1. 1 Internship at Frederick County Health Department Caitlin Morris Summer 2007

2. 2 Introduction  During June and July of 2007 I worked with the Frederick County Health Department, in Frederick, Maryland under the supervision of Mr. Larry Bohn.  I worked specifically in the Environmental Health section of the Health Department in which there are three main offices: Food Service Office, Community Relations Office, and Well and Septic Systems Office. Here I shadowed the sanitarians, which is considered a training step to joining the Department.

3. 3 Introduction Continued  By working with all three of these offices I was able to work with the people who maintain the public safety by ensuring that public and private facilities, within the governmental region are clean and sanitary.  I also learned the science behind why certain conditions are monitored and the different procedures used to carry out that monitoring.

4. 4 History of Public Health  The primary goals of public health are: to prevent human disease, injury, and disability; to protect people from environmental health hazards; and to educate and promote behaviors that lead to good physical and mental health.  Although formal public health departments are a relatively new concept their roots are historical entities. Sewers Quarantine Water treatment  Public Health is very important today when the number of people in a populated area is taken into account.

5. 5 Environmental Public Health  Handles all aspects of the natural and developed communities that may affect human health.  This is done by setting environmental parameters, laws and regulations, and encouraging the use of environmentally friendly and healthy behavior.  It is the responsibility of the E.H.D. to inspect different areas to ensure that the operation at a given site is adhering to the specific laws and regulations associated with that facility.

6. 6 Food Service Office  The Food Service Office (F.S.O.) is dedicated to describing and enforcing how to handle, prepare, and store food to best avoid food-born illnesses.  Restaurants, schools, nursing homes, temporary food sales (such as bake sales, carnival food stands, etc.), bars, and essentially any establishment that may be selling or preparing food for the public are inspected by this office.  Frederick County follows a prescribed set of regulations for each different type of operation. These regulations are described in the Code of Maryland Regulations, or COMAR.

7. 7 What Happens During a Food Service Investigation?  The primary facility to be inspected is always the kitchen, or food preparation area, although the entire establishment is inspected before the day is over.  Upon entering the kitchen a sanitarian always washes his or her hands. Then the investigation can begin.

8. 8 Food Service Inspection  Monitoring of temperatures is of vital importance for preparation, storing, and display of food, as well as hand- washing and cleaning of equipment.  Temperature guidelines are set by COMAR and are made specifically to avoid bacterial contamination.

9. 9 Temperature Guidelines  Hot Foods: 140°F or above  Cold Foods (storage and display): 45°F  Frozen Foods: 0°F or below  “Danger Zone”: for hot foods is below 130°F and for cold foods is above 45°F

10. 10 Food Service Inspection  Additional techniques to avoid bacterial contamination are enforced as well… These include: Frequent washing of hands with warm water and soap and the use of gloves and hairnets by those involved in food preparation. The staff is not allowed to eat in the food preparation area, especially from communal sources, such as dip trays for finger foods. Goods must be stored in air-tight containers and have expiration dates. The area where the goods are stored must be completely free of exposure to the outdoors. Dangerous chemicals cannot be stored above the food.

11. 11 Food Service Inspection  The bathrooms are carefully inspected to make sure that all the toilets flush, the sinks provide adequate warm water flow, soap is provided, etc.  All rooms are checked for the same following conditions: the presence of cracks in ceilings and walls, openings for vermin, the suitability of chemical storage areas, etc.  Finally the exterior of the facility is inspected for cracks and openings, as well as any safety hazards.

12. 12 Community Service Office  The Community Service Office (C.S.O.) handles a variety of health issues which can be divided into water quality, site inspections, burn permits, nuisance complaints, and rabies infections.

13. 13 Community Service Office Water Quality  The C.S.O. is responsible for testing water quality in existing and new wells for public and private homes. Wells are tested when they are first installed and subsequently they are tested at the request of the owner.  After sterilizing an actual source of the well water, such as a sink faucet, samples are collected to test for bacterium and fecal coliform, as well as turbidity and nitrates. These samples are sent to a lab to be analyzed and the results are disclosed to both the Health Department and the owner.

14. 14 Community Service Office Water Quality  Two categories of pool inspections: A pre-inspection checks for: safety signs that are visible to the public; restrooms that are well-stocked, functional, and clean; that the surface around the pool and the pool lining are in good condition; the water is clean and passes all chemical concentration tests; the filtering system is operating, and that the chemical room is properly marked and maintained. A routine pool inspection occurs after the pool is open to the public and looks at all the previously mentioned criteria.  Operators of a public pool must take a written examination administered by the C.S.O. to verify they are capable of maintaining the safe operation of the pools.

15. 15 Community Service Office Water Quality  The C.S.O. checks beaches and lakes that are used for recreational use. Water samples are collected and sent to a lab to be analyzed to ensure clean water. The department monitors cleanliness of the shore and beach area.  The C.S.O. also looks into any complaints made about beaches and lakes (as well as pools).

16. 16 Community Service Office Site Inspections  All plans for new subdivisions and other housing sites are reviewed by the C.S.O.  Daycare centers and homes housing adopted children are also inspected to ensure safe living conditions for children under the care of someone other than his or her parent.  Mobile home parks are also monitored for the quality of their well water.

17. 17 Community Service Office Burn Permits  Open burning is allowed in Frederick County, although there are several rules that must be adhered to… Only wood, wood products, and brush can be burned. Logs, stumps, leaves, cardboard, paper, pallets, or pressure treated lumber cannot be burned. The material to be burned must have originated on the property on which it is being burned. A burning permit must be obtained from the C.S.O.

18. 18 Community Service Office Nuisance Investigations  The C.S.O. responds to complaints about unsanitary living conditions.  They take pictures of the violation(s) and then contacts the responsible party.  Some of the common code violations are: Excessive accumulation of filth, garbage, and rubbish; discarded appliances; rodent harborage, inadequately protected or maintained swimming pools, the presence of more than two tires discarded on a property, and excessive animal feces in yards.

19. 19 Community Service Office Rabies  Rabies is a virus that can attack most mammalian animals, and is contracted through saliva or blood transfer. Outbreaks are serious because humans are not immune to the disease.  The C.S.O. also works with the Animal Control Offices to get testing results from possibly infected animals promptly and oversees the quarantine required of rabid animals.  Twice a year the C.S.O. offers vaccination clinics.

20. 20 Well and Septic Systems Office  The Well and Septic Systems Office (W.S.S.O.) works to ensure the proper disposal of human waste as well as the presence of potable drinking water.  These issues are linked, especially if a home is on well water.

21. 21 Well and Septic Systems Office Septic Systems

22. 22 Well and Septic Systems Office Septic Systems  Before the system can be installed a percolation test must be conducted. The test hole must be at least five feet and can be up to 14 feet. A measuring stick is placed in the hole, water is poured to a 2 inch level, and then the water is timed as it percolates through the soil. An acceptable percolation rate is one inch in 30 minutes after the ground has been presoaked.  In areas where an acceptable percolation test cannot be reached there are alternatives... Sand mounds raise the surface level where the field would be giving the appropriate depth and percolation rate.

23. 23 Well and Septic Systems Office Wells and Other Responsibilities  Although well testing is done in the C.S.O. well permits are issued in the W.S.S.O.  The site for a well is approved by the W.S.S.O. and the records of location, depth, and water yield are kept at this office.  Other responsibilities include: Soil evaluations for the suitability of new construction sites and lots. Conducting sanitary surveys of communities to determine possible well and septic problems. Investigating mosquito complaints.

24. 24 Conclusions and Acknowledgments After spending time with the different offices the real need for rules and regulations was obvious. These rules are not frivolous. They may seem silly for one person, but in the public and crowded world of today they are important and effective. The job of these offices is to ensure that the rules are followed, and subsequently that the public is safe. I would like to thank the Frederick County Health Department sanitarians, especially Mr. Larry Bohn, for allowing me to conduct my internship within their establishment.