1. Environmental Health in Colorado Presentation to Senate and House Agriculture and Natural Resource Committees April 30, 2008 Jeff Zayach, MS Vice President, Colorado Directors of Environmental Health Colorado Directors of Environmental Health

2. Improved health owes less to advances in medical science than to changes in the external environment, and to a favorable trend in the standard of living...medicine is in danger of neglecting what has hitherto proved its most powerful resource – the manipulation of the external environment. Grundy and Macintosh – from Man Adapting, Rene Dubos – Winner of the 1969 Pulitzer Prize for general non-fiction.

3. Environmental Health Protection Defined Environmental health protection refers to protection against environmental factors that may: Adversely impact human health Adversely impact ecological balances essential to long-term human health and environment National Environmental Health Association, April 1996

4. Examples of Environmental Health Services Provided at the Local Level Retail food safety inspection, licensing and training Body art inspection, licensing and training Water quality – Issuing septic system permits Monitoring, testing and investigation of Plague, Tularemia, Rabies, West Nile Virus, and Hantavirus Air quality monitoring, inspection, and education Emergency preparedness

5. Expanded Environmental Health Services at the Local Level Developing climate change policies and strategies Asthma Indoor air quality investigations, testing, and education Occupational health Meth lab investigation and clean up Integrating Land Use and EH – planning for a built environment Transportation planning Pollution prevention

6. Expanded Environmental Health Services at the Local Level Confined animal feeding operations Water quality – Ground, surface, and storm water Hazardous waste inspections Landfills and solid waste cleanups Well monitoring Lead investigation and education HAZMAT response Policy and regulation advocacy at the state and national level

7. Environmental Health as it Relates to the Oil & Gas Boom in Colorado Colorado has roughly 25,700 active wells An additional 40,000 wells are plugged and abandoned Wells are widely distributed around the state Two thirds (2/3) of Colorado Counties (42 of 63) have wells located in them Thirty (30)% of Colorado Counties (19 of 63) have at least two hundred wells Weld County has the most wells at over 10,000 (40%) Rio Blanco County and La Plata County each have over 2000 wells (10% each)

8. Oil & Gas Wells in Colorado

9. Environmental and Public Health Affects of Oil and Gas Wells Air Quality Impacts

10. Fugitive Dust

11. Drilling Operations Create Many Emissions

12. Burning Condensate Off Reserve Pit

13. Flaring During Well Completion

14. Evaporation Ponds

15. Heavy Diesel Emissions From Fracing Operations

16. Water Quality Impacts

17. Massive Pipeline Projects

18. Massive Well Pads

19. Spills

20. Proximity to Main Drainages

21. Drainages Used for Crop Irrigation

22. Contaminated Soils

23. Sewer Lines

24. Emergency Preparedness

25. Oil and Gas Wells Other Associated Impacts Increased truck traffic Increased truck traffic Increased railroad activity Increased railroad activity Development of new gravel pits Development of new gravel pits Occupational health and safety issues Occupational health and safety issues Communicable disease issues Communicable disease issues Substance abuse issues Substance abuse issues Citizens expect local government to protect them Citizens expect local government to protect them Local resource impacts Local resource impacts

26. Water Quality in Colorado These are just a few of the many water quality challenges we face in Colorado 2006 and 2007 assessments of lakes and rivers for fishable and swimmable waters – 230,000 miles of rivers assessed – 313,000 lake acres assessed Rivers – 12,800 miles are impaired and will require development of Total Maximum Daily Loads Lakes – 43,400 acres are impaired and will require development of Total Maximum Daily Loads

27. Water Quality in Colorado The total list of impaired water bodies statewide includes 160 water bodies affected by approximately 250 individual pollutants 15 fish consumption advisories for mercury on lakes, more proposed Primary sources of contaminants are selenium and mercury – resource extraction is the most common source when a source has been identified for selenium – mercury deposition is a global issue Local impacts – Boulder and South Boulder Creek, Fountain Creek, South Platte – protection of public health – need for local involvement

29. Lead Concerns in Colorado Public Health Affects – lower levels cause adverse effects on the central nervous system and kidneys – blood lead levels as low as 10 μg/dL, which do not cause immediate affects can cause: distinctive long-term symptoms associated with decreased intelligence and impaired behavioral development, decreased stature or growth, decreased hearing acuity, and decreased ability to maintain a steady posture long-term impacts at the population level can be significant Lead recalls – local impact

30. Lead Concerns in Colorado 1995 Denver lead study – 16.2% of 174 screened had levels above 10 ug/dL – Denver percentage before the study was 3.2% – highlight the problem of lead poisoning in the city and the need to provide resources for environmental investigation and intervention Minorities and low income are disproportionately affected Need at the local level – expanded/targeted testing – more follow up on blood levels at 10 ug/dL and above – more focused education – local ability for follow up is limited

31. Environmental Public Health in Colorado KEY: Solid Gray: These counties are served by local health departments. White with Gray Spots: These counties are served by public health nursing services but provide additional limited local environmental health services in addition to permitting individual sewage disposal systems. Solid White: These counties are served by nursing services with no local environmental health services provided except for permitting individual sewage disposal systems.

32. Environmental Health Service Providers at the County Level Environmental Health Specialists Public Health Nurses Public Works Employees Building Inspectors Land Use Planners HazMat Teams Fire Departments Local Emergency Planning Commissions Water/Wastewater Treatment Plants Soil Conservation Districts Watershed Groups Transit Authorities Housing Authorities Extension Agents State and Federal Government Citizens Colorado School of Public Health

33. University of Colorado Denver, Colorado State University, and the University of Northern Colorado Only Accredited School of Public Health in the Rocky Mountain Region (2010) Degree programs – Masters of Public Health – Masters of Science – Doctorate Program – Residency program – Certificate program – Distance learning

34. Colorado School of Public Health Masters in Public Health – Applied Biostatistics Program (UCD) – Community & Behavioral Health Program (UCD) – Community Health Education Program (UNC) – Environmental & Occupational Health Program (UCD) – Epidemiology Program (UCD) – Health Systems, Management & Policy Program (UCD) – Generalist Program (UCD) – Generalist Program (CSU)

35. Colorado School of Public Health Center for Public Health Practice Internships and practicum required for CSPH students Hub of public health training for the workforce – short courses, certificate programs, etc. – responsive to workforce needs, including training to meet the core competencies for public health professionals – topical training in disaster management and emergency response, epidemiology, statistics, emerging infectious diseases, among others Provide educational and training opportunities needed by state and local health departments as well as community based public health organizations Links to public health practice in Colorado communities Website: http://www.coloradosph.org/

36. Environmental Health Challenges Encourage evaluation of the current level of environmental health services in each of your counties Encourage environmental public health leadership in our communities Work with public health leaders to develop enhanced public health systems statewide

37. RESOURCES Examples of Environmental Health Service in Colorado Communities Aspen: Aspen: New recycling ordinance – www.aspenpitkin.com/depts/44/waste_ordinance.cfm www.aspenpitkin.com/depts/44/waste_ordinance.cfm Boulder Boulder: Septic Smart Initiative – www.SepticSmart.org www.SepticSmart.org Denver: Denver: Greenhouse Gas Inventory and Reduction Plan Eagle: Eagle: Frost Creek Water Quality Monitoring and Mitigation Plan Garfield Garfield - Air Quality Technical Work Group

38. RESOURCES Examples of Environmental Health Service in Colorado Communities Larimer Larimer: Retail Food program on the web – www.larimer.org/health/food/index.asp www.larimer.org/health/food/index.asp Northeast Northeast: Northeast Asthma Coalition San Juan Basin HD: San Juan Basin HD: Durango Silverton Narrow Gauge Rail Road Coal Smoke Task Force Summit: Summit: Food Safety Wall of Fame Tri-County: Tri-County: Rocky Mountain Arsenal Collaborative – http://www.tchd.org/arsenal.html http://www.tchd.org/arsenal.html Weld: Weld: STAR Program

39. Colorado Directors of Environmental Health Resource list of phone numbers, addresses and e-mails