Sarah Groom, Author at REHIS

Minimum Unit Pricing reducing alcohol consumption

November 27, 2022

The latest data published by Public Health Scotland (PHS) has concluded that Minimum Unit Pricing has reduced overall alcohol sales.

The study, carried out in collaboration with the University of Glasgow, shows a net reduction in total per-adult sales of alcohol of three percent in the three years following the implementation of MUP in 2018.

This reflects a 1.1% fall in Scotland in contrast to a 2.4% increase in England and Wales. The net reduction in total alcohol sales was driven by a reduction in per-adult sales of alcohol through the off-trade (supermarkets and other shops), with no observed impact to sales through the on-trade (restaurants and bars).

This work builds on an earlier report which demonstrated a similar fall in off-trade alcohol sales in the first 12 months following the implementation of MUP. This latest work strengthens these findings by demonstrating that initial fall in alcohol sales was maintained throughout the three years following the introduction of the legislation in Scotland. The methods used, such as including adjustment for a geographical control and for COVID-19 associated restrictions, provide confidence that the reduction in sales demonstrated are a result of the implementation of MUP.

Lucie Giles, Public Health Intelligence Principal at PHS, said:

“The latest data shows a reduction in per-adult sales of pure alcohol in Scotland at the same time an increase in England and Wales was observed. We found net reductions in per-adult sales of cider, perry, spirits and beer, and net increases in per-adult sales of fortified wine and wine. Taken together, the overall impact of MUP on total per-adult alcohol sales in Scotland was a 3% net reduction, driven by a reduction in off-trade sales. We found little evidence to suggest that MUP caused any changes in per-adult sales of alcohol through the on-trade, suggesting that MUP did not cause a substantial shift towards alcohol consumption in pubs.

“Our main finding was consistent across a range of different conditions as tested through our additional analyses. We can conclude that, across Scotland as a whole, MUP has been effective in reducing alcohol consumption in the first three years of implementation.”

Jim Lewsey, Professor of Medical Statistics 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 per-adult alcohol sales that we’ve shown is as a result of the introduction of MUP, rather than some other factor. Incorporating data from England & Wales into our analysis controls for any changes in sales in a neighbouring region where the legislation was not introduced. This was of particular importance with the COVID-19 pandemic occurring in our three year post-intervention study period, as we know the pandemic impacted on where people were able to purchase alcohol.

“We’ve been able to adjust for other factors, such as household income, sales of alcohol through pubs and clubs and of other drink types. This statistical method also allows us to take into consideration any existing trends and seasonal variation in the data, which may have existed independently of MUP, but which could have impacted on alcohol sales following its introduction. The methods we’ve used and the consistency in our results allow us to be confident that the reduction in alcohol sales is associated with the introduction of MUP in Scotland.”

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

Read the full report Evaluating the impact of Minimum Unit Pricing (MUP) on sales-based alcohol consumption in Scotland at three years post-implementation.

Inquest Concludes Prolonged Exposure to Mould Led to Death of 2 year old

The inquest into the death of two-year-old Awaab Ishak concluded on 15 November 2022, with the Coroner finding Awaab died as a result of a severe respiratory condition due to prolonged exposure to mould in his home environment.

The inquest was heard over seven days at North Manchester Coroner’s Court in front of HM Senior Coroner Ms Joanne Kearsley.

Awaab sadly passed away on 21 December 2020, aged just two years old. He lived at home with his parents in a housing estate in Rochdale, managed by Rochdale Boroughwide Housing (RBH). Awaab’s parents had previously made complaints about the black mould present in the kitchen and bathroom and had also made requests for re-housing.

Over the weeks prior to his death, Awaab developed flu-like symptoms and had difficulty breathing. On 19 December 2020, he was taken to Rochdale Urgent Care Centre due to his difficulty breathing and was then transferred to Royal Oldham Hospital, where he was given supporting treatment and then discharged.

Awaab continued with difficulties at home and his breathing became worse, so his parents requested a GP and gave him medication. As his presentation was worsening, he was taken to Rochdale Urgent Care Centre on 21 December 2020, where he was found to be in respiratory failure. He was transferred to Royal Oldham Hospital where upon arrival he was in cardiac arrest and sadly was pronounced dead on the same day.

The Court heard how Awaab’s health visitor sent a letter to RBH in July 2020 supporting a request for the family to move due to damp and mould. She expressed her concern over Awaab living in the flat and highlighted the health issues that the mould could cause him.

The Coroner has found the cause of death was:

1a) Acute airway Oedema with severe granulomatous tracheobronchitis

1b) Environmental Mould Exposure

The inquest heard evidence from a number of experts, medical professionals, and staff at RBH.

Pathologist Dr Philip Lumb who carried out Awaab’s post-mortem told the Court that Awaab’s throat was swollen to a degree that would compromise his breathing. His windpipe and other airways were also swollen and congested. There was evidence of fungus in his blood and lungs, and exposure to fungi was the most plausible explanation for the inflammation.

The inquest also heard from Professor Malcolm Richardson, who is an expert on moulds and fungi and their effect on health. He examined the family’s flat 10 days after Awaab died and found “extensive mould” on the walls and ceilings of the bathroom and kitchen and also found mould in a cupboard in the bedroom. He told the Court that the flat would have been contaminated “for some considerable time”.

Rochdale Council building surveyor, Daniel McVey, inspected the property two days after Awaab’s death and told the Court that it was not fit for human habitation without repairs being carried out. Despite this, Awaab’s parents had to continue living in the flat following Awaab’s death following unsuccessful requests for rehousing, despite Awaab’s mother being pregnant at the time.

Richard Blakeway of the Housing Ombudsman for England told the Court that the law needs to be reinforced to compel landlords to address damp and mould problems, as the issue is not given the same legal standing as gas safety and legionella. He said that some social landlords have an “outdated, ineffective, sometimes dismissive” approach with an overemphasis on blaming the tenant’s lifestyle.

Consultation launched on plans to restrict alcohol advertising

November 24, 2022

Alcohol companies could face tighter restrictions on advertising in order to protect society’s most vulnerable, under new proposals which have been set out by the Scottish Government.

The public’s views are being sought on plans to restrict adverts for alcohol at sporting events, on buses, and online and elsewhere – to reduce the appeal of alcohol and improve the nation’s health.

Proposals have been informed by the Children’s Parliament and the Young Scot Health Panel, delivering on the Government’s commitment to ensure that children and young people’s views are heard.

This is the latest step in efforts to reduce harmful drinking and alcohol-related harms in Scotland and follows the successful introduction of Minimum Unit Pricing, which has already reduced purchases of cheaper, more potent alcoholic drinks.

The public consultation is in line with the World Health Organisation’s (WHO) recommended approach to comprehensively restrict exposure to alcohol marketing.

Public Health Minister, Maree Todd, said:

“There is clear evidence that adverts which glamorise drinking can encourage young people to drink alcohol and have a detrimental impact on those in recovery from problem alcohol use.

“We are making progress already – with our minimum unit pricing reducing alcohol sales in the off-trade – but with 1,245 alcohol related deaths last year we know that more needs to be done if we are to tackle Scotland’s problematic relationship with alcohol.

“This consultation is an important step in doing that, and I am extremely grateful for the young voices who have helped us get this far.”

The public can view the proposals and give their views on the Scottish Government consultation website. The consultation will run for 16 weeks to allow for the Christmas holiday period and February recess, closing on 9 March 2023.

Public Health Scotland report highlights the impact of Minimum Unit Pricing on alcohol products and prices

Public Health Scotland (PHS) have published a report which evaluates the price and range of alcohol products in the Scottish off-trade sector in the 12 months following the implementation of Minimum Unit Pricing of alcohol (MUP).

The research shows that the average price of alcoholic drinks in the off-trade increased in Scotland to a greater extent than was seen in England and Wales over the same period. The increase in average prices during the study period was also greater than the rises seen between the two years in Scotland prior to MUP.

Before the implementation of MUP, supermarkets tended to have lower alcohol pricing than convenience stores. In the first 12 months after the introduction of MUP, prices in supermarkets increased more than those in convenience stores, meaning that both had a similar pricing level.

The greatest increases in price were seen in the types of alcoholic drinks that were priced the lowest relative to their alcohol by volume (ABV) prior to MUP, such as some ciders, perries and supermarket own-brand spirits – all of which tended to be priced below £0.50 per unit prior to MUP being implemented. The products that increased the least in average price, such as some ready-to-drink beverages, or those that decreased in price, such as some fortified wines in convenience stores, appeared most likely to see increased sales.

Changes were seen in sales across different container sizes, including reductions in the amount sold in larger single-item containers, especially for some ciders and own-brand spirits in containers of 1 litre and over. The amount of beer and cider sold in the largest multipacks also declined, while sales in smaller multipacks increased.

Dr Karl Ferguson, Public Health Intelligence Adviser at Public Health Scotland, said:

“In the first 12 months after MUP was implemented, we found that, especially for products that were priced below £0.50 per unit of alcohol prior to MUP, prices went up, the amount sold in larger container sizes went down, and sales also declined. We also found that, because of the price increase, even in instances where the volume of sales went down, the value (£) of sales remained fairly constant or increased.”

Most data (price outcomes, container size, multipacks, volume and value sales) were derived from weekly off-trade electronic point of sale data covering May 2016 to April 2019, obtained from market research specialist NielsenIQ.

Scottish Health Survey 2021 Released

November 10, 2022

The Scottish Health Survey (SHeS) is commissioned by the Scottish Government Health Directorates to provide reliable information on the health, and factors related to health, of people living in Scotland that cannot be obtained from other sources.

The series aims to:

estimate the occurrence of particular health conditions
estimate the prevalence of certain risk factors associated with health
look at differences between regions and between subgroups of the population
monitor trends in the population’s health over time
make a major contribution to monitoring progress towards health targets

For the first time, the data for the diet chapter of the SHeS, provides comparison with the SDGs as they were collected by a new methodology developed by Food Standards Scotland (FSS).

The overall picture of diet in Scotland remains very poor, with fibre intake among the worst of the survey results. Diets which are high in fibre are associated with a lower risk of heart disease, stroke, type 2 diabetes, and bowel cancer.

The data shows that, on average, adults consumed 17.2g of fibre per day, well below the target of 30g. Men, who typically have a higher total food intake, were more likely to achieve the target (8%), compared with women (5%).

Key findings from the report show that in 2021:

revalence of hazardous or harmful weekly alcohol consumption has reduced from 34% in 2003 to 23% in 2021. Nine per cent of adults reported ever having had a problem with alcohol, with 1% saying they still had a problem.
Five per cent of adults were current e-cigarette users, a reduction from 7% each year between 2015 and 2019.
Thirty per cent of adults were living with obesity. This was similar to or marginally higher than rates in each year since 2008 (ranging from 27% to 29%).
Around one in five of all adults consumed five or more portions of fruit and vegetables a day (22%). This was similar to levels since 2003 (21% in 2003).
One in five children (20%) aged 2 to 15 met the five-a-day recommendation for consumption of fruit and vegetables. This was significantly higher than in the years 2008 to 2019.
Almost half of all adults (48%) met the Scottish Dietary goal to reduce total fat intake to no more than 35% of food energy. Around one in five adults (22%) met the Scottish Dietary Goal for free sugarsintake to not exceed 5% of total energy.

The Scottish Health Survey main report is published alongside a short summary report on the Scottish Health Survey website. Key indicators for NHS health boards and local authorities are available via the Scottish Health Survey Dashboard.

Food Standards Scotland campaign encourages people to take a daily Vitamin D supplement

Food Standards Scotland have launched a campaign aimed at encouraging people to take a daily vitamin D supplement.

Getting enough vitamin D is important to support bone and muscle health.

In Scotland, between October and March, we don’t get enough of the right kind of sunlight for our bodies to make vitamin D.

Therefore, FSS are recommending that everyone considers taking a supplement containing 10 micrograms (400 IU) of vitamin D daily.

People who are more likely to be deficient in vitamin D are recommended to take a daily supplement all year round. Those more at risk include:

pregnant and breastfeeding women
infants and children under 5 years old
people who have low or no exposure to the sun, for example those who cover their skin for cultural reasons, are housebound, confined indoors for long periods or live in an institution
people from minority ethnic groups with dark skin such as those of African, African-Caribbean and south Asian origin, who require more sun exposure to make as much vitamin D

Visit our website to find out more about vitamin D.

Revised Draft National Planning Framework 4 laid in the Scottish Parliament

On the 10 November, the Draft National Planning Framework was laid in the Scottish Parliament for approval along with an Explanatory Report that outlines the changes from Draft NPF4 to the Revised Draft. This is a significant milestone for Scotland’s planning system.

The Revised Draft is a product of extensive engagement and collaboration and maintains the direction of travel that gained support through our 3 rounds of consultation: the Call for Ideas (2020), the Position Statement (2020) and Draft NPF4 (2021).

Proposals in NPF4 include:

enabling more renewable energy generation, outside National Parks and National Scenic Areas, to support the transition away from reliance on fossil fuels
supporting emerging low-carbon and zero emissions technologies – including hydrogen and carbon capture – and developments on land that unlock the transformative potential of offshore renewable energy, such as expansion of the electricity grid. Waste incineration facilities would be highly unlikely to receive permission
facilitating creation of cycling or walking routes, low carbon transport, more green spaces and opportunities for play, culture and tourism
helping rural communities grow by enabling more local homes and encouraging a more diverse rural economy
regenerating city and town centres to help them adapt to economic change while enabling people to access shops, schools and workplaces within a 20 minute walk or cycle
adopting a planned and evidence-based approach to delivering good quality and affordable homes that benefit communities.

NPF4 is required to be approved by the Scottish Parliament, then adopted by Scottish Ministers. On adoption we will commence the provisions in the Planning Act which will make NPF4 part of the statutory development plan.

Revised Draft NPF4 | Transforming Planning

Scottish Government Commences Development of the new National Marine Plan

The Scottish Government has officially commenced the development of the new National Marine Plan. This announcement follows the previous National Marine Plan Review in 2021 and the government’s decision in Programme for Goverment 2022 – 2023.

The first National Marine Plan was developed in 2015. It is now time to develop the new plan to face the twin crisis of climate change and nature loss and to support Scotland’s Blue Economy. Effectively managing how we use our marine space is critical in our transition to net zero by 2045.

National marine plan 2: engagement strategy – gov.scot (www.gov.scot)

Online Open Day at University of the West of Scotland

The University of the West of Scotland are running on Online Open day on Wednesday 30 November, where potential students can find out more about the BSc (Hons) in Environmental Health with Professional Practice and studying at the University of the West of Scotland. This degree course is accredited by the Institute and is the ideal step to becoming an Environmental Health Officer in Scotland.

For more information and to book a place go to here.

REHIS News – October 2022

October 26, 2022

Annual General Meeting

The Institute’s Annual General Meeting will this year be held in hybrid format, on Friday 18 November 2020 at 2pm. It will be held at the Edinburgh Training and Conference Venue and on MS Teams and is open to members of the Institute. Members should have received their papers by now which includes the agenda and details of nominees who are up for election to the Institute’s Council. To register to attend please refer to the Institute’s website: REHIS Environmental Health Update and Annual General Meeting – REHIS

Professional Development Opportunities

The Institute has a number of training and professional development opportunities currently taking bookings. These can be found athttps:/event-type/rehis-events/ and include Dog Control Training, the annual Pollution Update, the annual Health and Safety Update and the Institute’s Environmental Health Update which precedes the AGM. The Northern and Southern Centres also have training events available for booking on Smoke Nuisance and Gas Safety respectively.

The dog control training has been long anticipated and it would be hoped as many officers as possible, who have responsibility for serving Dog Control Notices, can manage to attend the training. Bookings for the in person day (3 November) must be made by Friday 28 October.https:/events/dog-control-training-part-2/ This day includes a number of speakers including dog behaviorists and the Dog’s Trust, offering information which can be shared with dog owners to assist in controlling their dog, the signs to look out for, when a dog may be moving towards a point of being out of control, ways to maintain personal safety around dogs and will offer ample time for sharing experiences. Delegates attending either/both training sessions from a local authority need not provide a purchase order number at the time of booking as funding made available by the Scottish Government can be utilized to attend the training.

Community Training – Save the Date

The REHIS Food and Health Update Seminar is being held on the morning of Wednesday 15 March 2023 (half day). The intention is to host this as a hybrid event. Details to follow in the coming months.

E-coli outbreak in East Lothian declared officially “over”

The multi-agency Incident Management Team (IMT) said there have been no new cases of the infection in more than 28 days, meaning that the outbreak has been concluded.

A total of 57 cases were identified and five nurseries in Musselburgh and Haddington were closed as a safety precaution during the outbreak of E-coli.

The IMT, which was formed to manage the outbreak response, thanked all of the affected families for helping to contain the outbreak and prevent further spread through the community.

Dr Graham Mackenzie, Consultant in Public Health Medicine and Chair of the IMT, said: “We are very grateful to families, nurseries, and other workplaces affected by this outbreak. Your collective action has helped to minimise the onward spread of this dangerous bug.”

Letters advising families about the conclusion of the outbreak and the most up to date information have also been issued.

Work is still continuing behind the scenes by the health care scientists in epidemiology and microbiology to try and identify the source of the infection.

The Health Protection Team is also working with and supporting some families through the clearance process, which is a normal part of an E. coli outbreak.

Dr Mackenzie reminded families of the need for ongoing good hand hygiene, especially as Scotland experiences an overall rise in the number of cases of E-coli.

He added: “This outbreak has highlighted the importance of careful handwashing, with soap and warm water, and drying hands thoroughly, before eating and after going to the toilet.

“It also reinforces the need to stay off nursery, school or work, while unwell. With most vomiting and diarrhoea illnesses it is important to stay off for 48 hours after symptoms have stopped. E. coli is different because of the seriousness of infection.

“The outbreak in Haddington and Musselburgh has coincided with a national rise in E. coli cases. It is important to remain vigilant.”

Avian Influenza Prevention Zone

Following an increase in the number of detections of avian influenza (bird flu) in wild birds and other captive birds, the Chief Veterinary Officers from England, Scotland and Wales have declared an Avian Influenza Prevention Zone (AIPZ) across Great Britain to mitigate the risk of the disease spreading amongst poultry and other captive birds.

This means that from 12:00 noon on Monday 17 October, it will be a legal requirement for all bird keepers in Great Britain to follow strict biosecurity measures to help protect their flocks from the threat of avian flu.

The introduction of the AIPZ comes after the United Kingdom has faced its largest ever outbreak of avian flu with more than 190 cases confirmed across the United Kingdom since late October 2021, with over 40 of these confirmed since the beginning of this month. The East of England has been particularly badly hit with cases in poultry and other captive birds. There have also been cases in the south west and findings in wild birds at multiple sites across Great Britain.

Avian influenza circulates naturally in wild birds and when they migrate to the United Kingdom from mainland Europe over the winter they can spread the disease to poultry and other captive birds. Maintaining strict biosecurity is the most effective method of protecting birds from the virus.

Keepers with more than 500 birds will need to restrict access for non-essential people on their sites, workers will need to change clothing and footwear before entering bird enclosures and site vehicles will need to be cleansed and disinfected regularly to limit the risk of the disease spreading. Backyard owners with smaller numbers of poultry including chickens, ducks and geese must also take steps to limit the risk of the disease spreading to their animals.

Public Health Scotland advises that the risk to public health from the virus is very low and Food Standards Scotland advises that avian influenzas pose a very low food safety risk for consumers. Properly cooked poultry and poultry products, including eggs, are safe to eat.

In a joint statement, the Chief Veterinary Officers for England, Scotland and Wales said:

“Bird keepers have faced the largest ever outbreak of avian flu this year and with winter brings an even more increased risk to flocks as migratory birds return to the United Kingdom.

“Scrupulous biosecurity and hygiene measures are the best form of defence, which is why we have declared an Avian Influenza Prevention Zone (AIPZ) across Great Britain, meaning that all bird keepers must take action to help prevent the disease spreading to more poultry and other domestic birds.

“The introduction of an AIPZ means that regardless of whether you keep a few birds or thousands, you are legally required to meet enhanced biosecurity requirements to protect your birds from this highly infectious disease.”

The introduction of an AIPZ follows a decision to raise the risk level for avian influenza incursion in wild Birds in Great Britain from ‘medium’ to ‘high’. For poultry and other captive birds the risk level has been raised from ‘medium’ to ‘high’ at premises where biosecurity is below the required standards, and from ‘low’ to ‘medium’ where stringent biosecurity measures are applied.

The nationwide AIPZ builds on the additional biosecurity measures that were brought in last week as part of the regional housing order that covers Norfolk, Suffolk and parts of Essex. The AIPZ, now in force across Great Britain, does not include a nationwide requirement to house birds. However, this is being kept under constant review.

There has been a prolonged season of avian influenza this year and with the now increased risk during the winter, the need to include a mandatory housing requirement in the AIPZ may arise. Further disease control measures will be based on the latest scientific evidence and veterinary advice.

The AIPZ means bird keepers across Great Britain must:

Keep free ranging birds within fenced areas, and ponds, watercourses and permanent standing water must be fenced off (except in specific circumstances, e.g. zoo birds).
Cleanse and disinfect footwear and keep areas where birds live clean and tidy;
Minimise movement in and out of bird enclosures;
Reduce any existing contamination by cleansing and disinfecting concrete areas, and fencing off wet or boggy areas
Keep domestic ducks and geese separate from other poultry.
Ensure the areas where birds are kept are unattractive to wild birds, for example by netting ponds, and by removing wild bird food sources;
Feed and water your birds in enclosed areas to discourage wild birds;

Keepers should familiarise themselves with our avian flu advice at www.gov.scot/avianinfluenza and report suspicion of disease to your local APHA Field Services Office.

The Avian Influenza Prevention Zone will be in place until further notice and will be kept under regular review as part of the government’s work to monitor and manage the risks of bird flu.

Dead wild birds may be infected, so don’t touch them unless wearing suitable protective clothing. When found on publicly owned land, the local authority will consider on a case by case basis the removal of carcases.

Poultry keepers and members of the public should consult our latest guidance to check the latest threshold for reporting dead wild birds to Defra’s national GB helpline on 03459 33 55 77 and should not touch or pick them up.