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

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.

Fireworks and Pyrotechnic Articles (Scotland) Bill passes

New legislation to control the sale and use of fireworks will improve public safety and benefit communities for years to come.

The Fireworks and Pyrotechnic Articles (Scotland) Bill passed following a Scottish Parliament debate and introduces a fireworks licensing system, with mandatory safety training, for people wishing to purchase and use fireworks.

It also introduces powers for local authorities to designate firework control zones, restrictions on the supply and use of fireworks, and a new offence to criminalise the supply of fireworks and pyrotechnics to under-18s.

Being in possession of a firework or other pyrotechnic in a public place, or at certain places or events, without reasonable excuse also becomes an offence.

The Bill is the final legislative part of work towards improvements in firework safety which began in 2019, with an overwhelming response to a consultation on the use of fireworks, across over 16,000 responses, delivering a very clear message on the desire for change. This lead to the creation of the Fireworks Action Plan and the establishment of the Firework Review Group, chaired by Alasdair Hay. The group made a series of recommendations for legislative and non-legislative changes to reduce the harm and the disturbance from firework use.

A further consultation last year, ahead of the Bill’s introduction, further demonstrated strong desire for change. Analysis of the 2021 consultation responses showed 84% of respondents agreed a fireworks licensing system should be introduced in Scotland.

The Bill received backing from a coalition of professional medical bodies including the BMA, The Royal College of Ophthalmology, and The British Society for Surgery of the Hand, along with support from emergency services and animal charities.

Community Safety Minister Ash Regan said:

“This ground-breaking new legislation will improve the lives of people right across Scotland.

“This is not a ban on fireworks. We still want people to enjoy them safely, for example attending organised displays.

“But this vitally important step will make firework use more predictable and safer. The Bill will ensure appropriate action can be taken over the dangerous or disruptive use of fireworks, as well as reducing the misuse of pyrotechnic devices such as flares.

“It also demonstrates our absolute commitment to further improve safety for communities across Scotland.

“I am deeply grateful for valued support and consideration this Bill received from NHS staff, the Scottish Fire and Rescue Service, the Scottish SPCA and Police Scotland.”

Clean Air Day 2022: Air pollution impacts every organ in the body

The evidence base behind Clean Air Day, the UK’s largest campaign on air pollution by Global Action Plan, today reveals the weight of scientific evidence has strengthened, thereby allowing the organisation to publicly confirm for the first time that air pollution can impact every organ in the body. 

The relationship between air pollution and our health has been studied for decades. However, 2022 is the first year Global Action Plan’s review of the evidence base, which is approved by a number of expert bodies, has been able to confirm that air pollution can have health impacts on every major organ in the body, can shorten our lives, contribute towards chronic illness and put us more at risk from COVID-19. When we breathe polluted air, it can inflame the lining of our lungs, moving into our bloodstream ending up in the heart and brain, causing lung disease, heart disease, dementia, strokes, and cancer.   

As part of Global Action Plan’s ongoing measurement of public attitudes and behaviours around air pollution in partnership with Opinium, survey data (conducted in June 2022) shows the lack of public awareness on the extent of the health impacts of air pollution. Poor air quality dirties every organ in the body, but Brits only connect it with lung related health issues. 

·       Nearly half (49%) of people think air pollution is connected to worsening of asthma symptoms and 46% to development of asthma.  

·       44% also rightly connect it to poor lung function development, 42% bronchitis, and 35% lung cancer. 

·       Only 12% of Brits associate it with strokes, 10% with dementia, and 18% poor brain development. 

While public understanding on the health impacts of air pollution is imperative, it is also important that people understand there are actions they can take to decrease air pollution.  

Global Action Plan’s Clean Air Day campaign explains the health impacts, but also showcases the simple steps we can all take to reduce the air pollution we cause and the positive impact that taking action will have for us and our wider community. Whilst these actions are important to give people the agency to tackle air pollution, the campaign also recognises the crucial role that decision makers play in creating clean air communities for all.  

Public Health Scotland has launched a new learning hub dedicated to challenging weight stigma

Public Health Scotland has launched a new learning hub dedicated to challenging weight stigma.

The hub is an evidence based online resource, aimed at increasing awareness of weight stigma, its impact, as well as identifying actions that can be taken to address it.

It has been informed by a wide array of experts from a range of sectors, including people with lived experience of higher weight and weight stigma. 

Aimed primarily at those who work in health and social care, public sector, third sector and community-based organisations; the hub provides content in sections with animations, video and support to take the learning into practice. The hub is free, and can be easily accessed by anyone interested in weight stigma.

Experience of weight stigma impacts on peoples mental and physical health, can create barriers to access services, and compromise wider public health efforts to prevent and treat obesity.

To find out more watch the short animation and visit the Challenging Weight Stigma learning hub.  

Man sentenced to 11 months imprisonment for large-scale fly-tipping in Glasgow

The Scottish Environment Protection Agency (SEPA), Police Scotland and Glasgow City Council have welcomed the sentencing of Declan Clarke (30) at Glasgow Sheriff Court, for large-scale fly-tipping offences across the city, particularly in the Drumchapel and Gartloch areas.

Clarke was sentenced on Wednesday 8 June 2022 to 11 months imprisonment.

He originally pleaded guilty on Thursday, 21 April, 2022, after being accused of dumping more than 51 tonnes of tyres and household waste at a number of sites in June and October 2020.

Mr Clarke collected tyres from garages for a fee and hired workers and vans to dispose of them in car parks and empty land.

Most of the tyres were dumped at Dalsetter Crescent in Drumchapel which was consumed in a fire on 24 July, 2020. Glasgow Sheriff Court heard the fire caused so much smoke it disrupted flights at Glasgow Airport. Two days later, Glasgow City Council workers cleared the remnants and found the debris consisted of 51 tonnes of tyres and 17 tonnes of household waste.

In addition, about 500 tyres were also dumped at Gartloch Farm, near Gartcosh to the east of Glasgow, in a two-week period in October 2020, with more deposited there on one day the following month.

Wildlife cameras installed at the farm after previous fly-tipping incidents captured Mr Clarke, using several different hire vans, dumping tyres on 12 occasions. He was eventually caught after the farm’s owner spotted Mr Clarke and a boy trying to free a van stuck in mud in one of his fields.

Furthermore, other tyres were left around the Drumchapel area at Drummore Road, Glenkirk Drive and the Donald Dewar Centre.

Police searched Clarke’s home on 20 November, 2020 and found him hiding under a bed. They also discovered a key for another hire van, which was parked outside his flat and found to be full of tyres. A mobile phone seized contained messages between Clarke and owners of garages and tyre fitters which discussed collecting the tyres. The messages appeared to indicate that Clarke was charging £1-£2 per tyre.

Prosecutors said the cost of cleaning up Dalsetter Crescent was £7,245.16, while the estimated cost of cleaning up Gartloch Farm was £120,000 and a further £2,800 to dispose of the remaining tyres.

Sentencing Clarke, Sheriff John McCormick said his actions constituted “fly-tipping on an industrial scale” at a number of locations. “The photographs and videos I saw spoke volumes,” he said. The sheriff said Clarke continued to dump “tens of tonnes of tyres” even after he knew he was a suspect. It was “not a victimless crime”, he added, as there was a cost to the public purse and landowners also had to make a “substantial” contribution to having the debris cleared.

Kath McDowall, Unit Manager at SEPA’s Serious Environmental Crime Team, said: “Waste crime has a serious and detrimental impact on our environment, communities and compliant businesses. Criminals see waste as a money-making enterprise and we work closely with partners to share information and work together to use the best powers to tackle this behaviour. We were pleased to work alongside Police Scotland in the detection and disruption of this significant waste offence, which has resulted in a sentence we hope will act as a deterrent to others.

“SEPA will continue to work closely with partners to tackle persistent non-compliance and criminal activity related to waste tyres, which have the potential to release hazardous substances into the environment if set on fire and are a blight on the landscape if not treated, recycled or disposed of properly.”

Sergeant Nigel McDonald, from Drumchapel police station, said: “Declan Clarke was an opportunistic criminal using his illegitimate business to collect tonnes of rubbish for a fee before just dumping them across the city.

“Not only did this end up costing significant sums for the authorities to clear up, but there has been serious and long-lasting environmental damage to a number of areas where tyres or waste were heaped and set on fire.

“It is sadly highly unusual for fly-tipping cases like this to result in a custodial sentence, but it goes some way to show the seriousness of Clarke’s repeated offences. I’d like to thank our partners at Glasgow City Council and SEPA for their efforts as part of our joint-investigation into this matter.”

Stephen Egan, Glasgow City Council’s Head of Parks and Streetscene, said: “This was a shocking example of fly-tipping and we welcome the outcome of this case.
“We had to divert significant resources to clear up the waste dumped by this individual and the subsequent fire was clearly dangerous and detrimental to the local environment. As has been shown by this case, someone guilty of fly-tipping is often just the tip of the iceberg.

“The garages and other businesses that passed their waste to this individual will have known the deal being offered was too good to be true and should have made sure their waste was disposed of lawfully.

“To protect our shared environment we all have a responsibility to dispose of our waste in the proper manner at all times.”

PRIMARY SCHOOL FILMMAKERS HIGHLIGHT SECOND HAND SMOKE DAMAGE

Photo caption: Primary 6 pupils from Blacklands Primary School celebrate their success World Environmental Health Day 2016 In support of the Federation’s World Environmental Health Day 2016 celebrations The Royal Environmental Health Institute of Scotland launched a competition for Scottish primary schools and invited Primary 6 pupils at these schools to demonstrate what 10 years of a smoke-free Scotland means to them as 10 year olds. The winning entry, a short video, was submitted by Blacklands Primary School, Kilwinning. A cheque for £1,000.00 will be presented to the school at morning assembly on 7 October by Professor Kofi Aidoo, Bernard Forteath and Colin Wallace. The runners-up, Viewlands Primary School, Perth submitted a poster and have received a cheque for £500.00.

REHIS/EHAI LIAISON MEETING, EDINBURGH

The annual liaison meeting with the Environmental Health Association of Ireland was hosted in Edinburgh in August. Professor Kofi Aidoo, REHIS President, chaired the meeting. Discussions covered a wide range of topics of mutual interest including organisational developments and updates, educational and training developments both professional and community, public health alcohol legislation in Ireland and the Irish EHO contribution, smoking areas in licensed premises, and the use of lobbying and media/social media in effective public health advocacy. Next year’s meeting will be hosted by EHAI in Dublin.

An Environmental Health Manifesto for Scotland

The Environmental Health Manifesto for Scotland explains what Environmental Health is, its importance to the continued protection of Scotland’s public health both now and in the future and describes how Environmental Health Officers (EHOs) and the wider environmental health workforce can help policy makers achieve their objectives. It also sets out four challenges facing the profession and the wider Scottish public. The Royal Environmental Health Institute of Scotland (REHIS) firmly believes that there are four key challenges that will act to protect and improve Scotland’s environmental health. The Institute will work with all stakeholders to face these challenges and to improve and protect public health in Scotland.

A copy of the manifesto and a two page flyer are attached.

UN ROLE FOR REHIS PRESIDENT

Professor Kofi Aidoo, the Institute’s President, will lead a group of global experts providing independent advice to the United Nations (UN) on food contaminants that could cause cancer. Kofi has served on the Joint Expert Committee on Food Additives, which is administered jointly by the UN and the WHO, for a number of years. Follow the link below for the full story – http://www.gcu.ac.uk/newsroom/news/article/?id=136884

IFEH SPECIAL INTEREST GROUPS

The President and Board of the International Federation of Environmental Health (IFEH) invite you to get in touch with Environmental Health colleagues across the globe by subscribing to the Federation’s Special Interest Groups – a great way to access over 50,000 environmental health/public health professionals and to exchange views and information on issues of interest to you! Full information is available at the IFEH website – http://www.ifeh.org/sig/.