title: Environmental health practice: statistically based performance measurement.
abstract: OBJECTIVE
  State environmental and health protection agencies have traditionally relied on a facility-by-facility inspection-enforcement paradigm to achieve compliance with government regulations. We evaluated the effectiveness of a new approach that uses a self-certification random sampling design.
  
  
  METHODS
  Comprehensive environmental and occupational health data from a 3-year statewide industry self-certification initiative were collected from representative automotive refinishing facilities located in Rhode Island. Statistical comparisons between baseline and postintervention data facilitated a quantitative evaluation of statewide performance.
  
  
  RESULTS
  The analysis of field data collected from 82 randomly selected automotive refinishing facilities showed statistically significant improvements (P<.05, Fisher exact test) in 4 major performance categories: occupational health and safety, air pollution control, hazardous waste management, and wastewater discharge. Statistical significance was also shown when a modified Bonferroni adjustment for multiple comparisons was performed.
  
  
  CONCLUSIONS
  Our findings suggest that the new self-certification approach to environmental and worker protection is effective and can be used as an adjunct to further enhance state and federal enforcement programs.
authors.affiliation: Rhode Island Department of Environmental Management, Office of Technical and Customer Assistance, Providence, RI 02908, USA. richard.enander@dem.ri.gov
authors.forename: Richard T
authors.initials: RT
authors.lastname: Enander
authors.forename: Ronald N
authors.initials: RN
authors.lastname: Gagnon
authors.forename: R Choudary
authors.initials: RC
authors.lastname: Hanumara
authors.forename: Eugene
authors.initials: E
authors.lastname: Park
authors.forename: Thomas
authors.initials: T
authors.lastname: Armstrong
authors.forename: David M
authors.initials: DM
authors.lastname: Gute
mesh_terms: D000397:Air Pollution / Q000517:prevention & control; D001336:Automobiles; D002568:Certification; D004782:Environmental Health / Q000592:standards*; D019983:Guideline Adherence; D006256:Hazardous Waste; D006801:Humans; D007221:Industry / Q000592:standards*; D012237:Rhode Island; D012449:Safety; D014865:Waste Disposal, Fluid
chemical_list: D006256:Hazardous Waste