Author: Peacock Carter

A study from US researchers claim that using unheated water to wash your hands is as effective at killing bacteria as using hot water.

The small study of 20 people found using water at 15oC left hands as clean as water heated to 38oC.

The study was carried out by researchers at the Rutgers University-New Brunswick in New Jersey, and the results were published in the Journal of Food Protection.

The study examined the effect of various factors, such as soap volume, water temperature, lather time, and the hand washing efficacy of the soap as formulated on the product.

They asked 20 people consisting of 10 men and 10 women to wash their hands 20 times each with water that was 15oC, 26oC or 38oC.

Volunteers were also asked to experiment with varying amounts of soap – ranging from 0.5mm to 2mm.

Before they started the tests, their hands were covered in nonpathogenic strain of Escherichia coli ATCC 11229.

Researchers say there was no difference in the amount of bacteria removed as the temperature of the water or the amount of soap changed.

Prof Donald Schaffner said: “People need to feel comfortable when they are washing their hands but as far as effectiveness [goes], this study shows us that the temperature of the water used did not matter.”

However, the researchers accept their study is small and say more extensive work is needed to determine the best ways to remove harmful bacteria.

In the UK, NHS say people can use cold or hot water to wash their hands. They say hands should be washed for at least 20 seconds and stress the importance of using enough soap to cover the whole surface of the hands.

Their guidance focuses on rubbing hands together in various ways to make sure each surface of each hand is clean.

The NHS’s advice on washing your hands is as follows:

• Washing your hands properly should take about as long as singing Happy Birthday twice (about 20 seconds)
• Wet hands and apply enough soap to cover the whole surface of the hand
• Rub palms together with fingers interlaced
• Rub each palm over the back of the other hand with interlaced fingers
• Rub between fingers on each hand
• Rub backs of fingers (interlocked)
• Rub around each thumb
• Rub both palms with finger tips and then rinse with warm or cold water
• Dry your hands well, ideally with a disposable towel
• Use a disposable towel to turn off the tap

Dr Jim Smith, one of the Institute’s Honorary Vice-Presidents, visited the Institute’s offices in Edinburgh on 18 May this year at the start of a vocational trip around Europe.

Jim is a past President of Environmental Health Australia, an independent public health planning consultant, a public health policy adviser to local government in Australia and holds a number of academic appointments including that of Adjunct Associate Professor at La Trobe University and at Flinders University.

Jim and two associates, Vivian Lin and Sally Fawkes, have recently launched the second edition of their textbook Public Health Practice in Australia – The organised effort and Jim kindly donated a copy of this highly acclaimed textbook to the Institute’s library.

It was a real pleasure to welcome Jim, a longstanding friend of the Institute, to our offices.

We wish Jim and his wife Debbie, and Bernard and Linda Forteath bon voyage for their European sojourn.

Photo Tom Bell, Dr Jim Smith and Bernard Forteath.

REHIS is delighted to announce the signing of a new joint award between the Institute and TEENS+ called Healthy You, Healthy Me.

TEENS+ (Transitional Educational, Extra Needs Support) is a full-time further education facility for young, post-school adults with severe and complex learning difficulties.

Most of the students at TEENS+ have Autistic spectrum disorders and the added complications these disorders can bring. The students have various conditions with associated communication and learning difficulties in addition to sensory impairments. TEENS+ helps to develop life and social skills, provide further education, guide young people towards employment and/or independent living.

Leigh-Anne Hunter, a team Leader and part of the education team at Teens+ has developed a healthy eating, food hygiene and understanding food programme which is accessible to all of the students within Teens+.

The students are provided with a huge variety of communication tools to empower them to learn and express themselves effectively. Individual student knowledge is reviewed continually through personal tutorials, staff feedback on student progress, individual and group feedback.

The Healthy You Healthy Me programme is set out in a workbook portfolio for students to complete with staff to assist. Dependent on student abilities these are completed electronically or by hand. This will include the student’s baseline knowledge of core modules at the beginning and then summative knowledge at end. Students will carry out lessons in various food hygiene and nutrition topics.

Tom Bell, REHIS Chief Executive and Jackie McCabe, Director of Training recently visited Teens+ to meet with Leigh-Anne and some students currently undertaking the Healthy You Healthy Me joint award programme.

Photograph one (left to right)

Emma Jamesion, TEENS+ Education Director

Tom Bell, REHIS Chief Executive

Jackie McCabe, REHIS Director of Training

Leigh-Anne Hunter, TEENS+ Team Leader (Food)

Photograph two (left to right)

Jackie McCabe, REHIS Director of Training

Katrina Carruthers, TEENS+ Student

Leigh-Anne Hunter, TEENS+Team Leader (Food)

 Doctors writing in the British Medical Journal Case Reports said sushi’s growing popularity in the West could be linked to a rise in parasitic infections.

A team of doctors from Portugal raised concerns after a 32-year old man was admitted to hospital complaining of pain in his abdomen just below his ribs, vomiting and had a slight fever since the previous week.

An endoscopy revealed larvae of a worm-like parasite firmly attached to an area of swollen and inflamed gut lining. Microbiological analysis showed the larvae belong to the Anisakis spp. The worm Anisakis nematodes causes’ zoonosis Anisakiasis which invade the stomach wall or intestines of humans. It is caused by consumption of contaminated raw or undercooked fish or seafood.

Two views of the parasite, seen here firmly attached to an area of the patient’s upper gastrointestinal tract. Photograph: Carmo et al/BMJ case reports

A special kind of net was used to remove the larvae and the patient rapidly recovered.

The doctors added that most cases of anisakiasis to date had been reported in Japan but warned: “However, it has been increasing recognized in Western Countries”

EU food hygiene legislation requires fish that is to be eaten raw should be frozen before it is sold to consumers to ensure any parasite have been killed.

However, if making your own sushi from fish at home ensure that a reputable recipe is followed and the fish has been frozen for at least four days in a domestic freezer.

The year’s Annual Environmental Health Forum was held in Greenock on 26 and 27 April. The Forum seen public health bodies and industry coming together in the interests of “Building Better Futures” which was the theme of the event.

The event was held in the Beacon Art Centre which provided a beautiful backdrop as the room overlooked views of the Firth of Clyde.

The first day seen a fully packed day of speakers. First speaker Dr De Caestecker, Director of Public Health at NHS Greater Glasgow and Clyde discussed what actions are needed to tackle health inequalities.

Professor George Morris, Independent Environmental Health Consultant spoke about rethinking the environment in public health. While speaker Mary Stewart from Population Health Directorate at the Scottish Goverment key message was that environmental health professionals play a crucial role in Public Health Reform.

This was followed by a presentation from Lorraine Tulloch of Obesity Action Scotland that showed one in four adults are obese and in order to change the future we need a change in our environment.

Geoff Ogle, Chief Executive from Food Standards Scotland discussed the sustainability of the environmental health resource in Scotland and how we need to target our response where it is needed. After lunch seen the big debate of whether environmental health service in Scotland should be continued to be delivered by local authorities with Professor George Morris speaking for the motion and Billy Hamilton speaking against the motion.

Following this Megan McPherson, Public Health Advisor for NHS Health Scotland demonstrated the Place Standard tool which is designed to evaluate the quality of a place. Final speaker Dr Mulcahy gave a thought-provoking talk about human biomonitoring for environmental health being used for proving prevention works.

The second day of the event held workshop sessions on occupational health and safety; food safety/food standards; public health and housing and pollution control/environmental protection.

One of the morning workshops was on occupational health and safety and had talks from Douglas Richardson, Head of Living Collections at Highland Wildlife Park about health and safety in a zoo environment. Jill Shedden, Managing Director of Knockhill Racing Circuit discussed health and safety at the nations motorsport centre. Final talk of the workshop was from Kevin Sewell, Assistant Emergency Planning Officer of Scottish Borders Council about safety advisory group process.

The other morning workshop was on public health and housing with the first talk of the session from Dr Emily Tweed, Speciality Registrar in Public Health at NHS Greater Glasgow and Clyde who discussed reconnecting public health and housing in Scotland. Liz Dickson, Private Sector Officer of Scotland’s Housing Network asked whether our homes are fit for the 21st Century and Mel Skipp, Health Policy Manager at Carnival Corporation and PLC spoke about environmental health measures on cruise ships.

The afternoon session on food safety and food standards had a presentation from Wendy Barrie, Director of Food Guide and Scottish Cheese trail about the artisan cheese scene. Cat Hay, Policy and Industry Liaison Manager from Food Drink Federation Scotland gave a trade association view on challenges for food and drink manufactures. The final talk of the workshop was from Derek Oliver, Environmental Health Service Manager at East Lothian Council who spoke about food crime.

The other afternoon session was on pollution control and environmental protection and had talks from Edel Ryan, Environmental Health Manager at Midlothian Council talk about carbon dioxide from a mining legacy. Andrew Taylor, Air Quality Policy Manager for the Scottish Government gave an update on air quality. While Graeme Duff, Associate Director at EnviroCentre Limited spoke about regeneration of Kingston gasworks and boatyard.

The annual event was hailed a success by both attendees and speakers. It provided an excellent opportunity to hear about recent changes and updates in environmental health while also providing an opportunity to communicate and network with others in the profession.

We hope to see you all again next year. Presentations delivered at the Forum can be found here

Hepatitis A cases in Lanarkshire Update A reminder regarding the importance of good hand hygiene has come from NHS Lanarkshire’s department of public health, environmental health and other agencies as part of the investigation and management of a hepatitis A outbreak.

The number of confirmed cases has increased from nine to 42.

Most of the cases recall having consumed food produced by the baker JB Christie before mid-April, through its outlets in Airdrie and Coatbridge.

As a precautionary measure, public health officials are continuing to raise awareness of the infection risk to help them identify other possible cases. Dr Femi Oshin, NHS Lanarkshire consultant in public health medicine, said: “While our investigations continue, we want to remind people that although the risk of contracting the infection is low, anyone who has experienced a flu-like illness, loss of appetite, nausea, fever, abdominal pains or jaundice (a yellowing of the eyes or skin), should contact their GP or, if out of hours, contact NHS24 by dialling 111.

“The investigation and assessment at the bakery indicated that products produced and sold between Monday 20 March and Thursday 13 April may have been affected, which is why we are advising anyone who ate bakery products which were produced by JB Christie between these dates, and who experiences the above symptoms, to contact their GP or, if out of hours, contact NHS24 on 111.

"A special helpline has been set up to help the public with general information about hepatitis A and about this outbreak. The freephone number for the helpline is 0800 028 2816 and it is open from 8am to 10pm daily.

“The bakery fully cooperated with our investigation and undertook additional control measures agreed by NHS Lanarkshire and North Lanarkshire Council, which enabled it to resume trading on Tuesday 2 May.”

As an additional precaution, the bakery also voluntarily disposed of all its fresh ingredients and any food stuffs which could transmit infection.

There are currently no public health concerns regarding the safety of food produced by the bakery. All 42 cases have had a medical assessment and of those patients who required hospital admission almost all have been discharged home.

Dr Oshin continued: “Hepatitis A is usually a food borne virus which can be spread by hand to mouth contact when there is poor hand hygiene. “As such, one of the best ways to prevent the spread of the hepatitis A infection is good hand hygiene – thorough hand washing and drying. “We would like to remind everyone that they can protect themselves by washing their hands, particularly after visiting the toilet and before preparing or eating food.”

Source: http://www.nhslanarkshire.org.uk/news/news/Pages/hepatitisAupdate.aspx

Inspections carried out by Environmental Health Officers from Aberdeen City Council found several instances of potential cross contamination at Aberdeen Royal Infirmary in their main production kitchen.

Initial inspections and revisits of the hospital kitchen were carried out in September last year and revealed several cross contamination issues during cold food preparation. Consequently several items of prepared ready-to-eat foods were voluntary disposed of at the time. Remedial Action Notices were also served for prohibiting the production of cold open ready-to-eat foods and also the use of the ready-to-eat meat slicer.

The cross contamination issues encountered were; storage of raw and ready to eat foods with raw sausages stored beside cooked chicken; lack of procedures for preparing ready to eat vegetables; lack of separate, designated and readily identifiable equipment for raw and ready to eat food; deficiencies in cleaning procedures and inadequate training of staff.

A revisit was made in January by Environmental Health Officers and took 21 swabs which all passed microbiological examination. However, a follow up inspection in February noted issues with cross contamination, stock control, cleanliness and no hot or cold water in a wash-hand basin. A further revisit was made in April to assess compliance with the enforcement notices and as the catering team had spent significant time and effort improving the Food Safety Management System and associated procedures both notices were withdrawn.

NHS Grampian said there was no evidence the health of any patients suffered but it has improved equipment and training. They also stated that significant investment has been made in new equipment and staff training.

A spokeswoman said: “We take the safe and hygienic preparation of food for our patients very seriously.

“It must be remembered that at no time was the kitchen at Aberdeen Royal Infirmary closed, nor was this ever suggested.

“There is absolutely no evidence that the health of any patient and/or staff members was affected, in fact swabs were taken on two occasions and submitted for microbiological examination and all swabs came back clear.

“That being said, we clearly fell below statutory standards – and our own standards – during these inspections which is very disappointing.

“Patients, relatives, staff and any other visitors to our sites should continue to have full confidence in the quality and standard of the food we produce.”

According to a new assessment published by the European Environment Agency (EEA), road traffic is by far the largest source of noise pollution in Europe, with an estimated 100 million Europeans affected by harmful levels.

The EEA briefing ‘Managing exposure to noise in Europe’ provides updated estimates of the numbers of people exposed to noise in Europe. It also provides an update on the measures being taken by EU member states in addressing noise issues.

Noise pollution remains a major environmental health problem in Europe, with the transport sector being a major cause. Road traffic noise is the dominant source affecting human exposure above the EU’s threshold of 55 decibels (dB) for daily exposure and 50 dB for night exposure. Around 100 million people are exposed to road traffic noise above 55 dB in the 33 member countries of the EEA. Of these, 32 million are exposed to very high noise levels (above 65 dB). Railways are the second largest source, with 19 million people exposed above 55 dB. Aircraft noise, close to major airports, is the third main source, with more than 4.1 million people exposed, followed by industrial noise within urban areas, with 1.0 million people exposed.

Noise from road traffic alone is the second most harmful environmental stressor in Europe, behind air pollution, according to the World Health Organization (WHO). The harmful effects of noise arise mainly from the stress reaction it causes in the human body, which can also occur during sleep. These can potentially lead to premature death, cardiovascular disease, cognitive impairment, sleep disturbance, hypertension and, at the least, annoyance.

The European Union has taken action to address the problem through the 2002 Environmental Noise Directive (END). The EU legislation requires Member States to prepare noise maps that inform the development of action plans designed to prevent and reduce harmful exposure. The briefing also presents an updated summary of the different types of measures used by countries to reduce noise. These range from actions that control noise at source, such as introducing low noise road surfaces, quieter aircraft and railway stock, through to measures such as improving urban design to reduce traffic volumes and restricting housing developments in high noise areas.

The briefing is a follow-up to the EEA’s Noise in Europe 2014 report and its release coincides with the Noise in Europe conference held in Brussels on 24 April and International Noise Awareness Day on 26 April. The briefing is based on the latest data reported to the EEA by its member countries in accordance with the EU’s Environmental Noise Directive (END). Accompanying the briefing are updated country factsheets and a new web-viewer which shows updated data on noise pollution across Europe.

The Land Quality Expert Advisory Group (EAG) of Environmental Protection Scotland have launched their guidance publication “Introduction to land contamination and development management” which is now open for consultation until 29th June.

One of the obstacles in developing land affected by contamination is understanding how to meet the regulatory requirements. This publication aims to help the developer and assessor understand what is expected by the Scottish regulating authorities in assessing and addressing land contamination issues. The purpose of this consultation is to ensure the publication reflects a consistent approach from local authorities and provides the necessary clarification.

The Land Quality Expert Advisory Group would like to take this opportunity to thank Dr Laura Toal, Sarah Hamill, Kirstie Ogilvie and Dr Iain McLellan for their contribution and diligence in producing this guidance publication.

Please email your consultation response, using the pro-form feedback form to admin@ep-scotland.org.uk

The Scottish Ministers are consulting to gather views on draft regulations for Private Water Supplies in order deliver the requirements of the Drinking Water Directive as amended (Directive (EU) 2015/1787) for larger private water supplies. These changes need to be transposed by 27 October 2017.

The Scottish Ministers propose to make the Water Intended for Human Consumption (Private Supplies) (Scotland) Regulations 2017. This would replace those provisions of the Private Water Supplies (Scotland) Regulations 2006 which apply to large private water supplies (“Type A” supplies) and freshly transpose the Drinking Water Directive as amended and other EU requirements for those supplies.

The Scottish Ministers also propose to update, and possibly replace, the 2006 Regulations in so far as they apply to small private water supplies (“Type B” supplies). It is envisaged that this will be done by means of a separate set of Regulations.

The consultation document is available through the Scottish Government consultation hub Citizen Space. Responses are welcomed to the consultation until 28 July.

The Scottish Government has confirmed that the avian influenza prevention zone covering Scotland was lifted on the 30th April.

The prevention zone required bird keepers in all areas of Scotland to put in placed enhanced biosecurity measures prior to letting their birds outside, in order to reduce the risk of disease.

The ban on shows and gatherings of poultry, waterfowl and game bird will remain in force until 15 May, when a new general license will come into force.

Cabinet Secretary for Rural Economy Fergus Ewing said: “This will be welcome news for many keepers who have opted to keep their birds indoors to protect them from a seasonally increased risk from highly pathogenic avian influenza H5N8. This decision has been made following the recent veterinary risk assessment concluding that the risk of avian influenza incursion to poultry and captive birds in Scotland had decreased to low.

“This has been a testing time for all of us, and I would like to thank all bird keepers in Scotland for their co-operation and vigilance. Your positive and committed response has helped us reach this point.”

Scotland’s Chief Veterinary Officer Sheila Voas said: “It is a relief to see that the risk of HPAI H5N8 in Scotland has reduced, but this does not mean we should be complacent; the risk of avian influenza has not disappeared. It is essential that bird keepers maintain effective biosecurity year-round, not just when a prevention zone is in place. All bird keepers should consider maintaining excellent biosecurity practices like washing boots and equipment with approved disinfectant, implementing effective rodent control, minimizing unnecessary visitors and reducing their flock’s contact with wild birds.

“I would also strongly urge businesses to reassess their contingency plans, given the new perspective this season’s outbreaks of H5N8 provides. Practical advice about their specific arrangements should be sought from their private vets, in consultation with their local Animal Plant and Health Agency office.”

Source: Scottish Government, https://news.gov.scot/news/avian-influenza-7

On 29 April, North Lanarkshire Council Environmental Health announced that it, along with NHS Lanarkshire’s Department of Public Health and other agencies, was investigating nine confirmed and nine suspected cases of hepatitis A in North Lanarkshire.

All the patients, who were treated as Monklands Hospital, were "well and responding to treatment".

Initial investigations indicated that there could be a link to the JB Christie bakery in Airdrie and as a precaution, and in line with public health guidance, environmental health and public health staff were working with the bakery to carry out further investigations. As a precaution, the bakery owners had contacted the outlets it supplies asking them to withdraw their products from sale.

The bakery has since reopened following a "deep clean" and any fresh ingredients or foodstuffs disposed of.

Bakery owner Andrew Chisholm said: "Throughout this period of closure a team of environmental health officers were invited into the bakery to review all aspects, policies and working procedures and they were very satisfied with their findings and thanked us for our immediate reactions.

"The bakery employees have been very compliant with the requests from the health board to be fully screened and with almost immediate results stating that no employee was at any risk to the public to work within a food environment."

NHS Lanarkshire consultant Dr Josephine Pravinkumar praised the bakery for its co-operation.

Hepatitis A is a viral infection which leads to inflammation of the liver and can cause mild to severe illness. The infection will clear with time and there are no long term effects.

For further information on Hepatitis A visit Health Protection Scotland at: http://www.hps.scot.nhs.uk/giz/hepatitisa.aspx?subjectid=91

NHS Choices at: http://www.nhs.uk/conditions/Hepatitis-A/Pages/Introduction.aspx