Educating the Future Environmental Health Workforce During COVID-19: Developing a Virtual Curriculum for Navajo Student Interns Using the Environmental Health and Land Reuse Certificate Program.

Beginning in 2016, the Agency for Toxic Substances and Disease Registry (ATSDR) and the National Environmental Health Association (NEHA) launched a partnership to create a free online course with the goal of building capacity within communities to help remediate and redevelop brownfields sites. Brownfields are land reuse sites often contaminated by harmful chemicals or redeveloped without proper environmental oversight. Due to their potentially hazardous status, brownfields sites can lead to harmful exposures in humans while accentuating and often exacerbating socioeconomic disparities within their communities. As a result of this partnership, NEHA and ATSDR launched the Environmental Health and Land Reuse (EHLR) Certificate Program in 2020. The Journal is pleased to feature this column to highlight an example of how the EHLR Certificate Program was used to build understanding and increase knowledge on this important topic within environmental health students. The findings and conclusions in this column are those of the authors and do not necessarily represent the views or official position of NEHA, ATSDR, or the Centers for Disease Control and Prevention. Furthermore, verbal permission was given by the students to use their work in this column.

Factors Influencing Risk for COVID-19 Exposure Among Young Adults Aged 18-23 Years - Winnebago County, Wisconsin, March-July 2020.

On May 13, 2020, the Wisconsin Supreme Court declared the state's Safer at Home Emergency Order (https://evers.wi.gov/Documents/COVID19/EMO28-SaferAtHome.pdf) "unlawful, invalid, and unenforceable,"* thereby increasing opportunities for social and business interactions. By mid-June, Winnebago County,† Wisconsin experienced an increase in the number of infections with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), with the largest increase among persons aged 18-23 years (young adults) (1). This age group§ accounts for 12.5% of the population in the county. To identify factors that influence exposure to COVID-19 among young adults in Winnebago County, characteristics of COVID-19 cases and drivers of behaviors in this age group were examined. During March 1-July 18, 2020, 240 young adults received positive SARS-CoV-2 test results, accounting for 32% of all Winnebago County cases. In 30 key informant interviews, most interviewees reported exposure to misinformation, conflicting messages, or opposing views about the need for and effectiveness of masks. Thirteen young adults described social or peer pressure to not wear a mask and perceived severity of disease outcome for themselves as low but high for loved ones at risk. Having low perceived severity of disease outcome might partly explain why, when not in physical contact with loved ones at risk, young adults might attend social gatherings or not wear a mask (2). Exposure to misinformation and unclear messages has been identified as a driver of behavior during an outbreak (3,4), underscoring the importance of providing clear and consistent messages about the need for and effectiveness of masks. In addition, framing communication messages that amplify young adults' responsibility to protect others and target perceived social or peer pressure to not adhere to public health guidance might persuade young adults to adhere to public health guidelines that prevent the spread of COVID-19.

All that glitters is not gold: Mercury poisoning in a family mimicking an infectious illness.

Three siblings with inhalational elemental mercury toxicity presented with fever, rash, and upper respiratory tract symptoms. The patients were heavily exposed to elemental mercury that was spilled in their home and then vacuumed. Initial whole blood mercury levels were elevated at >200 µg/L, 153 µg/L and 130 µg/L (Mayo Clinic Laboratories lab reference range <9 µg/L) for Cases 1, 2, and 3, respectively. All three required chelation with succimer. Clinically significant elemental mercury toxicity can resemble an infectious illness. Severe morbidity and mortality can be prevented if heavy metal poisoning is considered early, through a detailed history including an environmental exposure history. For elemental mercury spills in the home, safe and effective clean-up steps are needed. Improved public health education is needed to prevent similar household exposures.