Indoor Air Quality in Schools

source: – Indoor Air Quality Tools for Schools Action Kit graphic.

Public Health Community Advisory – Welcome to another school year! As students, teachers, and school staff return to school, it is good to review some of the health hazards that are potentially present in schools. One such hazard is the quality of air inside schools. According to the Environmental Protection Agency (EPA), the levels of air contaminants indoors are about two to five times higher than they are outdoors. This difference can adversely affect nearly 55 million people who spend most of their day inside elementary and secondary schools.

The main air pollutants in schools are microbial agents, volatile organic compounds (VOCs), radon gas, and combustion products. Other air pollutants, depending on the age and construction of the school, include asbestos and polychlorinated biphenyls.

Microbial agents, such as mold, mildew, dust mites, and bacteria, are a result of moisture problems in buildings. When exposed to these agents, people commonly develop allergic illness, asthma, respiratory infections, or other health effects. Typical sources of moisture include structural leaks, plumbing leaks, flooding, and heating, ventilation, and air conditioning (HVAC)-related humidity control problems.

Sources of VOCs include paints, solvents, building materials, air fresheners, adhesives, fabrics, and many more sources. Indoor air may contain hundreds of different VOCs. The main symptoms in schools from VOC exposure are eye, nose, and throat irritation and headaches. One of the more common VOCs found indoors is formaldehyde. Formaldehyde is used widely to manufacture building materials and numerous household products.

Radon is a naturally occurring, gaseous radioactive element. Parts of Nebraska and Iowa have some of the largest radon gas levels in the country. This radioactive gas can seep into buildings from soil and rocks beneath and around the foundation of the structure. Radon gas is harmful when trapped in buildings. Radon gas exposure does not cause acute symptoms; but long-term exposure has been linked to lung cancer.

It is important for schools to ensure that their HVAC systems are functioning properly. The HVAC system should filter the air, heat or cool as necessary, and control relative humidity during the cooling season. Some systems also introduce outdoor air during this process to dilute building contaminants. High levels of carbon dioxide are usually a sign that the HVAC system is not functioning properly, and that more outdoor air is needed. Excessive levels of carbon dioxide can make students and teachers feel drowsy and lethargic.

The EPA has developed an indoor air quality (IAQ) tool kit to assist school administrators with IAQ problems.

This article was written by Chandran Achutan, PhD, assistant professor in the UNMC COPH Department of Environmental, Agricultural, and Occupational Health.

Reported Cases of West Nile Virus Up from Previous Years


Public Health in the National News – Mosquitoes are more than just a nuisance. They are a real public health hazard, carrying a number of infectious diseases, most notably in the United States West Nile disease.

Already this year, 1,118 human cases of West Nile virus (WNV) have been reported in the United States, more than has been reported for a number of years. The outbreak has affected 37 states thus far in 2012, with Texas reporting the most number of cases. In Nebraska, recent weeks have seen a sharp increase in cases.

West Nile is an African disease that first appeared in the United States in 1999 and rapidly spread across the country. Its reservoir is various animals, especially birds, and it spreads to humans via mosquito bites. Most cases occur in the late summer months. In addition, the virus may be spread through blood transfusions or transplants.

Individuals with the most risk of WNV infection include those having weakened immune systems (i.e., HIV), the older or the very young, and those who are pregnant. The incubation period lasts five to fifteen days from the initial bite. The disease is diagnosed by antibody tests on blood and/or spinal fluid.

Most West Nile cases have no symptoms at all. The more mild form of the disease, West Nile fever, may show symptoms including fever, headache, or vomiting, while the more severe forms (encephalitis and meningitis) can show signs of confusion, loss of consciousness, muscle or arm/leg weakness, or stiff neck. Paralysis has been reported. Although rare, the more severe forms can potentially lead to death (about 10% of individuals with brain inflammation). However, in almost all mild cases, the outcome is good. Neurologic complications are much more common in the elderly (see Figure 1 below). West Nile symptoms are similar to many other diseases, so the usual directives about when to contact your physician apply, namely with a very high or prolonged (e.g., more than several days) fever, or neurologic symptoms such as confusion, stiff neck, weakness of an extremity, or unusually severe headaches.

There is no treatment for West Nile infection, so the focus is on prevention. To prevent infection individuals should avoid mosquito bites when possible, however, if you are going to be in an area with mosquitos, use mosquito repellant, wear long sleeves and pants, and avoid areas where standing water is present. Insect repellants with DEET can be effective for three to eight hours depending on the amount of DEET in the product. Higher DEET concentrations (e.g., above 30%) provide longer protection.

Source: MMWR 60:1013, Aug 5, 2011.







This article was written by Philip W. Smith, MD, professor, UNMC Internal Medicine, Division of Infectious Diseases, and UNMC College of Public Health Department of Epidemiology; and Michele Kassmeier, BS, graduate student in the Department of Epidemiology.

September 5, 2012 – “Health Information Exchange in Nebraska”


Health Information Exchange

College of Public Health Grand Rounds: “Health Information Exchange in Nebraska” presented by speaker panel: Marsha Morien, Instructor, Health Services Research & Administration; Anne Byers, eHealth Manager, Nebraska Information Technology Commission, Lincoln NE; Deb Bass, Nebraska Health Information Initiative (NEHII) , Omaha NE; Lina Lander, PhD, Assistant Professor, Department of Epidemiology, College of Public Health; and Donald Klepser, PhD, Assistant Professor, College of Pharmacy. Panel will provide background and overview of Nebraska strategic plan and federal cooperative agreement, provide current and future state of exchange through NeHII and eBHIN, and outline the evaluation findings and future evaluation projects.



College of Public Health Alumni Chapter Presents First Award

The UNMC Alumni Association College of Public Health Alumni Chapter has presented Jim Anderson, PhD, with its inaugural Spirit of Service Award. Dr. Anderson is a faculty member and associate dean in the College of Public Health.

“Dr. Anderson was one of the first champions of our alumni chapter and has continued to offer his generous support throughout the past few years,” said Stephen Jackson, MPH ’06, COPH Alumni Chapter president. “We truly value Dr. Anderson’s leadership and he is certainly a deserving recipient of our chapter’s first award.”

The UNMC Alumni Association chapters make awards each year to distinguished, honorary and young alumni. For a complete list of award categories and awardees,

Aja Pelster – Exceptional Incoming PhD Student Assistantship Awardee

Aja Pelster

Aja Pelster won an Exceptional Incoming PhD Student Assistantship Award in July and has started her PhD in Health Promotion and Disease Prevention Research in our college. The competition for these UNMC-wide awards was fierce, and we are delighted that Aja was selected as an award recipient. Aja is energetic, dedicated, and intelligent and shows great promise as a future scholar in the field of sexual health.  In the course of her MPH, which she recently completed at the UNMC College of Public Health, she exhibited a superior ability to grasp complex ideas, pose critical questions, and provide unique and thoughtful insights. Aja’s insatiable curiosity and dedication to improving the health and well-being of the public will no doubt prove her a valuable addition to the doctoral student body at UNMC.

Sheetal Sawant

Sheetal Sawant

Student Highlight – Sheetal Sawant is a second-year MPH student in biostatistics. She was born in Mumbai (still known as Bombay to many), the biggest city in India, and went to school in a scenic suburb on the outskirts of Mumbai. Her journey in the field of health care began when her sister joined the School of Medicine to pursue bachelor’s degrees in Ayurvedic medicine and surgery. Four years later Sheetal followed her sister into the world of medicine and health care and joined the School of Dentistry. She completed her bachelor’s in dental surgery from the prestigious Maharashtra University of Health Sciences, and practiced dentistry for about three and a half years in Mumbai.

 The preventive and community dentistry experiences that Sheetal gained during her bachelor’s internship at St. George Government Dental College, Mumbai, along with her firsthand experience serving the community under the guidance of an experienced dental surgeon in Mumbai, further strengthened her interest in the field of dental public health. She moved to Omaha in 2009, and was accepted into the College of Public Health (COPH) MPH program at UNMC in fall 2010. She has been a graduate assistant in the COPH Department of Biostatistics since spring 2011.

 The warm and welcoming atmosphere is what Sheetal admires most about the COPH. The key features that attracted her to consider pursuing her MPH were the friendly and helpful nature of the faculty and staff and the funding opportunities that are provided to the students. According to Sheetal, the opportunity to work on real-life projects related to her field of interest via the service-learning/capstone experience and internship opportunities are the highlights of the program. She is currently working on two projects, one with the Omaha District Dental Society and another with the Office of Oral Health and Dentistry, Nebraska Department of Health and Human Services. Sheetal believes that her coursework and her work on real-life projects have helped her get a better taste of and be well prepared to further her interest in the field of dental public health.