Author: Peacock Carter

The World Health Organization (WHO) has published new guidelines which bring together the most recent evidence to provide practical recommendations to reduce the health burden due to unsafe and substandard housing.

The guidelines provide new evidence-based recommendations on how to reduce major health risks associated with poor housing conditions in 4 areas:
• Inadequate living space (crowding)
• Low and high indoor temperatures
• Injury hazards in the home
• Accessibility of housing for people with functional impairments.

The guidelines also identify and summarise existing WHO guidelines and recommendations related to housing, in relation to water quality, air quality, neighbourhood noise, asbestos, lead, tobacco smoke and radon.

The guidelines take a comprehensive, intersectoral perspective on the issue of housing and health and highlight co-benefits of interventions addressing several risk factors at the same time.

The guidelines aim to inform housing policies and regulations at the national, regional and local level and emphasise the importance of collaboration between the health and other sectors and joint efforts across all government levels to promote healthy housing.

The guidelines’ implementation at country-level will in particular contribute to the achievement of the Sustainable Development Goals on health (SDG 3) and sustainable cities (SDG 11). WHO will support member states in adapting the guidelines to national contexts and priorities to ensure safe and healthy housing for all.

‘WHO Housing and health guidelines’ can be accessed at: https://www.who.int/sustainable-development/publications/housing-health-guidelines/en/

The Scottish Health Protection Network (SHPN) has issued new guidance, replacing the 2013 Guidance for the Public Health Management of Infection with Verotoxigenic Escherichia coli, which is designed to support the development of those arrangements and assist in response to E. coli cases by health protection teams, environmental health departments and other stakeholders. It is also part of a suite of materials that has been produced in parallel with, and it should be used alongside, the ‘Scottish STEC Enhanced Surveillance Form’.

Over a number of years, there has been a large amount of work to reduce the burden of disease from E. coli O157 through a host of interventions aimed at preventing, or minimising risk of, infection.

However, cases still occur, both sporadically and in outbreaks, and rapid response to these situations is necessary for protection of the public health. Additionally, there has been an increase in the number of non-O157 STEC, and increasing evidence of the disease burden of E. coli O157 Shiga-toxin negative organisms.

This document:

• notes the current epidemiology of E. coli in Scotland, including the increase in non-O157 STEC
• expands and further details the local diagnostic and reference laboratory testing procedures currently available
• and refreshes the advice on public health actions in light of the best available evidence

The guidance can be accessed at: https://www.hps.scot.nhs.uk/pubs/detail.aspx?id=180.

Fast food adverts could be banned from council-owned sites in the Capital as part of an effort to tackle obesity.

Liberal Democrat Cllr Kevin Lang has tabled a motion at a full council meeting, calling for an investigation into “the legal powers available to ban fast food advertising on sites owned by the council, including bus and tram stops”.

This follows a similar ban that will come in force from 25 February in London that will bring in a fast food advertisement ban on its public transport network, after 82 per cent of residents supported the proposals. The restrictions will apply to advertisements on all modes of transport controlled by TfL, including the underground, overground, London buses, trams and river services.

If Cllr Lang’s motion wins support, the council will draw up a timetable to hold a public consultation on such a ban as well as a “financial appraisal of any new restrictions” including replacing projected lost revenue from other advertising sources.

Cllr Lang said: “Advertising has a major influence on the decisions we all make. It is why fast food companies spend billions of pounds on their adverts every year.

“Yet as a country, we are facing an obesity crisis with national obesity levels amongst the highest in the developed world. The question is whether the council is helping or hindering that by allowing sites such as bus and tram stops to be used for fast food advertising. I believe the approach now being taken forward in other cities is worth looking at.

“The London experience certainly showed strong public support for banning fast food advertising across that city’s transport network. It would be interesting to know whether there is similar support here in Edinburgh. It is certainly not the only answer to the obesity problem but it may help.”

An Advertising Association spokesman said: “Advertising restrictions, like the one tabled, will certainly negatively impact income and revenue incomes for the city council, but are likely to have little or no effect on childhood obesity levels in the city.

“It is important to note that the advertising rules currently in force in the country are among the strictest in the world and that the advertising in question helps pay for Edinburgh’s transport network and infrastructure.

“International experience and independent research have shown an advertising ban would have minimal impact on the wider issues that drive obesity, which is caused by many complex factors and means help is needed at a community level.”

A discount store in the north of Glasgow has been refused an alcohol licence following concerns that drinking in the local area was double the Scottish average.

Home Bargains in Springburn had applied to Glasgow City Council’s licensing board to sell wines, beers and spirits.

However, the bid was rejected by Glasgow City Council’s licensing board after it was pointed out that alcohol-related harm in the area was more than double the national average.

Elaina Smith, of Glasgow city health and social care partnership, told the licensing board on: “This neighbourhood is already filled with supermarkets and stores which sell alcohol.

“To have another one would make the problem even bigger. The existing harm levels in Springburn are above the Scottish rates.

“Selling alcohol in this Home Bargains is likely to add to the problem.”

Councillor Margaret Morgan said: “I am shocked that the alcohol harm rate in Springburn is 220% above the national average.

“People can buy alcohol from Tesco and Lidl. Having another shop selling alcohol is going to make the issue even bigger.”

Members were informed by the Home Bargains representative that the shop in Clydebank, West Dunbartonshire, could sell alcohol and there had not been any problems.

Councillor Alex Wilson said: “I am very aware of the retail park in Clydebank – it adds value to the area.

“But I am also concerned about the alcohol-related harm levels which have been presented to us.

“I would like to know what you would do to address that and give the board some comfort?”

A representative for Home Bargains said: “I don’t agree that the supply of alcohol would lead to people drinking more or drinking more harmfully.

“What we can enforce is the Challenge 25 and work with the local authority and police if there were concerns about people’s drinking habits.

“We have staff who are trained at identifying signs of people who are intoxicated and they would not sell them alcohol.”

Mr Wilson replied: “While I agree with you on some things, I have seen severe intoxication on many occasions in Springburn shopping centre which worries me.”

Councillor Matt Kerr said: “We have to understand that there are vulnerable people in this area who are more likely to drink alcohol.”

Ms Smith added: “There are high levels of extreme poverty. They may not intentionally go to the store to purchase alcohol but if they see a bargain they will pick it up.
Following the discussion members refused the licence.

Twenty-one out of 55 bottles of vintage Scotch whiskies tested at a specialist laboratory have been found to be fake.

The research was conducted at the Scottish Universities Environmental Research Centre (SUERC), based in East Kilbride which is home to one of the UK’s four Radiocarbon Accelerator Units. The lab used advanced radiocarbon dating techniques to forensically test and analyse a range of different whiskies. The analysis, which took more than 9 months to complete, measured residual concentrations of a radioactive isotope of carbon present in the alcohol contained in each bottle in order to establish the ages of the whiskies.

The samples had been sent for analysis by whisky broker Rare Whisky 101 (RW101) on the back of growing concern surround the proliferation of fake whisky in the secondary market.T he bottles had been selected at random from auctions, private collections and retailers.

Of particular note are three rare whisky bottles identified as fakes this included an Ardbeg 1885, which had been acquired from a private owner, Thorne’s Heritage early 20th Century blended whisky purchased from an auctioneer and a bottle of Ardbeg purported to be bottled in 1960’s bought from a retailers.

RW101 said a total of 10 single malts purporting to be from 1900 or earlier were found not to be genuine.

The company said that if tests had proven all 21 bottles to be genuine, collectively they could have been valued at about £635,000. Individual bottles could have fetched anything from £2,500 for the lowest value bottle right up to an estimated £150,000 for the oldest, most valuable bottle.

Professor Gordon Cook, head of the SUERC Radiocarbon Laboratory said: ‘We have had significant help from the major distillers who provided whisky samples of known age that allowed us to start this work.

‘However, it has been our collaboration with Rare Whisky 101 and their provision of really old and rare whiskies that has allowed us to really push this work forward to what we consider to be the Gold Standard technique for identifying the age of a whisky.

‘It is disappointing to see the large percentage of vintage whiskies that turn out to be fake. However, we have developed a very powerful technique to beat the fraudsters and I’d advise anyone thinking about selling what they consider to be an early product to have it analysed.

‘Recently, we have analysed four bottles of early whisky (including a rye whisky from the USA), purported to have been distilled between the mid-19th to the early 20th century, for members of the general public. Of these, three were genuine, so there are really old and rare whiskies in existence.’

The process through which these whiskies have been dated is based on the evolving science of identifying levels of radiocarbon (or C-14) within the liquid. Carbon-14 is that element’s only radioactive isotope and every piece of organic material. Its relatively slow rate of radioactive decay means it has a half-life of 5,370 years. In other words it takes that long for half of it to be gone. Measuring how much Carbon-14 remains in a sample gives an accurate indication of how old it is.

The energy content of a large number of main meals in major UK restaurants is “excessive” and the full service restaurant meals tend to be higher in energy content than fast food meals, research published in the BMJ has found. 

University of Liverpool researchers analysed thousands of meals from places like Nando’s and McDonald's. The researchers examined at more than 13,500 meals on the menus of 21 full service restaurants and six fast-food chains. 

The observational study accessed online nutritional information for each restaurant and extracted the number of kilocalories for each eligible meal. Although nutritional information tends not to be displayed on UK restaurant menus in store, some restaurant chains provide this information on their websites. For those who did not not provide nutritional information on their UK website the researchers requested this information

The study found that in of all the restaurants included, the mean energy content of main meals was 977kcal. A sizeable proportion (47%) were “excessive” in energy content (≥1000 kcal), and only a small minority (9%) were in line with public health recommendations for main meal energy consumption (≤600 kcal). 

On average, the energy content of main meals served by full service restaurants was 268 kcal higher than that of main meals served by fast food restaurants. Full service restaurants also tended to serve more highly calorific main meals and provide fewer main meals meeting public health recommendations for energy consumption.

Well-known restaurant chains with high calorie content included Harvester, at 1,166 calories, JD Wetherspoon, with 1119 calories, and Nandos, on 1,019 calories. The biggest offender was Hungry Horse with 1358 calories on average in a main meal. 

Among fast food chains, meals at Burger King had an average of 711 calories, followed by Wimpy, at 721 calories, and McDonald’s at 726 calories. The highest meal in a restaurant classed as “fast-food” was at KFC, with an average of 987 calories.

Even when the study compared similar meals, the energy content in restaurant meals was greater. Burger meals in restaurants contained an average of 414kcal more than burger meals in fast-food chains, while salad meals in restaurants were   slightly higher in calories on average than fast food salads.

Dr Eric Robinson, lead researcher from Liverpool's department of psychological science, said the results were "shocking" but probably underestimated the calories consumed in restaurants as the analysis did not include drinks, starts, desserts or side orders. 

He said: "Only one-in-ten of the meals we surveyed could be considered a healthy number of calories.

He said: "It's really clear what the food industry need to do – they need to act more responsibly and reduce the number of calories that they're serving."

Britain’s restaurant habits are fuelling its obesity crisis he said, with four in ten adults eat out at least once a week.

Dr Robinson said the poor nutritional content of 'fast food' is well known but full service restaurants where dining tables are provided have received less attention.

Dr Robinson said portion size, the ingredients used and cooking methods could explain the difference, but he said the food industry had to make changes.

"It's really clear what the food industry need to do. They need to act more responsibly and reduce the number of calories that they're serving."

Researchers said many public health experts had focussed concern on fast foods, but not paid enough attention to the stodgy and fatty fare sold in high street restaurants.

Kate Nicholls, chief executive of trade association UKHospitality, said restaurants, pubs and other hospitality businesses were already taking action to reduce calories and offer healthier dishes – but there were costs to consider too.

"Proposals to shrink the size of dishes or cap calories would be yet another burden for hard-pressed operators to absorb, resulting in prices going up and investment in businesses going down; inevitably negatively impacting the overall customer experience."

The researchers said it was possible the fast-food sector was now offering more lower-energy meals and healthier options, after pressure from campaigners to do so.

Food Standards Scotland is currently consulting on a proposal to improve the out of home food environment in Scotland which closed on 22 February 2019. 

“(Over)eating out at major UK restaurant chains: observational study of energy content of main meals” published by the BMJ can be found here.

Food delivery platform, Just Eat has announced plans to display the official Food Hygiene Rating of each of its UK restaurant partners directly on its platform both in-app and online.

Following consultations with the Food Standards Agency (FSA) and Chartered Institute of Environmental Health (CIEH), Just Eat will launch its trial of the initiative in Northern Ireland in early 2019 with over 600 restaurants. Following a full evaluation of the trial, a national roll-out will be implemented later in the year.

Whilst Just Eat already provides a link to the FSA’s website on each restaurant’s menu page so that customers can access food hygiene ratings, the change will make ratings instantly clear in-app and online.

Graham Corfield, UK managing director at Just Eat, said: “We are always looking to do more for both our partners and customers and displaying hygiene ratings will provide better access to this important information than ever before.”

The BBC Watchdog Live has found that leading restaurant and coffee shop chains are giving out incorrect allergy advice.

Acting as customers with food allergies, Watchdog Live's journalists covertly filmed staff at Frankie & Benny's, Pizza Hut, Nandos, Pizza Express, Starbucks and Costa. The journalists asked staff if specific dishes contained one of the 14 major allergens, including nuts, mustard and celery – which is often used as flavouring in stocks and sauces.

None of the outlets visited had allergens listed on menus or labels, so customers must rely on staff being able to give accurate information.

Five out of the 30 outlets visited gave the reporters incorrect information.

By law, cafes, restaurants and takeaways should be able to give customers clear information about which dishes contain allergens. 

Out of the six chains, only Pizza Express gave accurate advice in each of the five branches visited.

Starbucks, Costa, Frankie & Benny's and Nando's said that the incidents Watchdog's undercover team experienced fell short of their usual standards. They told the programme they've addressed the issues with staff at both a regional and national level. 

Pizza Hut told the BBC that while the information provided to Watchdog's undercover journalist was ultimately correct, it is now taking steps to make allergy information clearer.  The pizza chain is introducing QR codes on menu cards this week, and will be making the font size of text in its nutritional guide bigger in the new year. 

At a Costa Coffee branch, the reporter asked for a mince pie they knew contained milk, however even after thoroughly consulting the allergy book they were told by staff that it contained soya milk. 

In one Frankie & Benny's restaurant the undercover journalist told staff she had a celery allergy and enquired about eggs royale, which contains celery, according to the company's website. The server did not at any point consult a product information guide or check with the kitchen, but assured the journalist that the dish didn't contain any celery. 

In a branch of Pizza Hut, a reporter asked if the mac n' cheese contained mustard, which is listed as an ingredient on the company's website. A member of staff showed the reporter a book containing allergy advice, but neither the reporter or the staff member could understand the information in the book.

When the reporter asked if the pepperoni pizza contained mustard, he was told that the member of staff couldn't give him any more information than that listed in the allergy book, which was unclear.

At a Nando's restaurant, the reporter asked if a burger contained mustard. The server guessed that it didn't, but on checking the allergen book, discovered that the burger did in fact contain the ingredient.

While in one branch of Starbucks the advice was ambiguous, with a staff member initially telling the reporter the item he'd chosen – a lemon loaf cake with almonds in the ingredients – did not contain nuts, but ultimately advising there was still a risk of nut contamination.

At one Frankie and Benny's restaurant, a reporter was asked to agree to terms and conditions that state Frankie and Benny's can never guarantee that a dish is completely free of any allergen – except for gluten. The server told the reporter the form "saves our back".

Frankie & Benny's owner The Restaurant Group told Watchdog Live that the allergy advice presented to customers to read and tick is not a disclaimer. The firm added that it does not ask its customers to waive their rights.

The findings come three weeks after Watchdog Live found supermarket bakery counters giving incorrect allergy information, prompting Sainsbury's and Asda to pledge to introduce allergy labels on all in-store bakery products.

Cuts to environmental health departments are putting the public at “high risk of harm”, according to the Unison Tipping Point Study.

The study used Freedom of Information requests to local authorities and a Scotland-wide survey of UNISON members working in environmental health departments to examine the impact of austerity in areas such as food safety and standards, waste management and pollution control.

It found the teams have to manage an ever-increasing workload with significantly reduced resources, leaving many working long hours as they struggle to maintain a service that keeps the public safe.

More than two-thirds (67%) of those who responded said there had been cuts or severe cuts in their service this year, while 95% said there had been cuts or severe cuts in the last five years.

Fewer than one in five (18%) believe their teams have the resources to deliver an adequate service to the public while two-thirds say they are working late and skipping breaks and lunch to try to get more work done.

There are five per cent fewer environmental health officers and around a fifth (21%) less people in other roles in the teams than in 2012/13 and budgets have been cut by 14% compared to 2012/13 and by 12% since 2016/7.

In addition, 90% say their workload is higher than five years ago while 76% described morale in their team as low or very low.

The report said cuts to environmental health team budgets are leaving staff overworked, underpaid and stressed.

It warned this means “citizens and the wider environment are at a high risk of harm” and calls for an end to austerity and for investment in public services.

Mark Ferguson, chairman of Unison Scotland’s local government committee, said: “This report shows our environmental health services have reached tipping point, leaving us all at risk of harm.

“Our members are under enormous pressure, with many working long hours trying to maintain a quality service.

“This survey shows a dedicated workforce who are struggling under the sheer volume of work, with nine in 10 saying their workload is higher than five years ago.

“Teams are now reacting to complaints rather than focusing on working to prevent things going wrong.

“Our members can see departments depleted, with the loss of experienced staff, fewer proactive inspections and services being drastically cut.

“Not only does this put people in danger it also pushes costs onto other public bodies – which costs more money than investing in a high quality environmental health service.”

The report also highlighted a looming skills gap as almost half of respondents to the survey, carried out in June 2018, are aged between 46 and 55 – with another fifth due to retire over the next ten years. It warned with fewer staff being taken on to develop this will mean a huge loss of knowledge, which it said is vital in such a complex protective service.

The report said teams are now reacting to complaints rather than focusing on working to prevent things going wrong, with some areas of work completely cut back on, increasing the risk of accidents, food poisoning, contaminated land and vermin infestation.

Tom Bell, chief executive of REHIS was asked to make comment by “The Herald” regarding the findings, he said the Institute had warned about the effect of cuts on services, but now the effect had reached a “critical point” and was concerned that it had led to a slump in the number taking BSC (Hons) in environmental health.

Tom Bell also suggested that consideration should be given to establishing a central fund that would allow local authorities to address the lack of training placements for student/graduate trainee Environmental Health Officers (EHO). This in turn would give confidence to school leavers considering studying environmental health at the University of the West of Scotland that the chances of a career as an EHO are high.

Tom continued: “We are now at the stage where there are a very small number of individuals coming through to fill an increasing number of vacancies. So it has been very very poor management by local authorities, in that they haven’t foreseen this situation, and if they have, they have decided that the work of the environmental health officers has not been sufficiently important to justify really investing in the future and ensuring training places are available.”

Tom also stressed that the Institute has been warning Convention of Scottish Local Authorities (CoSLA), local authorities and the Scottish Government and its agencies of our concerns for many years and not only in recent months.

A CoSLA spokesman said: “As our #essentialservices campaign makes abundantly clear, we need a fair settlement from December’s Budget to continue to provide the essential services our communities rely on
“As we see from things like this, it is clear that the impact of past local government settlements are having a biting impact.”

A Scottish Government spokesman said: “Despite continued UK Government real-terms cuts to Scotland’s resource budget, we have treated local government very fairly.

“In 2018-19, councils will receive funding through the local government finance settlement of £10.7 billion. This will provide a real terms boost in both revenue and capital funding for public services.

“Local authorities are responsible for managing their own budgets and priorities, including environmental health.

“The Finance Secretary will present the Scottish Government’s future funding for local government in the Scottish Budget later this year.”

Unison Tipping Point Study can be found here: http://www.unison-scotland.org/library/2018-Environmental-Health-final.pdf

Three supermarket chains have given confusing or incorrect information on allergens in their bakeries, the BBC Watchdog has found.

Branches of Asda, Sainsbury's and Tesco gave wrong or unclear details to the undercover reporters from the BBC’s consumer programme. The reporters visited 24 supermarket bakeries, five of which showed cause for concern. 

The retailers said they would review their labelling and staff training.

The EU says that consumers must be made aware when one or more of 14 particular allergens – including nuts, sesame, milk, eggs and wheat – is used as an ingredient in food products. In the UK, non-pre-packaged food does not need to be individually labelled on packaging, but stores must ensure clear and accurate information is readily available. 

In one Asda bakery, staff said an item did not contain the allergen sesame, when it was in fact listed as an ingredient for the product on the store's website.

In other Asda stores, the programme found staff were able to give a general warning that products may contain nuts or seeds, without being able to identify specific allergens contained within the recipe.

Reporters for the programme also found Tesco did list allergens on most of its products, but not for unwrapped bread rolls, paninis and pastries in some stores. At one branch, an undercover reporter posing as someone with a milk allergy found a senior member of staff who was unable to locate any ingredients information for an unpackaged panini that contained milk.

Sainsbury's did not list any of the 14 allergens on packaging or shelf labels in their in-store bakeries, but did tell customers to "ask a bakery colleague" about allergens. A staff member at one branch told an undercover reporter a raisin whirl was free of nuts – but when the staff member found a product information guide it listed almonds as an ingredient. 

Sainsbury's said it would update its labels "to include more specific allergen information".

Tesco said it exceeded "the current legal requirements", but in light of the Watchdog investigation a spokesperson said the food retailer would be "reviewing how allergy information is displayed moving forward".

Asda said in all the instances flagged up by Watchdog Live, its staff "ultimately advised the customer not to buy the product". But a spokesman added the supermarket was "also working to implement detailed allergen labels on our in-store bakery products".

The Watchdog Live’s report was shown on 7 November 2018 on BBC One.

On the 27 October 2018, a group of 7 students and a lecturer from a small class of 13 students gathered for a meal in Edinburgh to celebrate 40 years since they all met for the first time as first year students attending the block release course of Sanitary Science at Napier College.

The date they gathered also happened to be 36 years to the day, when they all attended for their professional exams and interviews with the Royal Sanitary Association of Scotland, the leading professional body prior to the formation of the Chartered Institute of Scotland and then REHIS. The class from Napier College were accompanied by the principal lecturer on the Sanitary Science Course, Professor Francis McManus.

The route into the environmental profession in those days comprised four years of block release study, with annual exams and the maintenance of an annual practical record of training, whilst gaining practical experience from their employing Local Authority, culminating in professional exams to gain professional status to become a qualified EHO.

The group below, always a very social bunch, raised their glasses on several occasions to lecturers form the college, to Iain McDonald (deceased) their Gold Medal student and the Sanitary Science Course itself. An enjoyable evening was had by all recounting a number of escapades and organised visits to distilleries and breweries organised by the college. The course provided an excellent education for professional environmental health officers, and many pictured below are chartered EHOs still working either in the private or the public sector still plying their trade to promote and protect public health.

The class next plan to meet up again in 4 year’s time to celebrate 40 years since their own graduation.

Pictured below are (left to right) Jean Allan, Elaine Devine, Kevin Boyle, Francis McManus, Campbell Stewart, Neil Doherty, Lesley Cooke and Roy Stewart.