota        1        0.8
Ohio               11        8.7
Oklahoma            1        0.8
Oregon              1        0.8
Pennsylvania        3        2.4
South Caroline      1        0.8
South Dakota        2        1.6
Tennessee           2        1.6
Texas               4        3.1
Utah                1        0.8
Virginia            5        3.9
Washington          8        6.3
West Virginia       2        1.6
Total              127     100.0

TABLE 5

Ranking of Technical Areas

Technical Area                     Number of Responses

Water quality                              111
Food protection                            101
Wastewater                                 100
Water supply                                92
Environmental epidemiology                  87
Soils                                       84
Recreational environmental health           78
Air quality control                         78
Vector control                              77
Hazardous materials                         74
Solid waste management                      72
Environmental health planning               70
Environmental microbiology                  68
Environmental chemistry                     59
Housing                                     46
Institutional health                        45
Radiation health                            45
Injury prevention                           42
Industrial hygiene                          28
Occupational health and safety              26
Global environmental health                 18
Noise control                               14

Technical Area                     Percentage of Responses

Water quality                               87.4
Food protection                             79.5
Wastewater                                  78.7
Water supply                                72.4
Environmental epidemiology                  68.5
Soils                                       66.1
Recreational environmental health           61.4
Air quality control                         61.4
Vector control                              60.6
Hazardous materials                         58.3
Solid waste management                      56.7
Environmental health planning               55.1
Environmental microbiology                  53.5
Environmental chemistry                     46.5
Housing                                     36.2
Institutional health                        35.4
Radiation health                            35.4
Injury prevention                           33.1
Industrial hygiene                          22.0
Occupational health and safety              20.5
Global environmental health                 14.2
Noise control                               11.0

REFERENCES

Association of Schools of Public Health. (1994). What is public health? http://www.asph.org/aa_section.cfm/3/ (16 Jan. 2002).

Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry (2000). Report of the CDC/ATSDR Working Group on a shared vision for environmental public health at CDC/ATSDR. Atlanta, GA: National Center for Environmental Health. http://www.cdc.gov/nceh/sharedvision/SharedVision.pdf (16 Jan. 2002).

Department of Health and Human Services. (2000). Healthy people 2010. http://wwv.health.gov/healthypeople/document/ (16 Jan. 2002).

Environmental Careers Organization. (1999). The complete guide to environmental careers in the 21st century. Washington, DC: Island Press.

Greenberg, M. (2001). Earth day plus 30 years: Public concern and support for environmental health. American Journal of Public Health, 91(4), 559-562.

Hearne, S.A., Locke, P.A., Mellman, M., Loeb, P, Dropkin, L., Bolger, G., Fink, N., & Byrnes, M. (2000). Public opinion about public health--United States, 1999. Morbidity and Mortality Weekly Report, 49(12), 258-260.

Koplan, J.P., & Fleming, D.W (2000). Current and future public health challenges. Journal of the American Medical Association, 284(13), 1696-1698.

Pew Environmental Health Commission. (2000). America's environmental health gap: Why the country needs a nationwide health tracking network. http://health-track.org/reports/pehc (16 Jan. 2002).

Treser, C.D., Tres, A., Boatright, D., Conway J., Kodama, A., & Woodbridge, D. (1998). Environmental health education and agency jobs (Final report of Health Resources and Services Administration Special Projects Grant No. D38 AH 00064-01). Portland, OR: Association of Environmental Health Academic Programs.

RELATED ARTICLE: Specific Knowledge Required in 14 Entry-Level Environmental Health Job Postings

Application of biology

Application of chemistry

Application of physical sciences

Basic sanitation principles

Building-related

Camps

Community health

Consumer product safety

Day care facilities

Fire safety

Food

Hazardous waste

Institutional environmental health

Lead

Local, federal and state laws

Lodging 

Logical or scientific understanding

Milk sanitation

Occupational

Principles of environmental science

Private wells

Proper waste disposal

Recreational facilities 

Recreational waters

Risk assessment

Septic systems

Solid waste

Traffic planning

Vectors

Wastewater

Water

Corresponding Author: Michele Morrone, Assistant Professor, Environmental Health Sciences, School of Health Science, Ohio University, E325 Grover Center, Athens, OH 45701. E-mail: <[e-mail]>.