Author: Sarah Groom

Public Health Scotland (PHS) and The Lancet have published new evidence showing the impact of alcohol minimum unit pricing (MUP) on deaths and hospital admissions attributable to alcohol consumption.

The study estimated a 13.4% reduction in deaths, and a 4.1% reduction in hospital admissions, wholly attributable to alcohol consumption following the implementation of MUP. The study also found that MUP reduced deaths and hospital admissions where alcohol consumption may be one of a range of causative factors. The findings cover the period from MUP implementation up to the end of 2020.

This latest report builds on previous work that estimated alcohol sales reduced by 3% in the three years following the implementation of MUP.

Alison Douglas, chief executive of Alcohol Focus Scotland welcomed the news. She said, “The whole point of minimum unit pricing is to save and improve lives; this research shows it is doing just that. The reduction in deaths of more than 150 per year is great news and significantly higher than was hoped for based on the Sheffield University modelling.

“It shows the Scottish Government and Scottish Parliament were right to pursue this path-breaking policy in the face of fierce industry opposition. Today fewer families are grieving the heart-breaking loss of loved ones as a result.

“It is particularly heartening to see the positive impact is greatest for people living in our most deprived communities who for too long have suffered the most. Taking bold public health action has paid off and shown that population-level action can stem the tide of alcohol harm.

“The Scottish Government must now renew and uprate the minimum unit price. And it must act on alcohol marketing which also drives consumption and harm.”

Dr Grant Wyper, Public Health Intelligence Adviser at PHS, said: “Our study estimates that, following more than two and a half years of implementation, around 150 deaths, and around 400 hospital admissions, wholly attributable to alcohol consumption, were averted each year due to MUP. The greatest reductions were seen for chronic alcohol health harms, in particular alcoholic liver disease, which were slightly offset with less certain evidence of increases in acute alcohol health harms. The findings highlight that the largest reductions were found for males, and for those living in the 40% most deprived areas, groups which are known to experience disproportionally high levels of alcohol health harms in Scotland.

“We know that those living in the most socioeconomically deprived areas in Scotland experience alcohol-specific death rates more than five times higher compared to those living in the least deprived areas. The results published today are therefore very encouraging in addressing this inequality, and the overall scale of preventable harm which affects far too many people.”

Professor Daniel Mackay, Professor of Public Health Informatics at the School of Health and Wellbeing, University of Glasgow, said: “The methods we’ve used in this study allow us to be confident that the reduction in alcohol health harms we’ve shown is due to the introduction of MUP, rather than some other factor. This was important as the COVID-19 pandemic occurred towards the end of our study period and may have had an impact on alcohol-related health harms that was unrelated to MUP. Our main findings for the whole study period were consistent with findings from an additional analysis that focused on the pre-pandemic period only.

“In fact, we tested our main finding across a range of different scenarios and found the results to be largely consistent with our main finding, strengthening our conclusion that MUP has been effective at reducing the harm to health caused by alcohol.”

The MUP Evaluation Portfolio comprises of a number of research studies that are being undertaken to assess the impact of MUP across a range of outcomes, all of which have now been concluded. A report bringing together all the evaluation findings will be published in June 2023.

Read the PHS report

Read the PHS briefing

Read the study published in the Lancet

Drinks producers are being encouraged to register for Scotland’s deposit return scheme, which will go live on 16 August 2023.

Drinks producers are asked to register with the scheme administrator, Circularity Scotland, in order to participate in the recycling scheme and to help ensure that they meet their regulatory requirements.

Circularity Scotland confirmed that by midnight on 28 February, producers responsible for more than 2 billion recyclable drinks containers had registered for the scheme, representing more than 95% of the total volume of products sold in Scotland each year.

Products from a range of sectors including global soft drinks, craft brewers, wine importers and distilleries have been registered with the scheme. By 28 February, 26,000 products had been registered, illustrating the scale of the scheme and the choice that will exist for consumers.

Registration for Return Point Operators (RPOs) is also open.

An RPO is anyone who provides a service for the collection of recyclable PET plastic, metal and glass containers included in Scotland’s scheme and refunds consumers’ deposits.

This service can range from accepting returns over the counter and refunding consumers’ deposits from the till, to operating a Reverse Vending Machine which will automatically accept containers and refund deposits as vouchers.

Most retailers and hospitality businesses that sell drinks to take away are legally required to operate a return point. However, they can apply for an exemption based on proximity to other return points or environmental health reasons. This is being managed by Zero Waste Scotland.

The scheme is expected to cut littering by a third, reducing the amount spent by local authorities on litter clean up, and will increase recycling rates of single-use drinks containers from the current rate of approximately 50% towards 90%.

The First Minister has also written to the UK Prime Minister, reiterating that the UK Government must exclude the deposit return scheme regulations from the Internal Market Act. 

A formal process has been agreed between the UK Government and devolved governments to allow for certain policies to be excluded from the effects of UK Internal Market Act where relevant regulations differ between UK nations and agreement has been reached to manage divergent policy. This has already been used successfully to exclude Scotland’s ban on certain single-use plastic items to ensure the ban was effective.

The Scottish Government first requested an exclusion for DRS as part of the single use plastic exclusion in July 2021. The UK Government only agreed to grant a narrower exclusion, covering the single use plastic regulations only. A further request, for a specific DRS exclusion, commenced in autumn 2022.

New report from Zero Waste Scotland shows that clothing is contributing more to climate change than plastic.

Clothing is the most environmentally-damaging type of household waste, accounting for nearly a third (32%) of the carbon impacts of Scotland’s household waste despite making up only a small proportion, by weight (4%) of the waste we bin. 

That’s according to Zero Waste Scotland’s new carbon metric report, which highlights the cost to the climate of the items commonly thrown away from homes in Scotland. 

ZWS data suggests only 5% of people in Scotland are aware that clothing is the worst type of waste for the environment, with 61% saying it’s plastic.

The data also shows that 14% say they think about the environmental impact of a garment before they buy it.

Now, Zero Waste Scotland is teaming up with creative partners, from online influencers to street artists, to highlight the extent of the problem and get people reconsidering our consumption of clothing. 

They include The Rebel Bear, who has created two largescale public artworks based on world-famous paintings in Scotland’s Central Belt. 

Hokusai’s The Great Wave is reworked as a tsunami of wasted clothes which has been painted on a hoarding at the former Debenhams store at the St Enoch Centre on Glasgow’s Argyle Street. In Dundee, another hoarding beside Slessor Gardens shows a new version of Munch’s The Scream with the well-known figure surrounded by piles of new clothing. 

Iain Gulland, Chief Executive of Zero Waste Scotland, said: 

“If we’re serious about tackling climate change we need to rethink our consumption of goods and materials. 

“The average Scot consumes more than twice the sustainable amount of materials per year¹, and our throwaway culture encourages that approach. It’s an environmental imperative that we turn this around, and The Rebel Bear’s artworks confront that reality in a really stark, and visually engaging, way. 

“The circular economy gives us the opportunity do things differently without compromising on quality of life, evolving an economy that’s better for both people and planet in which goods and materials are valued and made to last. 

“Our campaign and the thought-provoking content within it is designed to empower everyone in Scotland to cut the environmental impact of our consumption down to size.” 

Guidance setting out private rented sector landlords’ responsibilities for ensuring their property meets updated standards has been published (Repairing Standard – Statutory Guidance for Private Landlords

The Repairing Standard, contained in the Housing (Scotland) Act 2006, covers the legal and contractual obligations of private landlords to ensure that their property meets a minimum physical standard.

The Standard was updated on 1 March 2019 to clarify existing legislation and to introduce new elements. Landlords have been given five years to carry out work to bring housing up to meet these new elements, with a statutory deadline of 1 March 2024. 

From 1 March 2024, all private rented properties will be required to have:

• central heating, 
• a kitchen with adequate space and facilities to prepare and store food
• common areas that are safe to use and properly maintained
• circuit breaker device that reduces the risk of electrocution and fire
• existing requirements for safe gas and electrical systems will be extended to other types of fuel

Similar standards are already in place in the social rented sector.

The guidance also covers the action landlords must already take to prevent damp and mould.

Housing Secretary Shona Robison said:

“Landlords have one year to meet our updated Repairing Standard, which will improve the condition of private rented property, make homes safer and ensure consistency between the social and private rented sectors.

“The majority of private landlords will already be meeting these standards. The guidance published today will help landlords better understand their responsibilities and ensure those who do need to carry out works can do so in advance of the 1 March 2024 deadline.

“All rented homes are required to meet standards that ensure they are free from damp and mould, and this guidance will help us to ensure this happens in the private rented sector.”

Welcome to our February News. The Institute is celebrating 40 years!  On 16 February 1983, The Royal Sanitary Association of Scotland and The Scottish Institute of Environmental Health amalgamated to form The Royal Environmental Health Institute of Scotland. As part of the celebrations, our President Evonne Bauer will feature this important milestone at the Annual Environmental Health Forum in April.
 
This month, we welcomed our newest member of staff to the team. Lucy Campbell has started as an Administrative Assistant supporting Margaret O’Hare in Community Training.  Her role includes the preparation and issuing of course packs and processing candidate certificates.
 
Plans are well underway for an exciting programme of centre events and professional updates for the year ahead.  As always, these are featured on our website in the events section.
 
 REHIS Annual Environmental Health Forum

 

This year’s Annual Environmental Health Forum, under the theme ‘embracing modern day challenges’ will be held as a Hybrid event from Kilmardinny House, East Dunbartonshire on Tuesday 25 April 2023.

The Forum will cover a wide range of topical updates relevant to professionals in both the public and private sectors. Confirmed speakers include Professor George Morris, Professor Phil Mackie, COSLA, Obesity Action, FSS, ASH Scotland and Police Scotland.  Awards, diplomas, and certificates will also be presented during the Forum. The full programme and booking details will be published on the REHIS website very soon.https:/event-type/rehis-events
 
Food and Health Presenters Seminar

The Annual Presenters’ update seminar for Registered Presenters in Food and Health and Cooking Skills is being held on Wednesday 22 March on MS Teams.  As always, we have a varied and engaging number of speakers for the event and hope that you will join us for what promises to be an interesting and informative half day.  For details of the programme and booking arrangements –  REHIS Presenter’s Update Seminar for Food and Health and associated Food and Health Courses – REHIS
 
Thank you to Past President, Colin Wallace

 Our Honorary Treasurer, Martin Henry recently presented Colin Wallace with a small token of thanks for Colin’s many years of service to the Institute as an elected member of the Council, former Chair of the Examinations and Professional Standards Committee and President in both 2008 and 2013. Colin was also one of the Institute’s representatives on the International Federation of Environmental Health and was well known internationally for promoting the Scottish Environmental Health profession.   Colin took the decision to retire from Council at the AGM back in November 2022, and on behalf of the Institute we wish to thank Colin for his huge contribution to the work of the Institute and profession.
 
REHIS at SCOTHOT
 
ScotHot, Scotland’s leading showcase for food, drink, hospitality, and tourism, is returning to the SEC Glasgow on 8-9 March 2023. Visitors at ScotHot will be able to see the newest artisan foods, the latest drink trends, inspirational tableware, technology and catering equipment.  Professional organisations and training companies will also be there promoting what they do. The Institute will be attending the event to promote the Environmental Health Profession and REHIS Community Training Courses.  It is free to attend if you register through www.scothot.co.uk , so come and see us on stand 269!
 
REHIS Secondary Schools Initiative
 

We are thrilled to announce that the Institute and Food Standards Scotland (FSS) are continuing their co-funding arrangement for REHIS Schools Initiative for another year.  The Initiative is available to all secondary schools in Scotland for pupils aged between 13 and 18 and the co-funding will provide secondary pupils with the resources to complete the REHIS Elementary Food Hygiene course and the REHIS Elementary Food and Health qualifications in 2023. 

Keep Scotland Beautiful’s (KSB) Spring Clean will take place this year from 17 March until 17 April.

The Environmental charity is urging the public to play their part in tackling Scotland’s litter emergency.

Last year’s Spring Clean saw thousands of volunteers roll up their sleeves and organise more than 100 events.

Get involved by:

• Organising a litter pick in your community. Check out guidance to help you set-up a safe and successful event. Make sure you register it through the members site so that KSB can track all the activity across Scotland. 
• Joining a public litter pick. Check out the Clean Up Scotland map for events you can join.
• Completing a litter survey and help gather data on common litter items and behaviours.
• Young people can also take part in the Litter League competition and compete against others on a national and regional level, to claim clean up glory by collecting the most bags of litter!

Find out more here.

Public Health Scotland (PHS)have published their Gastrointestinal and Zoonoses Biennial Report for 2020/2021. The release provides provisional information on laboratory reports of Gastrointestinal and Zoonotic (GIZ) pathogens in Scotland up to the end of 2021.

It is the first such report published by Public Health Scotland since it was established in April 2020 during the COVID-19 pandemic.

In previous years, PHS produced separate annual reports for each organism. This year, it has been integrated these into a single report.

Data presented in the report include general trends as well as seasonality, demographics, and incidence rates by NHS health board for the main GIZ pathogens for the years 2020 and 2021. Also discussed are other zoonotic pathogens and a summary of outbreaks of infectious intestinal disease with PHS involvement in years 2020 and 2021.

Unfortunately, the surveillance of general outbreaks of infectious intestinal disease in Scotland has lapsed due to the pressures of the COVID-19 pandemic. Therefore, the report covers only outbreaks in which PHS were involved and is not a comprehensive record of outbreaks of infectious intestinal disease in Scotland. PHS will for 2023/24 re- establish ObSurv (the surveillance system established in 1996 for all general outbreaks of Infectious Intestinal Disease in Scotland) as a more comprehensive surveillance system.

Salmonella

In 2020 and 2021, there were 12 outbreaks of Salmonella identified by whole genome sequencing. In 10 of them, the mode of transmission was foodborne and they were part of UK-wide outbreaks. Two outbreaks were local and were also believed to have been caused by food.

The largest was a Salmonella Enteritidis outbreak linked to processed poultry, which sickened 26 people. Salmonella Typhimurium in Brazil nuts affected 11 and Salmonella Infantis in pork scratchings caused 21 illnesses.

Nine outbreaks of Shiga toxin-producing E. coli (STEC) were reported in 2020 and 2021. Three in 2020 were caused by E. coli O157 and one by E. coli O145. In all four outbreaks, which affected 13 people, the source was linked to food and they were part of UK-wide outbreaks. In 2021, there were five outbreaks with 14 cases. Three were due to E. coli O157 and one each by E. coli O145 and E. coli O26.

In 2021, two Listeria outbreaks were recorded, which were part of UK-wide events and only one person in Scotland was sick in each incident.

Campylobacter and E. coli data
Officials said routine reporting was suspended during the early pandemic years because of “significant” service disruption, as almost all resources were redirected but a return to an annual report is planned.

In 2020, PHS received 5,392 laboratory reports of Campylobacter and this figure was 5,890 in 2021. These are down on the 5,977 reports in 2019.

The incidence rate in males remained greater than in females in 2020 and 2021, as seen in previous years. The highest rates continued to be seen in young children aged less than one year old to 4 years old and adults aged 65 and older. In 2020, the spring-summer peak was delayed, potentially because of the initial lockdown of public health measures to control the COVID-19 pandemic.

PHS received 113 lab reports of E. coli O157 in 2020 and 137 in 2021 compared to 149 in 2019. The highest incidence rates continue to be in young children aged less than one year to 4 years old and most isolates were reported in the summer months.

In 2020, there were 100 lab reports of non-O157 STEC, and 122 in 2021 versus 109 in 2019. The highest incidence rates were in young children aged less than one to 4 years old and adults aged 65 and older.

Listeria, Salmonella and Shigella figures
Thirteen cases of Listeria were recorded in 2020 and 17 in 2021. Only seven reports were noted in 2019. Most are in the 65 and over age group.

PHS received 342 reports of Salmonella in 2020 and 330 in 2021 compared to 757 in 2019. The highest incidence rates were amongst young children and elderly adults.

The two most common types remain Salmonella Enteritidis and Salmonella Typhimurium. In 2020, they accounted for 57 percent of all reports of Salmonella, and 42 percent in 2021. Other common types included Newport, Infantis, Stanley, and Agona.

There were 38 cases of Shigella in 2020 and 27 in 2021. These are down from 102 in 2019. The drop was driven by fewer Shigella Sonnei reports.

Viruses and parasites
In 2020, PHS received 211 lab reports of norovirus and 349 reports in 2021, compared to 885 in 2019. Usual seasonal trends were not seen in 2020 and 2021. The incidence rate in females was greater than in males in 2020 and 2021 and the highest rates continue to be in young children aged less than one to 4 years old and adults older than 65.

“The decrease in laboratory reports in 2020 and 2021 probably reflects the changes in social mixing, increased hygiene measures in place as well as social distancing and more stringent care and visiting arrangements in place during the COVID-19 pandemic,” according to the report.

In 2020, PHS received four lab reports of Cyclospora and one in 2021, compared to 16 in 2019. None of the four cases in 2020 were travel related but the case in 2021 was believed to have been acquired overseas.

Of 16 lab reports in 2019, 13 were thought to have become sick abroad. The drop in 2020 and 2021 may reflect changes in travel behavior related to the pandemic, according to the report.

There were 11 reports of hepatitis A in 2021 and 10 in 2020. Fifty cases were recorded in 2019.

In 2020, PHS received 127 lab reports of Hepatitis E, and 96 in 2021, compared to 158 in 2019. Fourteen cases of Yersiniosis, four of Taeniasis, and 42 of Toxoplasmosis were also recorded in 2021.

ASA, the UK’s advertising regulator, has upheld a complaint from health charity ASH Scotland in its ruling about medicinal smoking cessation advertising claims by vaping company VPZ regarding its e-cigarette products.

The Advertising Standards Authority’s UK Code of Non-broadcast Advertising and Direct and Promotional Marketing (CAP Code) – the rule book for non-broadcast advertisements, sales promotions and direct marketing communications – states that marketing communications must not contain medicinal claims unless a product is authorised for those purposes by the Medicines and Healthcare products Regulatory Agency (MHRA).

Claims that e-cigarettes are capable of helping users to quit smoking cigarettes or reduce the amount that people smoke are considered medicinal claims, and such claims are prohibited in the absence of a relevant MHRA licence – which no e-cigarette product sold in the UK has yet received.

The advert, which breached CAP Code (Edition 12) rule 22.5 (Electronic cigarettes), was published on the company’s website under the headline ‘Make the switch today with the VPZ Vape Clinic’ and contained several explicit references to smoking cessation. The ASA’s ruling states that ‘the ad must not appear again in its current form.’

The ASA ruling was covered by Channel 4 covered where they interviewed Prof Emily Banks, author of the global systematic evidence review.

Sheila Duffy, Chief Executive of health charity, ASH Scotland, said: “We welcome ASA’s ruling which draws a clear line for profit-making vaping businesses like VPZ inappropriately using medical language about e-cigarettes in advertising sales pitches.

“Staff working for vaping companies are not qualified to provide medical advice, and these companies are not health stakeholders. Not one single e-cigarette product has been licensed by the MHRA to be used as a smoking cessation aid.

“As a health charity, we advise people in Scotland who want to leave tobacco behind to contact their local specialist Quit Your Way stop smoking services, which are available for free from the NHS. 

“Quit Your Way is run by trained health professionals and offer expert, person-centred support to help individuals to make fully informed decisions about ways to quit smoking, which doesn’t need to involve using any kind of substance or commercial product.”

People who are aiming to give up smoking can call Quit Your Way Scotland’s free helpline on 0800 848484 or create a quit plan at www.quityourway.scot

The Scottish Air Quality Annual Seminar 2023 run by the Scottish Government as part of the Scottish Air Quality Database and Website project will be carried out over three 2-hour long webinars on Wednesday 15, 22 and 29 March between 13:00 and 15:00 GMT.

You can register for the free event here.

The IFEH Magazine Environment & Health International January 2023 Edition is now available here.

The IFEH intends to produce a practitioner / student edition of the flipbook in April and the Editor would welcome any content by the beginning of April.

Articles for the next addition are being sought and can be submitted to the editor at Andrew.Mathieson@anu.edu.au

The Scottish Government have sent a letter to the UK Government repeating concerns about the Retained EU Law Bill and revised amendments.

The Scottish Ministers’ view is that the Bill should be withdrawn completely. However, in advance of the Lords committee stage, the Scottish Government has re-published a suite of amendments to alter its application to Scotland. These amendments were sent on 10 February via letter from the Cabinet Secretary for Constitution, External Affairs and Culture, Angus Robertson, to the new Secretary of State for Business and Trade, Kemi Badenoch. 

The correspondence and annexed amendments can be found online here.

The aim of the amendments is to reduce the risk of harm to law in devolved areas and respect the roles and responsibilities of the Scottish Government and the Scottish Parliament. In addition to re-publishing the 17 amendments proposed for the Commons, the Scottish Government have also published two additional amendments (amendments 18 and 19) relating to the powers in the Bill given to UK Ministers which would enable them to make changes to the devolved statute book. As a general point of principle, the Scottish Government would expect any changes to the devolved statute book to be made by the Scottish Ministers and not by UK Ministers.

Global Action Plan, which organises the annual Clean Air Day, and Impact on Urban Health, have launched a new information page to raise awareness of the negative environmental impacts of wood burners.  

Wood burners are known to emit PM2.5 which can cause illnesses such as asthma, coronary heart disease and lung cancer and even homes with ‘eco’ burners are three times more polluted than those without.  

However, woodburning stoves remain popular, with a 60% rise, compared with the same time last year, in sales of firewood reported in September by The Independent, suggesting that people may be unaware of the health impacts.  

However, although the increase in demand for firewood is understandable, the impact on local and national air quality cause by a sudden spike in the use of wood burners could be significant. Stoves that use solid fuels are known to emit high levels of PM2.5, with one study in London suggesting between 23 and 31% of this particulate matter pollution in the capital resulted from wood burning, despite most of the city – and large swathes of the UK – being classed as Smoke Controlled Areas since 1956.

Rachel Pidgeon, Portfolio Manager at Impact on Urban Health, said: ‘Air pollution has devastating effects on people’s health and disproportionately affects some of the most vulnerable people in our communities, including children. Wood burning is a major source of fine particulate matter, which is one of the most harmful pollutants, yet people’s awareness of this impact is low. This is a significant barrier to reducing it. 

‘Educating people about the link between wood burning, pollution and health without judgement is an essential step towards behaviour change and ultimately regulation as well as support to transition to other energy sources for those who need it.’