Author: Peacock Carter

An interesting journal article has been published by the Royal College of Physicians of Edinburgh focusing on developments of public health in the last 50 years from a personal perspective.

The paper examines five decades of developments in public health, focusing on some of the most influential events of the period, and was inspired by the 50th anniversary of the graduation in medicine of one of the authors Former Chief Medical Officer Sir Kenneth Calman. It commemorates selected highlights from his career and, in so doing, documents a key period of challenges and transformations, predominantly from a Scottish perspective. 

It was a period which saw the evolution of the public health agenda from communicable diseases to diseases of lifestyle, the change from a hospital-orientated health service to one dominated by community-based services, and the increasing recognition of inequalities as a major determinant of health. 

This paper documents selected highlights from Sir Kenneth Calman’s career including the Aberdeen typhoid outbreak, AIDS, bovine spongiform encephalopathy, foot and mouth disease, radioactive fallout, the invention of computerised tomography and magnetic resonance imaging, and draws parallels between the development of the modern understanding of public health and the theoretical background to the science 100 years earlier.

The Journal paper can be access here. 

Scotland has met its statutory annual climate change target for the third year running, after achieving a 49% reduction in greenhouse gas emissions.

The latest figures, which are calculated against a 1990 baseline, show the country is set to exceed its current 2020 climate change target and continues to outperform the UK as a whole.

In western Europe, amongst the EU-15 member states, Scotland is second only to Sweden (51%) and ahead of Finland (42%), Germany (25%) and Denmark (23%).
The statistics also reveal emissions of the single most significant greenhouse gas – carbon dioxide – have fallen by more than 50%.

Climate Change Secretary Roseanna Cunningham said:
“These statistics are hugely encouraging and show we have almost halved the greenhouse gases emitted in Scotland – underlining our role as an international leader in the fight against climate change.

“We all have a role to play in that fight and I want to thank the households, communities and businesses who are working hard every day to reduce their own emissions.

“But we must go further and faster if we are to meet our responsibilities to our children, grandchildren, and future generations.

“Our ambitious Climate Change Bill will ensure we do exactly that – by setting a new 90% reduction target for 2050 and paving the way towards achieving net-zero emissions as soon as possible.”

The REHIS Award for Meritorious Endeavours in Environmental Health 2018 will be presented to Professor Kofi Aidoo at the Institute’s Annual Awards Ceremony in Edinburgh on 15 November. At this event the REHIS President’s Award will be presented to The Cyrenians for their Good Food Programme. The Council of the Institute offers its sincere congratulations to the recipients of both awards.

Environmental Health Officers (EHO) from Aberdeen City Council expressed “serious concerns” over the safety of the food being served at the DoubleTree by Hilton in Aberdeen City after they visited the premises on 8 February.

The EHOs found that staff at the DoubleTree by Hilton Aberdeen City Centre hotel were deliberately relabelling food to extend its shelf life and also falsifying delivery records.

The steps taken to conceal the exact age and freshness of foodstuffs meant the EHOs could not say whether they were safe for consumption. They immediately ordered the withdrawal of three items from the restaurant menu and the destruction of almost 100 individual food items.

They said: “Should similar standards be found by this service again, consideration will be given to reporting this matter directly to the procurator fiscal recommending prosecution.”

The EHOs’ original report noted: “We arrived to start our inspection at 9am so it was not possible for all of those foods to have been made on that day. “After discussion with kitchen staff it was found that staff had been falsifying food records and re-labelling foods to extend their shelf life.”

Some food products were deemed out of date, others potentially unsafe, while others were concerning because their exact date could not be correctly identified. One sauce was described as “unidentifiable”.

Among the other breaches of food hygiene practices, inspectors noted that “sandwiches within the walk-in chill were covered with a wet, visibly dirty chef cloth”.
Packets of naan breads were found “strewn across the floor” within the walk-in freezer, while salmon was being prepared in a manner that had the potential to be hazardous to health.

Hand contact surfaces within the kitchen, particularly fridge handles, were found to be “very dirty and sticky to the touch”, indicating “a lack of frequent handwashing by staff”.

An orange juice machine was found to be “visibly dirty and rusty on the inside” while “nobody was aware how often it was cleaned.

In all, 97 individual food items had to be disposed of, including raw prawns, fish, chicken, and red meat, “visibly deteriorated” horseradish cream, piping bags of squid ink mash, a variety of prepared vegetables and a number of sauces. Cullen Skink, ham hock terrine and a salmon dish had to be removed from menus.

In the wake of the inspection, hotel management were told by officers they were “extremely concerned to find a general lack of control over food safety risks and a lack of appreciation of the importance of food safety among kitchen staff.
It became clear that two different food safety policies were being used and causing confusion to DoubleTree staff members, while the newest policy was found to be “inaccurate, inconsistent and had not been implemented in practice on the premises”.

An Aberdeen City Council spokesperson said: “The report followed a routine inspection, carried out in line with procedure. The food business operator resolved the immediate issues at the time of the inspection.”

A subsequent inspection carried out on March 27 found that while the inspector was “pleased to find a significant improvement” there were still outstanding unsafe issues.

A spokesperson for the hotel said: “We expect to uphold the highest of standards when it comes to food preparation at our hotel. We have been working closely to fully address the matters raised in the EHO’s February report. We have been working closely to fully address the matters raised in the report. As a result we have adjusted our processes and conducted training sessions for our team members, the EHO re-visited us in March and have indicated they are satisfied with the measures we have taken.”

Every food business has a responsibility to ensure that the food they produce is safe for their customers, however when there is lack of compliance of with food hygiene regulations EHOs will take appropriate action to ensure public health is protected. This case clearly demonstrates the crucial work that EHOs in Local Authorities in Scotland undertake on a daily basis.

ASH Scotland, the national charity tackling smoking and health, has won a major international award on World No Tobacco Day (31 May 2018) for its work improving Scotland’s health.

The World No Tobacco Day Award is given by the World Health Organization to a select few groups each year. ASH Scotland has received it following decades of work advocating a Scotland free of the harm and inequality caused by smoking. Other winners in 2018 include the British Heart Foundation.

Morris Fraser, the Scottish Government’s tobacco policy lead, presented the award to ASH Scotland Chief Executive Sheila Duffy and ASH Scotland staff on Edinburgh’s Castle Street which you can see pictured.

In honouring ASH Scotland, the World Health Organization had this to say:

“ASH Scotland has shown strong leadership in persuading the Scottish Government to announce an end-game target of a tobacco-free Scotland by 2034, one of only a few nations to have done so.

“ASH Scotland was instrumental in persuading the Scottish government to announce in 2013 that it would implement plain packaging for tobacco products, successfully lobbied for Scotland’s national target to halve the number of children exposed to tobacco smoke in the home by 2020 […] and successfully advocated for a bill outlawing smoking in a vehicle with a child present.”

Sheila Duffy, Chief Executive of ASH Scotland, congratulated the British Heart Foundation and other award winners and said:

“I’m honoured and delighted that ASH Scotland has received the World Health Organisation’s 2018 World No Tobacco Day Award, the highest award given by WHO in this field. It recognises the leadership and work of our organisation over many years and Scotland’s strong ongoing commitments to reducing the harms of smoking.

“There is still much to do to reduce the heartbreak that cigarettes cause in people’s lives, and we will continue to work hard with all those in Scotland who want to make smoking history.”

The Food Hygiene Game, a training resource approved by REHIS, which we originally reported on in an article in Januaryhas made its way to Tonga.

Focus Games, the developer of the game, donated three free games to the REHIS president and IEHF representatives to take to the 15th World Congress on Environmental Health in Auckland, New Zealand in March 2018. 

Although one of the games was won by an attendee from Ireland, it was donated to Bronwyn Thompson from Australia to take with to her volunteer placement in Tonga within the Ministry of Health. 

Bronwyn Thompson played this game with the Health Inspectors from the Ministry of Health and stated it was: “fiercely fought battle with lots and banter and questions leading to chocolate as a final prize”

She also went on to say: “The game was greatly enjoyed by all and has started some conversations about how to impart and encourage learning in other areas of environmental health.”

The photo above shows some of the team playing the first game in the main office in Nuku'alofa Tonga.

The Food Hygiene Game wasdeveloped by Focus Games Ltdand is an educational board game for up to 12 players, which tests and reinforces knowledge delivered on the course in a fun and interactive way.

The Food Hygiene Game is ideally suited for structured food hygiene training courses, or as an informal learning activity in the hospitality or catering industry. It is also a fantastic resource for food education in Home Economics, Food Technology or other food related classes at school or college. 

To learn more and get your copy of The Food Hygiene Game priced at £60 (+VAT), visit www.foodhygienegame.co.uk

Experts from retail, the waste and chemical industries, the public sector and academia have joined a Scottish Government panel tackling plastic pollution.

The government has also appointed current Electoral Commissioner Dame Sue Bruce as chair of the Expert Panel on Environmental Charges and Other Measures, a group that will provide advice on dealing with disposable cups and plastic straws.

She will be joined by behavioural expert Professor Dame Theresa Marteau, economist Professor Liam Delaney, Mike Barry, the director of sustainable business at Marks & Spencer, Roger Kilburn from the biotech and chemical industry, Professor Margaret Bates from the waste industry and Professor Aileen McHarg who will bring legal expertise.

SEPA chief executive Terry A'Hearn, Zero Waste Scotland chief executive Iain Gulland and disability adviser Professor Kate Sang will also sit on the group. A 2050 Climate Group representative will provide a young person’s perspective.

Environment Secretary Roseanna Cunningham said:

“Scotland has demonstrated leadership in tackling plastic pollution. We were the first country in the UK to commit to introducing a deposit return scheme and we are currently consulting on proposals to ban the manufacture and sale of plastic-stemmed cotton buds, one of the items most commonly found on our beaches. 

“But I want to go further, and the creation of our expert panel  is an important step towards seriously addressing this issue in Scotland. The panel’s expertise and skills from across waste, legal, retail and public sectors as well providing a voice for young people and disabled people, will help us identify the bold actions we can take in Scotland to encourage long-term, sustainable changes in consumer and producer behaviour.”

A report from the European Environment Agency (EEA) is the first review of how the 33 EEA member countries (including the 28 European Union Member States) have assessed the risks from climate change, and how they used this information in developing adaptation policies to address these risks. 

The purpose of the report is to share experiences and knowledge and to highlight approaches and practical solutions that countries have used to produce and present their assessments. It also aims to promote a better understanding among experts and policymakers involved in adaptation planning. The findings will contribute to better informed decision making and adaptation in key vulnerable sectors, such as agriculture, fisheries, biodiversity protection, spatial planning and infrastructure development.

The report is based on information about relevant multi-sectoral assessments reported from EEA member countries. 

The National climate change vulnerability and risk assessments in Europe, 2018 report can be accessed here.

The Local Air Quality Management Policy Guidance for Scotland’s local authorities has been updated. The guidance has been revised to take account of changes to industrial emissions legislation and requirements.

The guidance is intended to help local authorities with their local air quality management duties under Part IV of the Environment Act 1995. It sets out:

• the statutory background and the legislative framework within which local authorities have to work;
• the principles behind reviews and assessments of air quality and the recommended steps that local authorities should take; 
• how local authorities should handle the designation of Air Quality Management Areas (AQMAs) and the drawing up and implementation of action plans;
• suggestions for taking forward the development of local air quality strategies;
• suggestions on how local authorities should consult and liaise with others;
• the role of transport-related measures in improving air quality;
• the general principles behind air quality and land use planning;
• the effects of biomass on air quality;
• the relationships between air quality and noise policy.

The guidance is intended for all local authority departments involved in local air quality management (LAQM), including environmental health, corporate services, planning, economic development and transport planning. The guidance complements the information and advice contained in Cleaner Air for Scotland(CAFS), which was published in November 2015. 

This policy guidance, along with accompanying technical guidance (TG (16)) and CAFS are the primary guidance documents to which local authorities should have regard when carrying out their air quality review and assessment work. The guidance replaces the LAQM policy guidance published in February 2009. 

The guidance can be accessed here.

Health Protection Scotland (HPS) Gastrointestinal and Zoonoses team have published two surveillance reports for Norovirus and Hepatitis E. 

In 2017, HPS received 866 laboratory reports of norovirus (NV), a rate of 16.3 per 100,000. This was a decrease of 683 (44.1%) on the 1549 reports received in 2016 and was the lowest number of reports over the past 10 years. The average number of reports per year in the previous nine years had been 2013 reports, with a range of 1306 to 3109 reports. 

The laboratory reports arise from confirmed infection in the whole population (community and healthcare). Laboratory confirmations represent just a small proportion of the true incidence in the community. 

Laboratory reports of norovirus show a distinct seasonal trend, with the highest number of reports during the winter months. However, whilst reports are most common during the winter months, infection can occur throughout the year. 

Laboratory reports of NV also showed a distinct age distribution affecting predominantly the elderly and young, with 51% (444/866) reported from those aged 65 years and over, 27% (233/866) from those under five years of age, while none of the other age bands accounted for more than 3% of reports. The distribution of laboratory reports among those at the extremes of age probably reflects those from whom samples are most likely to be taken. 

Reports of hepatitis E (HEV) infection in Scotland have increased in recent years, as they have elsewhere in the UK. Since 2011, laboratory reports of HEV in Scotland have increased from 13 in 2011, to a peak of 206 in 2016. In 2017, HPS received 170 reports of HEV, a decline of 36 (17.5%) on the number in 2016. 

The overall rate of HEV in Scotland in 2017 was 3.2 per 100,000, with a predominance of infection in older males, similar to the trend seen elsewhere in the UK. In 2017, 110 (65%) reports were from males of which 45 (41%) were aged 65 years and older. 

HPS is working with Food Standards Scotland, the Scottish Government, NHS boards and Public Health England to improve understanding of the epidemiology of HEV, including risk factors and exposures, to inform public health management and control. 

Norovirus – Surveillance report for 2017 available here.

Hepatitis E – Surveillance report for 2017 available here. 

The UK government has confirmed a new Environmental Principles and Governance Bill will ensure environmental protections will not be weakened as Britain leaves the EU.

A consultation started on 10th May on the contents of the Environmental Principles and Governance Bill, which will establish a world-leading body to hold government to account for environmental outcomes.

The body will support the UK government’s commitment to ensure this generation is the first to leave the environment in a better state than that in which it was inherited.

The body will provide scrutiny and advice to protect and enhance precious landscapes, wildlife and natural assets and would be able to hold government to account on environmental legislation.

Subject to consultation, the new body could specifically be responsible for:

• providing independent scrutiny and advice on existing and future government environmental law and policy;
• responding to complaints about government’s delivery of environmental law; and
• holding government to account publicly over its delivery of environmental law and exercising enforcement powers where necessary.

The Government is also consulting on its intention to require ministers to produce – and then have regard to –a statutory and comprehensive policy statement setting out how they will apply core environmental principles as they develop policy and discharge their responsibilities.

Currently environmental decisions made in the UK – from improving air and water quality to protecting endangered species – are overseen by the European Commission and underpinned by a number of these principles, such as the precautionary principle, sustainable development and the ‘polluter pays’ principle.

While these principles are already central to government environmental policy, they are not set out in one place besides the EU treaties. The new Environmental Principles and Governance Bill will ensure governments continue to have regard to important environmental principles through the policy statement, which would be scrutinised by Parliament.

The consultation seeks views on whether or not the principles to be contained in the policy statement should be listed in primary legislation.

The consultation can be accessed here.

Source: https://www.gov.uk/government/news/new-environment-law-to-deliver-a-green-brexit

Food businesses in Glasgow are being encouraged to improve the overall nutritional quality of food on sale by signing up to the Glasgow Food Pledge. 

Participation in the Glasgow Food Pledge, which is operated by Glasgow City Council Environmental Health, asks that food businesses make three changes to their practices such as:

• Reducing portion size
• Changing the cooking oil to a healthier alternative
• Reducing salt
• Offering healthier options in promotions
• Offering fruit
• Promoting low sugar drinks or water

These changes will provide an improved choice of food on sale in the community and in turn will make a contribution towards the Scottish Dietary Goals. Businesses taking the pledge will benefit from promotion within the local community and wider afield. 

The aim is to apply the principles of reformulation to small businesses. Small changes can make a big difference.

The Glasgow Food Pledge, originally piloted in Shettleston is a means of enabling Food Law Enforcement officers to open a dialogue with a business in the form of a questionnaire and fact sheets. Quite often this is the first time that the business has had a conversation regarding the nutritional quality of food on sale. It reflects the recent high profile reformulation exercises i.e Irn Bru reducing the sugar content ahead of the sugar tax implementation.

Although the project is being piloted in Shettleston, the aim is for the pledge to be widened out to the east end with a view to an eventual roll out across the city.

The development of the Glasgow Food Pledge involved working with pupils at Eastbank Academy in Shettleston, who were surveyed and 60 per cent said they would like to be able to choose healthier food.

Young people at Eastbank Academy indicated that the healthier food choices they wanted included pasta, salad, fruit and vegetables.

Business making the pledge will be promoted locally. The first business to receive the award was Wee Anne's Cafe on Shettleston Road. The business appeared in the Glasgow Evening Times.

Thank you to Paul Birkin, Team Leader, Environmental Health, Glasgow City Council for contributing this article. 

Photograph obtained from Evening Times article.