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MEETING PACKET JANUARY 2015 • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH PublicIiealth 120 Wf1SHINGTON STREET,4 FLOOR Prevent,Promote.Protect. TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL Iramdin&salem.com Lk1tRY RAMDIN,RS/RF,1-[S,CI-K),(.;P-F: MAYOR HEALTI-1 AGf NT NOTICE OF MEETING You are hereby notified that the Salem Board of Health will hold its regularly scheduled meeting Wednesday January 7, 2015 at 7.00 PM Senior Center S Broad St. 1'`Floor MEETING AGENDA 4 r 1. Call to order z 2. Approval of Minutes r>r m D 3. Chairperson Announcements 4. Public Health Announcements/Reports/Updates c a. PHN Report b. Health Agent c. Administrative d. Council Liaison 5. Reorganization of the Board This notice posted on "Offi i Bulletin Board" City Hall, Salem, Mass. on �th �v C?0/,j 6. Miscellaneous at J/ :3 1 qN in accordan MGL Chap. 3OA, 7. jou nt Sections 18-25. Larry Ramdin Health Agent cc: Mayor Kimberley Driscoll, Board of Health, City Councilors Next regularly scheduled meeting is February 12, 2015 at 7pm at City Hall Annex, 120 Washington Street Room 312. Know your rights under the open meeting law MGL chapter 30A ss. 18-25 and City Ordinance section 2-2028 through 2-2033 CITY OF SALEM BOARD OF HEALTH MEETING MINUTES December 9, 2014 it DRAFT MEMBERS PRESENT: Dr. Barbara Poremba, Chair, Dr. Shama Alam& Dr. Danielle Ledoux, Paul Kirby& Janet Greene OTHERS PRESENT: Larry Ramdin Health Agent, Council Liaison Beth Gerard & Suzanne Doty, Public Health Nurse MEMBERS EXCUSED: TOPIC DISCUSSION/ACTION 1. Call to Order 7:00pm 2. Minutes of Last Meeting Dr. Ledoux motioned to accept the minutes with corrections. 2°d (Sept 91"& 241") P. Kirby; 4 for, 0 against, 1 abstention. Motion passes. 3. Chairperson Announcements None. 4. Monthly Reports-Updates A. Health Agent Report Burial permits are now electronic; there will be no hard copies available in the office. Funeral home will be allowed to print a copy for burial. Approved. Copy available at the BOH B. Public Health Nurse *November's flu clinic at the High School was also an EDS Report drill. The fire department has communication devises for us to use during an emergency *The Board of Health Department is looking for non-medical volunteers to join the MRC Suzanne completed a `just in time training" for fit testing that she can use during an emergency *Two TB cases have been closed *Suzanne will send a list of state reportable diseases to the new board members. Approved. Copy available at the BOH C. Administrative Report Overtime is over budget. Funds will be transferred to cover the overage. P. Kirby motioned to approve reports - 2nd by J. Greene Approved unanimously. Copy available at the BOH D. City Council Liaison *The keeping of chickens' ordinance is in front of City Council. Updates *Request from BOH to reduce size is still tabled at this time. � s 5. Hearing Request— Joyce Redford, Director, North Shore Cape Ann TAPP Hawthorne Hotel smoking in Program, received a complaint on their hotline on 7/17/14 workplace violation stating; "Someone was smoking in the Hawthorne Hotel in a conference room on the 2nd floor." On 7/21/14 Joyce Redford &Inspector Peter King investigated the 2"d floor of Hawthorne Hotel where they did smell smoke. They asked an employee if there was an office there, if it was a smoking floor and if they smoke in that office. The employee confirmed that the Manager, Michael Harrington, did smoke in his office on the 2"d floor and that is was a smoking floor. Mr. Harrington was under the impression that because it was a smoking floor he could smoke there. After receiving the violation letter from the Board of Health Department, Attorney Mihos, who represents the Hotel, asked for a hearing on this matter. Attorney Mihos read a statement into record from Mr. Harrington. The hotel also paid the violation at the meeting. A copy of the statement is available at the BOH office. J. Redford informed the Board of the following: *Saugus approved Tobacco2l, which like Salem, goes into effect 1/1/15 They also discussed a ban flavored tobacco. This does not including menthol. *In Danvers a presentation was made to the Board *Revere is in discussions about this topic *Lynn is also interested and will start discussing this soon. *Also state required signs for 21 will be provided by NSCATC 6. Presentation by RCG- Matthew Picarsic showed a power point presentation on the Washington St and Dodge proposed new development Street An amendment and clarification are in process for item# 13, Grease Management System, in the proposed conditions given to Mr. Picarsic by Larry Ramdin, Health Agent. 7. New Business: matters not anticipated Some of the BOH members had a conflict with the regularly prior to posting of agenda scheduled meeting on January 13, 2015. The meeting has been changed to Wednesday January 7, 2015, pending availability of a meeting room. Chairperson Poremba announced that the meeting would 8. Executive Session- Purpose#1 adjourn after the Executive Session. Dr. Ledoux motioned to start the executive session - 2nd Dr. Alam. Approved unanimously Dr. Ledoux motioned to close executive session-2"d by Dr. Alam. Approved unanimously r 8. MEETING ADJOURNED: 10:55 Ospectfully submitted, Heather Lyons-Paul Clerk of the Board Next regularly scheduled meeting is January 7, 2015 at 7pm Salem Senior Center, S Broad Street, 1st floor Salem. I Health Agent report January 2015 - Announcements • Mark Danderson was confirmed as a member of the Salem Board of Health term to end March 12018 • The Board of Health through the MAOPC grant, facilitated the funding of a presentation that addresses substance abuse by Chris Herren former NBA player, at the Salem High School. The program has been scheduled for March 96' • Suzanne Doty, Public Health Nurse and Heather Lyons Paul, Principal Clerk graduated from the Massachusetts Local Health Institute. "Foundations of Local Public Health" program, on March 4th • Mayor Driscoll has appointed Mary Butler as the Chief of Police. Chief Butler was promoted from lieutenant to acting captain in December 2014.In that capacity she served as the commanding officer of the department's special operations division, with oversight of the community impact unit, special response unit, traffic division, and records office. She is a 28 year veteran of the Salem Police Department since 1987, where she has overseen patrol division and the community impact unit as a lieutenant, served as public information officer and detective, and worked as administrative aide to former Chief Robert M. St. Pierre. • The Sanitarian vacancy has been posted and initial interviews were conducted. The posting will remain open until a suitable candidate is selected Community Outreach • An initial meeting of the Salem task force on Opiate overdose and use reduction was held and plans are underway to formalize the task force. A second meeting is scheduled for March 10. Public Health Highlights • An Administrative vas held at the request of Bruce Tinkham, the owner of 33 Buffi rn Street. Mr. Tinkham wished to discuss issues related to a housing correction order, his compliance and challenges he is facing in meeting total compliance due to refusal by the tenants to allow entry into the unit to allow Mr. Tinkham and his contractor to complete corrections. _ • The Department has responded to no heat complaints, 2 of which were on weekends. All issues were resolved 406 Meetings and Trainings - i • Larry Ramdin met with potential owners of 3 food establishments to discuss requirements _ for opening their operations. • David Greenbaum attended the Northshore React meeting _ • Larry Ramdin and Suzanne Doty attended the NSCAEP Coalition meeting Inspections Item Monthly Total YTD 2014 Total Certificate of Fitness 25 69 559 Inspection Certificate of Fitness 3 3 17 reinspection Food Inspection 15 25 384 Food Re-inspections 13 13 124 Retail Food 3 0 23 Inspections Retail Food 0 0 7 reinspection General Nuisance 0 2 14 Inspections Food— 0 0 1 Administrative Hearings Housing Inspections 20 37 183 Housing re- 2 9 39 inspections Meetings and Trainings - • Larry Ramdin met with potential owners of 3 food establishments to discuss requirements for opening their operations. • David Greenbaum attended the Northshore React meeting • Larry Ramdin and Suzanne Doty attended the NSCAEP Coalition meeting Inspections Item Monthly To YTD 2014 Total Certificate of Fitness 25 69 559 Inspection Certificate of Fitness 3 3 17 reinspection Food Inspection 15 25 384 Food Re-inspections 13 13 124 Retail Food 3 0 23 Inspections Retail Food 0 0 7 reinspection General Nuisance 0 2 14 Inspections Food— 0 0 1 Administrative Hearings Housing Inspections 20 37 183 Housing re- 2 9 39 inspections Rodent Complaints 0 0 23 Court 0 2 10 Hearings/filings Trash Inspections 0 18 218 Orders served by 0 0 2 Constable Tanning Inspections 0 0 1 Body Art 0 0 1 Swimming pools 0 0 23 Bathing Beach 0 0 100 Inspection/testing Lead Determination 0 0 1 Septic Abandonment 0 0 1 Septic System Plan 0 0 1 Review Soil Evaluation 0 0 1 Percolation tests 0 0 2 Total 68 181 1737 I Suzanne Doty RN, BSN Salem Board of Health Public Health Nurse Public Health Nurse Report Reporting on January 9th 2015 to March 5th 2015 Disease Prevention • Investigated reportable diseases and reported case information to MDPH. • In contact with North Shore Pulmonary Clinic and MGH pulmonary clinic on current active tuberculosis cases. • In contact with NSMC Infection Control department for prevention of disease within the hospital. • A Salem resident was notified that they were in contact with active Tuberculosis requiring a PPD;I was able to obtain PPD from DPH and preform the test for this resident, the result was negative. • Completing input of patient information for all flu vaccines given_ this season into MIIS (Massachusetts Immunization Information System). Health Promotion • Updated the Salem Board of Health Facebook and Twitter pages with information on Measles, information on the Medical Reserve Corps and links regarding heart health for the month of February. • Posted a recruitment.letter on the Salem Patch Bulletin board providing information on what the Medical Reserve Corps is and how to sign up. • Provided the Director of Nursing,Paula Dobrow, with information from the CDC regarding Measles. Meetings/Trainings • Completed the Local Public Health Institute"Foug0tions for Local Public Health Practice in Massachusetts"course. This class began on October 15`h, included 3 in-person class session as well as weekly modules and webinars. Graduation was held on Wednesday March 41h • Attended Personal Protective Equipment training on Topsfield regarding how PPE should be used in the community. • Attended the Emergency Preparedness Coalition meeting on February 25`h with a focus on using WebEOC for ordering supplies in the event of an emergency,updates regarding the MRC and discussion on community concerns. • Attended the Salem React meeting on February 261h at the police department with the Community Impact Unit, Salem Council on Aging and North Shore Elder Services to discuss ongoing and new issues involving seniors in our community and ways to assist them. Monthly Report of Communicable Diseases January 2015 Disease #Of Cases New Carry Over Discharged Running Total for Reported Total for 2014 2015 Tuberculosis 2 0 1 1 2 5 (Active) Latent 0 0 0 0 0 31 Tuberculosis* Calicivirus/No 1 1 0 1 1 1 rovirus Campylobacte 0 0 0 0 0 10 riosis Chikungunya 0 0 0 0 0 1 Ehrlichiosis 0 0 0 0 0 1 Enterovirus 0 0 0 0 0 0 Giardiasis 0 0 0 0 0 0 Group A 0 0 0 0 0 2 Streptococcus Group B 1 1 0 1 2 6 Streptococcus Haemophilus 0 0 0 0 0 0 Influenzae Hansen's 0 0 0 0 0 0 Disease Hepatitis B* 0 0 0 0 0 2 Hepatitis C* 0 0 0 0 2 37 Influenza* 6 6 0 6 16 27 Legionellosis 0 0 0 0 0 0 Lyme 0 0 0 0 0 7 Disease* Malaria 0 0 0 0 0 1 Meningitis 0 0 0 0 0 2 Pertussis 0 0 0 0 0 2 discuss ongoing and new issues involving seniors in our community and ways to assist • them.. - .. Monthly Report of Communicable Diseases January 2015 Disease #Of Cases New Carry Over Discharged Running Total for Reported Total for 2014 2015 Tuberculosis 2 0 1 1 2 5 (Active) Latent 0 0 0 0 0 31 Tuberculosis* Calicivirus/No 1 1 0 1 1 1 rovirus Campylobacte 0 0 0 0 0 10 riosis Chikungunya 0 0 0 0 0 1 Ehrlichiosis 0 0 0 0 0 1 Enterovirus 0 0 0 0 0 0 iGiardiasis 0 0 0 0 0 0 Group A 0 0 0 0 0 2 Streptococcus Group B 1 1 0 1 2 6 Streptococcus Haemophilus 0 0 0 0 0 0 Influenzae Hansen's 0 0 0 0 0 0 Disease Hepatitis B* 0 0 0 0 0 2 Hepatitis C* 0 0 0 0 2 37 Influenza* 6 6 0 6 16 27 Legionellosis 0 0 0 0 0 0 Lyme 0 0 0 0 0 7 Disease* Malaria 0 0 0 0 0 1 Meningitis 0 0 0 0 0 2 • Pertussis 0 0 0 0 0 2 A Health Dept. Clerical Report FY 2 0 Burial Permits Permits Plan Reviews Certificate of Copies / Fines Revenue Permit Fees $25 Fitness $50 July-14 $450.00 $815.00 $850.00 $2,115.00 Food Service Est. <25seats $14o August $900.00 $2,415.00 $1,950.00 $5,265.00 25-99 seats $28o >99 seats $420 September $775.00 $1,000.00 $180.00 $950.00 $200.00 $3,105.00 Retail Food <i000sq' s7o October $625.00 $1,804.00 $1,350.00 $7.00 $3,786.00 1000-10,000 $28o >1o,000 $420 November $675.00 $0.00 $90.00 $1,700.00 $2,465.00 Temp.Food 1-3 days s3oo December $850.00 $50,095.00 $3,450.00 $54,395.00 4-7days s600 >7days $ January-15 Example of>7 day temp food permit. $0.00 14(da s)divided bY 7=2 x s600=$1200 February $0.00 Frozen Desserts $25 March $0.00 Mobile Food $210 April $0.00 Plan Reviews New s18o May $0.00 Remodel s90 June Catering $25 per eventl$2oo $0.00 catering kitchen Body Art Est. $315 Total $4,275.00 $56,129.00 $270.00 $10,250.00F $207.00 $71,131.00 Body Art Practitioner 135 Tobacco Vendors $135 Fiscal Year Budget 2015 Suntan Est. $140 Rec.Day Camp $10 Salary Starting Ending Expenses Ext.Paint Removal s35 Full Time $341,229.00 $173,558.79 Starting Ending Transport Off.Subst. s1o5 Part Time $15,997.00 $11,447.00 $17,050.00 $6,887.91 Overtime $2,000.00 $339.34 Swimming Pools Seasonal $140 Balance $359,226.00 $185,345.13 Health Clinic Revolving Account Annual$210 Nonprofit$40 $13,560.72 Title V Review $180 Well Application s18o Disposal works $225/i80 Centers for Disease Control and Prevention 7 V LO 5 Y S; irbidity and Mortality Weekly Report Weekly/Vol.63/No.49 or December 12,2014 i = State Laws Prohibiting Sales to Minors and Indoor Use of Electronic Nicotine Delivery Systems — United States, November 2014 Kristy Marynak,MPPI,Carissa Baker Holmes,MPHI,Brian A.King,PhDI,Gabbi Promoff,MAI,Rebecca Bunnell,ScDI,Timothy McAfee,MDI (Author affiliations at end of text) Electronic nicotine delivery systems(ENDS),including elec- . combustible tobacco products are rapidly reduced(1).Therefore, tronic cigarettes(e-cigarettes)and other devices such as electronic when addressing potential public health harms associated with hookahs, electronic cigars, and vape pens, are battery-powered ENDS,it is important to simultaneously uphold and accelerate devices capable of delivering aerosolized nicotine and additives strategies found by the Surgeon General to prevent and reduce to the user.Experimentation with and current use of e-cigarettes combustible tobacco use, including tobacco price increases, has risen sharply among youths and adults in the United States comprehensive smoke-free laws,high-impact media campaigns, (1,2).Youth access to and use of ENDS is of particular concern barrier-free cessation treatment and services,and comprehensive given the potential adverse effects of nicotine on adolescent brain statewide tobacco control programs(1). development (3). Additionally, ENDS use in public indoor areas might passively expose bystanders(e.g.,children,pregnant women, and other nontobacco users) to nicotine and other INSIDE potentially harmfid constituents (4,�: ENDS use could have of p y 1151 Estimated Influenza Illnesses and Hospitalizations the potential to renormalize tobacco use and complicate enforce- Averted by Vaccination—United States,2013-14 i ment of smoke-free policies(1).State governments can regulate Influenza Season the sales of ENDS and their use in indoor areas where nonusers 1155 Incidence of Sickle Cell Trait—United States,2010 might be involuntarily exposed to secondhand aerosol(4,5).To 1159 Global Invasive Bacterial Vaccine-Preventable learn the current status of state laws regulating the sales and use Diseases Surveillance—2008-2014 Of ENDS,CDC assessed state laws that prohibit ENDS sales to 1163 Airport Exit and Entry Screening for Ebola— minors and laws that include ENDS use in conventional smoking August-November 10,2014 prohibitions in indoor areas of private worksites,restaurants,and 1168 Ebola Virus Disease in Health Care Workers— bars.Findings indicate that as of November 30,2014,40 states Sierra Leone,2014 prohibited ENDS sales to minors,but only three states prohibited 1172 Rapid Assessment of Ebola Infection Prevention ENDS use in private worksites,restaurants,and bars.Of the 40 and Control Needs—Six Districts,Sierra Leone, states that prohibited ENDS sales to minors,21 did not prohibit October 2014 ENDS use or conventional smoking in private worksites,restau- 1.175 Clinical Inquiries Regarding Ebola Virus Disease rants, and bars.Three states had no statewide lawy prohibiting Received by CDC—United States,.July 9- v' w ENDS sales to minors and no statewide laws prohij�'ting ENDS November 15,2014. : use or conventional smoking in private worksites, restaurants, 1180 Announcement and bars.According to the Surgeon General, ENDS.have the 1183 QuickStats potential for public health harm or public health benefit(1).The possibility of public health benefit from ENDS could arise only if 1)current smokers use these devices to switch completely from Continuing Education examination available at combustible tobacco products and 2) the availability and use of http://www.cdc.gov/mmwr/cme/conted_info.html#weekly. 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'��,,�-t�,.`yTti#�� a, .,s Morbidity and Mortality Weekly Report _ Data on state laws enacted as of November 30,2014,were children aged <18 years can legally purchase ENDS in the Columbia- obtained from CDC's State 3'obacco-Activities Tracking and - -"-remaining it states,including the District of j Evaluation(STATE)System for the 50 states and the District Whereas 27 states,including the District of Columbia,have of Columbia.* STATE contains tobacco-related state laws comprehensive smoke-free laws that prohibit smoking in res- collected quarterly from the LexisNexis online legal research taurants,worksites,and bars,only three limit indoor ENDS database.t This study examined laws that explicitly prohibit: use: New Jersey, North Dakota, and Utah (Figure 2).Thus, 1)ENDS sales to minors;and 2)ENDS use in indoor areas of an estimated 303 million U.S.residents,including 70 million nonusers of these products private-sector worksites,restaurants,and bars.Laws that made children, live in states in whi der secondhand smoke from general reference to tobacco products or tobacco consumption, can be passively exposed to without explicit reference to ENDS,were excluded.State laws cigarettes and other combustible tobacco products or ENDS covering private-sector worksites, restaurants and bars were aerosol.No states have enacted comprehensive smoke-free laws assessed to determine whether these laws align with CDC's or laws prohibiting ENDS use in private worksites,restaurants, definition of a comprehensive smoke-free law(i.e.,prohibiting and bars since 2012(Table). smoking in all indoor areas of private worksites, restaurants, Two states (New Jersey and Utah) prohibit ENDS sales to and bars) (�i . U.S. Census Bureau estimates as of July 2013 minors and indoor smoking and indoor ENDS use in private were used to estimate population coverage-5 worksites, restaurants, and bars (Table).Three states (Nevada, A total of 40 state laws prohibit ENDS sales to minors Pennsylvania,and'Iexas)have neither type of law(Table).Among (Table), sales are prohibited to persons aged <18 years in the 40 states with laws prohibiting ENDS sales to minors,21 lack 36 states and<19 years in Alabama,Alaska,New Jersey,and laws that prohibit conventional smoking and ENDS use indoors Utah(Figure 1).Twelve states enacted such laws effective dur- in private worksites,restaurants;and bars(Table). ing 2010-2012,compared with 12 states in 2013,and 16 states Discussion by November 30, 2014 (Table). Approximately 16 million An increasing number of states have enacted laws prohibiting -Additional information available at httpJ/wwwcdc.gov/tobacco/statesystem. ENDS sales to minors,but 11 states,including the District of (ENDS laws will be added to the STATE system database in 2015.) Columbia,have not.Far fewer states have passed laws prohibit- t Additional information available at hup://wwwlo&ncxis.com. ing ENDS use indoors,and no states have enacted such laws 4Additional information available at htV.//5afinder2.oe...grn'/faoes/tab6.,icad jsf/pWdprodurniewxhtmL?pid=PEP 2013—PEPAGESEX&prodType=rable. since 2012.The comparative lack of laws prohibiting ENDS 1146 MMWR / December 12,2014 /Vol.63 / No.49 i J Morbidity and Mortality Weekly Report FIGURE 1.Stateswith and without laws prohibiting sales of electronic youth prevention efforts,including.preemption of stricter ocal nicotine delivery systems (ENDS)to minors*—United States, policies and weak enforcement requirements(9).Additionally, _ November 30,2014 laws prohibiting sales to minors are likely to have limited effec- tiveness as a youth tobacco prevention strategy if not coupled with proven interventions such as comprehensive smoke-free laws(1,9).Thus,among the 21 states that have laws prohibit= ing sales of ENDS to minors but do not have comprehensive smoke-free laws, protections against the use of conventional tobacco and ENDS in indoor public places would benefit p DC public health.Laws prohibiting sales of ENDS to minors that allow for local action and feature strong enforcement prisions are more likely to help prevent youth access(9). The recent rapid increase in ENDS use by youth and adults might be partially attributable to increased advertising of these products,particularly on television(10).Some marketing sug- gests that ENDS can be used in places where smoking is not Prohibits ENDS sales to minors(n=40) allowed(1)or refers customers to advocacy groups that oppose IN No prohibitions on ENDS sales to minors(n=11) indoor ENDS use prohibitions(3).**tt These groups contend Minorsareclefined by statute as persons aged<1 8years,except in fburstateswhere that ENDS emit fewer toxins than combustible tobacco,and theyare defined as personsaged<1 9years(Alabama,Alaska,NewJersey,andUtah). that public use could encourage smokers to switch to ENDS. However,ENDS aerosol is not as safe as clean air.Nicotine is use indoors could be attributable to limited knowledge about a psychoactive chemical with known harms and irritant effects the potential health effects of public ENDS use and to the (1). Research has documented the presence of secondhand sting state -free laws(1). nicotine exposure using. ronmental monitoring complexities he Prohibiuo s on ENDS use in public places meight be benefi- measurement of b omarkers lam among exposed nonusers and (St7) cial in multiple ways.First,prohibitions could preserve clean Moreover, public ENDS use might prolong smoking by indoor air because ENDS aerosol can contain harmful and facilitating situational substitution of ENDS when smoking potentially harmful constituents,including nicotine and other is not allowed,rather than complete substitution(1,3).Using toxins (4,5,7), and some ENDS can be modified to deliver a public health standard, policies should consider potential marijuana and other psychoactive substances (8). Second, adverse impacts on the entire population,particularly children based on the experience that smoke-free policies result in and nonusers.(1). diminished social acceptability of smoking(9),restrictions on The Food and Drug Administration (FDA) has issued a ENDS use in public might help support tobacco-free norms. proposal to regulate additional products meeting the legal Third,such restrictions could support smoke-free law enforce- definition of a tobacco product, including ENDS, through ment because some ENDS use can be difficult to distinguish authority,granted by the Family Smoking Prevention and from conventional smoking, thus complicating smoke-free Tobacco Control Act.44 If finalized as written,the rule would policy enforcement.Accordingly, it is important that efforts establish,among other provisions:restrictions to prevent sales to integrate ENDS into smoke-free.laws uphold or strengthen, to minors,to prohibit free samples, and to prohibit vending not weaken,existing protections against secondhand smoke machine sales, unless in a facility that never admits minors. exposure(13). The proposed rule must undergo several steps before becoming The relatively rapid adoption of laws prohibiting ENDS final,and during this period there could be further increases sales to minors compared with the slow adoption of laws in youth ENDS use. Furthermore, FDA regulation will not prohibiting ENDS use in public indoor spaces might be address certain key policy interventions related to ENDS,such attributable,in part,to the tobacco industry,which has actively as use in public places.The Family Smoking Prevention and advocated for state legislation to prevent minors from purchas- Tobacco Control Act allows states and localities to adopt or ing ENDS 5 This is of concern because industry-supported continue to enforce additional or more stringent requirements youth-access bills have contained provisions that undermine **Additional information available at htcp://wwwhowtonjoyvaping.com/home-1. tt Additional information available at http://sfata.org/cafs-to-action. fAdditional information,available at.http://www.commerce.senate.gov/ WAzlditional-information available at http://wwArgpo.g-/fdWs/pkg/PLAW- public/?a=Files.Serve&File_id=7e32673d-795b-44ce-979b-cc9d6c4fl d48. 111 pub131/content-detail.html. MMWR / December 12,2014 /Vol.63 / No.49 1147 Morbidity and Mortality Weekly Report ' TABLE.State laws_prohibiting sales of electronic nicotine delivery systems(ENDS)to minors and laws prohibiting conventional smoking and the use of ENDS in indoor.areas.of.private worksites,restaurants,and bars,—United States,Noyember 30,201 .. . . State smoke-free law Effective date of Prohibits conventional Includes Summary of laws law restricting smoking in worksites, as of ENDS sales to minors restaurants,and bars restriction iv ENDS use enacteNovemberd30,014 ; (minimum age allowed[yrs]) (effective date) (effective date) State yq Alabama 8/1/2013(19) YA 8/22/2012(19) YA/SF Alaska 9/13/2013(18) 5/1/2007 No YA — Arizona - Arkansas 8/16/2013(18) YA 9/27/2010(18) YA/SF California 3/25/2011 08) 7/1/2006 NO YA Colorado Connecticut 10/l/2014(18) 12/1/2002 No YA/SF Delaware 6/12/2014(18) No SF District of Columbia 1/1/2007 YA i Florida 7/1/2014(18) YA Georgia 7/1/2014(18) 006 No YA/SF 11/16/2 Hawaii 6/27/2013(18) YA 7/1/2012(18) YA/SF Idaho 1/1/2014(18) 1/1/2008 N° YA Inlinoisdiana ana 7/1/2013(18) No YA/SF 7/1/2008 7/1/2014(18) YA/SF Iowa 7/1/2010 No j Kansas 7/1/2012(18) YA Kentucky 4/10/2014(18) YA Louisiana 5/28/2014(18) No SF 9/11/2009 YA/SF Maine 2/1R008 No Maryland 10/1R012(18) 7/5/2004 No SF Massachusetts 5/1/2010 No SF Y Michigan 10/1/2007 No aAF Minnesota 8/1/2010(18) Mississippi 7/1/2013(18) YA . Missouri 9/10/2014(18) 10/1/2009 No SF Montana 6/1/2009 No YA/SF Nebraska 4/9/2014(18) Nevada YA New Hampshire 7/31/2010(18) Yes(7/11/2010) YA/SF/EF 3/12/2010(19) 4/15/2006 SF New Jersey 6/15/2007 No New 7/24/2003 YA/SF New York CO 1/1/2013(18) No YA North Carolina 8/12013(18) Yes(12/6/2012) SF/EF. 12/6/2012 YASF North Dakota g/2/2014(18) 12/7/2006 No / Y Ohio Oklahoma 11/1/2014(18) 1/1/2009 No SF Oregon Pennsylvania 3/12005 No YA/SF Rhode Island 6/30/2014(18) YA 6/7/2013(18) YA/SF South Carolina No 7/1/2014(18) 11/10/2010 YA South Dakota 7/1/2011(18) Tennessee Texas 1/1/2009 Ye.(5/8/2012) YA/SF/EFUtah 4 5/11/2010(19) ar YA/SF Vermont $ 7/1/2013(18) �* 7/1/2009 N° YA Virginia 7/1/2014(18) No YA/SF Washington 7/28/2013(18) 12/8/2005 YA 6/27/2014(18) YA/SF West Virginia 4/20/2012(18) 7/5/2010 No YA Wisconsin Wyoming 3/13/2013(18) N/A Total -w 40 27 - 3 -fre law t prohibits smoking te has a Abbreviations:YA=youth access(state law prohibits nd baarrs EF sales ENDS-free(state of ENDS to minors); prohibits the use of ENDSENDS n ndoor areas of Private orksitess,raestaurants,and bars).n hensip4e smoke indoor areas of prnrate worksites,restaurants, 1148 MMWR / December 12,2014 /Vol.63 / No.49 J Morbidity and Mortality Weekly Report _ TABLE.State laws_prohibiting sales of electronic nicotine delivery systems(ENDS)to minors and laws prohibiting conventional smoking and the use.of ENDS in indoor.areas.of.private worksites,restaurants,atndbars-United States,N9Yember:30; y1 ___ _ .. . State smoke-free law ! Effective date of Prohibits conventional Includes Summary of laws law restricting smoking In worksites, ENDS sales to minors restaurants,and bars restriction on ENDS use enacted as of State (minimum age allowed(yrs)) (effective date) (effective date) November 30,2014 Alabama 8/1/2013(19) YA YA Alaska 8/22/2012(19) Arizona (18) 5/1/2007 No A/SF Arkansas 8/16/2013(18) YA Califomia 9/27/2010(18) No YA/SF Colorado 3/25/2011(18) 7/1/2006 YA Connecticut 10/1/2014(18) Delaware 6/12/2014(18) 12/1/2002 No YA/SF District of Columbia 1/1/2007 No SF Florida 7/1/2014(18) YA Georgia 7/1/2014(18) No YA/SF Hawaii 6/27/2013(18) 11/16/2006 YA Idaho 7/1/2012(18) 1/1/2014(18) 1/1/2008 No YA/SF Illinois YA i 7/1/2013(18) Indiana j Iowa 7/1/2014(18) 7/1/2008 No YA/SFYA I Kansas 7/1/2012(18) 7/1/2010 No YA/SF Kentucky 4/10/2014(18) YA j Louisiana 5/28/2014(18) SF 9/11/2009 No i Maine No YA/SF i Maryland 10/1/2012(18) 2/1/2008 SF Massachusetts 7/5/2004 No 5/1/2010 No SF Michigan 10/1/2007 No YA/SF Minnesota 8/1R010(18) YA Mississippi 7/1/2013(18) YA Missouri 9/10/2014(18) No SF lonnoo9 Montana 4/9/2014(18) 6/1/2009 No YA/SF Nebraska Nevada YA New Hampshire 7/31/2010(18) j New Jersey 3/1212010(19) 4/15/2006 Yes(7/11/2010) YA/SF/EF ! 6/15/2007 No SF i New Mexico 7/24/2003 No YA/SF New York 1/1/2013(18) YA North Carolina 8/1/2013(18) F. North Dakota 12/6/2012 Yes(12/6/2012) SF/YA/EF j Ohio 8/2/2014(98) 12/7/2006 No YA 11/12014(18) Oklahoma SF Oregon 1/1/2009 No Pennsylvania 3/1/2005 No YA/SF Rhode Island 6/30/2014(18) YA South Carolina 6n12013(18) No YA/SF South Dakota 7/12014(18) 11/10/2010 YA Tennessee 7/1/2011(18) Texas 1/1/2009 Ye-,(5/8/2012) YA/SF/EF Utah 5/11/2010(19) YA/SF Vermont 7/1/2013(18) 7/1/2009 NO YA , Virginia 7/1/2014(18) Washington 7/28/2013(18) 12/8/2005 No YA/A F West Virginia 6/27R014(18) 7/5/2010 No YA/SF Wisconsin 4/20/2012(18) YA Wyoming 3/13/2013(18) Total 40 27 _ 3 N/A oke-free law that prohibits indoor aations:YA youth access(state law prohibits reas of private worksites,restaurants,and bars-,EF=ENDS-free(state law prohibits thales of ENDS to minors);SF= e (state of ENDS n doocomprehensive areas of pmrivate worksites,restaurants,and bars�n 1148 MMWR / December 12,2014 /Vol.63 / No.49 Morbidity and Mortality Weekly Report - -.. - FIGURE 2.States with and without laws prohibiting smoking and use of electronic nicotine delivery systems(ENDS)in indoor areas of private worksites,restaurants,and bars—United States,November 30,2014 1I ®DC { i i Prohibits indoor smoking,and indoor ENDS use(n=3) Prohibits indoor smoking only(n=24) ®No comprehensive*smoke-free air law or prohibition on indoor ENDS use(n=24) i *CDC defines a state smoke-free air law as comprehensive if it prohibits smoking in indoor areas of private worksites,restaurants,and bars. Although ENDS might have the potential to benefit estab- lished adult smokers if used as a complete substitute for all products,combusted tobacco p , ENDS should not be used by than those stipulated.Additional national and state policies youths and adult nontobacco users because of the adverse effects of nicotine and other risk exposures,as well as the risk addressing retailer licensing,Internet sales,taxation,and mar- for progression to other forms of tobacco use(1).The findings keting could further prevent youth use of ENDS and other in this report suggest that states have additional opportunities tobacco products(1,3). to prevent access to ENDS,avoid renormalization of tobacco The findings in this report are subject to at least two limits- us and preserve clean indoor air standards. tions.First,STATE does not contain bills under consideration, Proven tobacco prevention strategies, including compre- regulations,local laws, opinions of attorneys general, or case hensive smoke-free laws and robust prohibitions against sales law decisions for tobacco control topics other than preemp- o minors, could be effective in preventing youth ENDS use '!, tion. Importantly, over 200 localities have included ENDS and denormalizin tobacco use.Simultaneously upholding and prohibitions in their comprehensive smoke-free laws 1s Second, S the strength of each law or the specific language contained in accelerating strategies proven to prevent conventional tobacco each law was not assessed.Statutory definitions of ENDS(e.g., use,support tobacco cessation,and prevent secondhand smoke . For example, some as a tobacco product) vary across states exposure would benefit public health(1,3). wl states' statutory definitions of ENDS define the products as ._f Acknowledgments alternative nicotine or vapor products that are exempt from Allison MacNeil, MPH, Kisha-Ann S.Williams, MPH, Office regulations or taxes that apply to tobacco products.Including on Smoking and Health, National Center for Chronic Disease ENDS in the state or local statutory definition of tobacco Prevention and Health Promotion,CDC;Ryan Patrick,JD,Noah products could facilitate the extension of additional tobacco _ Kingery,MayaTech Corporation. - control policies to ENDS, such as retailer licensing require- 10ffice on Smoking and Health,National Center for Chronic Disease ments,taxation,and marketing provisions. prevention and Health Promotion, CDC (Corresponding author: Kristy Marynak,ktnarynak@cdc.gov,770-488-5493) 11 Additional information available at http://www no-smoke.orglpdf/eci kws•Pdf MMWR/ December 12,2014 /Vol.63 / No.49 1149 Morbidity and Mortality Weekly Report References 6.CDC.State smoke free laws for worksites,restaurants,and bats—United _ -- --- State,2000-2010.MMWR Morb Moft-d WUy Rep 20H;60.472=5. 1.US Department of Health and Human Services:Thi:health consequences 7.BAW M, Martfnez-Sanchez JM, Sureda X, et al. Cigarettes vs. of smoking-50 years of progress:a report of the Surgeon General.Atlanta, _ e-cigarettes:passive exposure at home measured by means of airborne GA:US Department of Health and Human Services,CDC;2014. marker and biomazkers.Environmental Res 2014;135076-80.Epub 2.King BA,Patel F.Nguyen KH,Dube SR Trends in awareness and use of electronic cigarettes among U.S.adults,2010-2013.Nicotine Tob Res ahead of print. 2014.Epub ahead of print. 8.Durmowicc EL.The impact of electronic cigarettes on the paediatric 3.Grana R, Benowitz N, Glantz S. E-cigarettes: a scientific review. Population.Tob Control 2014;23:ii41-6. Circulation 2014;129:1972-86. 9.US Department of Health and Human Services.Preventing tobacco use among youth and young adults:a report of the Surgeon General.Atlanta, 4.Gon ML,Kama T,Gawron M,Knysak J,Kosmidet L.Nicotine levels in electronic cigarettes:Nicotine Tob Res 2013;15:158--66. GA:US Department of Health and Human Services,CDC;2012. 5.Schripp T, Markewitz D, Uhde E, Salthammer T. Does e-cigarette 10.Kim AE,Arnold -2 12.Am ko PrevE cigarette advertising expenditures consumption cause passive vaping?Indoor Air 2013;23:25-31. in the U.S.,2011-2012.Am J re Med 2014;46:409-12. u,. r tyr ' 4�1 • e aY i 1 j 1150 MMWR / December 12,2014 /Vol.63 / No.49 I1 Morbidity and Mortality Weekly Report _ References 6.CDC.State smoke-free laws for worksites,restaurants,and bars—United _ --•..._._ _- Stat�2000-2010.MMWR-Morb ModalWkly-Rep 20H;60:472=50 " _ I:US Departrnentof I ealth and Human"Servica.The health-consequences y Baljbb M, Martfnei-S£nchez JM, Suteda X, et al. Cigarettes vs. GA smoking=50 years of progress:a report the Surgeon General.2014.al.Atlanta, e-cigarettes:passive exposure at home measured by means of airborne G US Department of Health and Human Services,CDC; marker and biomarkers.Environmental Res 201403507640.Epub 2.King BA,Patel R;Nguyen KH,Dube SR.Trends in awareness and use ahead of print of electronic cigarettes among U.S.adults,2010-2013.Nicotine Tob Res 8"Durmowfcz EL The impact of electronic cigarettes on the paediatric 2014.Epub ahead of print population.Tob Control 2014;23:ii41-6. 3.Grana R, Benowitz N, Glantz S. E-cigarettes: a scientific review. 9,US Department of Health and Human Services.Preventing tobacco use Circulation 2014;129:1972-86 among youth and young adults:a report of the Surgeon General.Atlanta, 4.Goniewicz.ML,Kuma T,Gawron M,Knysak J,Kosmider L.Nicotine CA-US Department of Health and Human Services,CDC;2012. levels in electronic cigarettes.Nicotine Tob Res 2013;IS:158-66. 10.Kim AE,Arnold KY,Makarenko O.E-cigarette advertising expenditures 5.Schripp T, Markewitz D, Uhde E, Salthammer T. Does e-cigarette consumption cause passive vaping?Indoor Air 2013;23:25-31. in the U.S.,2011-2012.Am J Prev Med 2014;46:409-12. 9, �t • i j 1150 MMWR/ December.12,2014 /Vol.63 / No.49 i CITY OF SALEM BOARD OF HEALTH MEETING MINUTES January 21, 2015 DRAFT MEMBERS PRESENT: Dr. Shama Alam, Chair, Janet Greene, Paul Kirby, Dr. Danielle Ledoux &Dr. Barbara Poremba OTHERS PRESENT: Larry Ramdin Health Agent, Council Liaison Beth Gerard &Heather Lyons-Paul, Clerk of the Board TOPIC DISCUSSION/ACTION 1. Call to Order 7:30pm 2. Vote to recommend to Dr. Ledoux motioned that the Salem Board of Health support the reduction city council the reduction in the size of the Board from 7 to 5 members. of the Board of Health 2"d Janet Greene -No discussion - all in favor Members Councilor Gerard will be making a motion to Council for a Home rule petition to amend Ch. 654 of 1972. 3. New Business/Scheduling of Future Agenda Items A. Agenda items *City seals for Martin Fair and Gayle Sullivan. Dr. Poremba will talk to Gayle. for next month *Larry Ramdin provided information to the Board about a nuisance complaint. Board has instructed Mr. Ramdin to delay the delivery of nuisance complaint until the Board can discuss it at the next meeting. There was a brief discussion about open meeting law and conflict of interest law. Beth Rennard and Victoria Coldwell will be contacted for clarification. *Executive session and tobacco suspensions will be added to the agenda for next month 4. Meeting adjourned: Dr. Poremba motioned to adjourn the meeting 2"d Dr. Ledoux all in favor Meeting adjourned at 8:15pm Respectfully submitted, Heather Lyons-Paul Clerk of the Board Next regularly scheduled meeting is February 11, 2015 at 7pm At Senior Center P Floor 5 Broad Street, Salem