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REHIS Fellow and Past President, Emeritus Professor Kofi Aidoo has been appointed to a prestigious role for his standing in the international public health community.

The Institute was delighted to learn that the Singapore National Medical Research Council has recently appointed Kofi to the Scientific Advisory Board Open Fund – Large Collaborative Grant (OF-LCG) programme titled “Integrated Innovations in Infectious Diseases (I3D)”.

The OF-LCG aims to support the best teams of researchers from public institutions to advance human health and wellness, and create economic value for Singapore and Singaporeans, through the pursuit of excellence in research and its applications.

Along with two other SAB members, he will advise and guide the research team in their research directions, as well as providing feedback to the National Medical Research Council (NMRC) Office on a yearly basis on areas such as

• Research progress, directions and priorities;
• Research collaborations, locally and internationally with academia and industry;
• Potential to exploit any background and foreground Intellectual Property (IP);
• Human capital and research capability development;
• Impact of the research activities on the industry, economy, health/ healthcare and the society;
• Research translation pathway.

The Institute congratulates Kofi on this new appointment and wish him all the best in this role.

REHIS Diploma in Environmental Health and Higher Certificate in Food Practice – Professional Examinations

The Professional Examinations (Interviews) are taking place on Tuesday 1 to Thursday 3 October at the Carnegie Conference Centre, Dunfermline. The Institute wishes the best of luck to all 24 candidates.

REHIS Environmental Health Update and Annual General Meeting

The free to members Environmental Health Update is being held as a hybrid event on the morning of Friday 22 November from the COSLA Conference Centre in Edinburgh. The programme and booking form will be available soon.
This event will be followed by the Institute’s 24th Annual General Meeting. 
For information on how the Institute is governed and the committee structures, please see here Governance and Committees – REHIS

REHIS Annual Environmental Public Health and Housing Update, 27 November 2024

The annual Public Health and Housing update event is being held on 27 November 2024. The online event will have a series of presentations on a wide range of subjects.  The programme and booking form will be available soon.

World Environmental Health Day – 26th September 2024
World Environmental Health Day (ifeh.org)

As part of their updated position statement, Royal College of Paediatrics and Child Health (RCPCH) is calling for stronger action from the UK government to protect children from the health harms of air pollution.

Paediatricians at the RCPCH highlight their concerns in a newly updated position statement published on 19 September, which summarises recent scientific evidence on the child health impacts of air pollution. They call for stronger government and local authority action to tackle air pollution, focusing on combating top UK sources of two of the most harmful pollutants: PM2.5 and nitrogen dioxide.

Air pollution poses severe risks to children’s health. PM2.5, one of the most harmful air pollutants, can be breathed deep into the lungs and absorbed into the bloodstream, affecting children’s developing organs, exacerbating respiratory and cardiovascular diseases, and increasing the chance of developing long-term health conditions in adulthood. 

Children are especially vulnerable to air pollution because they inhale more air than adults in proportion to their body weight, breathe closer to ground-level sources of air pollution such as vehicle exhausts, and are less able to control their exposure than adults. Exposure to air pollution doesn’t just affect physical health. It has also been linked to slower response times and decreased attentiveness school children, as well as serious mental health problems such as psychosis.

Recent studies showed that 86% of new schools being built in England are in unsafe air pollution areas, while in 2018 UNICEF found that children in around 2000 London schools and nurseries were being exposed to illegal levels of nitrogen dioxide pollution. However, a lack of monitoring around UK schools means that many more children may be exposed to harmful levels of air pollution throughout the school day.

RCPCH’s newly updated position statement summarises recent research on how indoor and outdoor air pollution impact child health and calls for bold but necessary policies to improve air quality, especially in and around schools and hospitals. 

The statement highlights the following key recommendations:

• Protecting children in schools by monitoring air quality and empowering local authorities to act when pollution exceeds limits.
• Enacting a Clean Air Act (Ella’s Law) to establish a legal right to clean air across all four nations of the UK and committing to the WHO Air Quality Guidelines.
• Implementing and expanding Awaab’s Law to protect private renters from hazardous living conditions, such as damp and mould.
• Investing in sustainable transport to ensure half of urban journeys can be walked or cycled by 2030, with accessible public transport for all.
• Phasing out domestic wood-burning in urban areas while supporting rural residents and those in fuel poverty to transition to cleaner heat sources.

You can read RCPCH’s updated position statement and recommendations here.

The Scottish government has temporarily dropped restrictions on the installation of wood burning stoves in newbuild homes or conversions.

On 19 September, Minister for Climate Action Alasdair Allan sent letters to the chief executives of all Scotland’s local authorities announcing that the ban had been lifted with immediate effect.

On April 1, 2024, new building regulations came into force in Scotland “banning the use of polluting heating systems such as oil and gas boilers, and bioenergy – including wood-burning stoves” in new homes, as the Scottish Government explained.

However, the rules were put under review in May after concern a ban on wood burners would negatively impact on people living in rural areas.

The new rules were designed to help reduce air pollution and tackle climate change by encouraging builders to install clean heating systems such as heat pumps or heat networks. 

But some opponents of the legislation had said they did not have access to the main gas supply and relied on log burners for heat during power cuts.

Deputy First Minister Kate Forbes previously said she had concerns about the ban, citing the impact it could have on older people in her Skye, Lochaber and Badenoch constituency.

A ministerial direction means that wood burners and other biofuel heating systems including peat can still be installed pending the outcome of the review.

Food Standards Scotland have published a paper which sets out their position in relation to processed and ultra processed foods (UPFs).

There has been growing interest in the topic of food processing in recent years, with lots of reports linking ultra-processed foods with health and environmental outcomes and emphasising the prominence these foods have within our society.

There is no universally agreed definition of a processed food, however the NOVA classification is the most commonly used classification system. The NOVA system groups foods and food ingredients into four categories based on their level of processing and not their energy or nutrient content. These are unprocessed, or minimally processed foods, processed culinary ingredients, processed foods and ultra-processed foods.

The Scientific Advisory Committee on Nutrition (SACN) reviewed the evidence in relation to processed foods and health and found that, whilst there is evidence of a link between processed and ultra-processed foods and health, there were uncertainties around the quality of the evidence available. Additionally, it is currently unclear how much of this relationship may be explained by other nutritional risk factors, such as calorie, fat, sugar or salt content.

Based on this evidence from SACN, and because definitions for processed or ultra- processed foods do not consider their energy or nutrient content (which are key determinants of the healthiness of a product), Food Standards Scotland (FSS) does not consider the evidence in relation to processed and ultra-processed foods and their impact on health to be sufficiently robust to warrant any change in dietary advice or policy direction for improving diet and diet related health in Scotland.

In comparison, there is strong and robust evidence that diets high in calories, fat and saturated fat, sugars and salt increase the risk of many chronic diseases, including heart disease, stroke, type 2 diabetes and many types of cancer. This risk could be mitigated through decreased consumption of high fat, sugar and/or salt (HFSS) foods, in line with existing dietary advice for a healthy diet. FSS therefore continues to advise consumers to move towards a healthy and more environmentally sustainable diet, as depicted by the Eatwell Guide.

Read the Position paper here.

The number of food safety alerts and fraud investigations exchanged between European member states went up in 2023.

The European Commission, which manages the Alert and Cooperation Network (ACN), said there was a significant increase in notifications compared to 2022.

The network includes the Rapid Alert System for Food and Feed Network (RASFF), the Administrative Assistance and Cooperation Network (AAC), Agri-Food Fraud Network (FFN) and the Plant Health Network (PHN).

There was an 8 percent rise in RASFF notifications to 4,695 notices, of which almost 4,200 mentioned food. The most notices by origin involved Turkey, China, Poland, India, Netherlands, and France.

As in previous years, more than a third of notifications were border rejections, involving mainly pesticide residues in fruit and vegetables from Turkey, followed by Egypt and India.

More than 150 notifications were for Salmonella in poultry products from Poland. 85 alerts mentioned aflatoxins in nuts and seeds from the United States.

Pathogenic microorganisms were the second most common hazard category in food. Salmonella was the most frequent, followed by Listeria monocytogenes, E. coli, and norovirus, all primarily in products of animal origin.

There were 48 foodborne outbreaks posted in RASFF. Norovirus was identified as the probable cause in 17 cases, Salmonella in 11, Listeria in five, histamine poisoning in two, and E. coli in two cases. Eighteen incidents involved multiple countries.

As part of investigations into a multi-country Salmonella outbreak traced to chicken kebab from Poland, defects on traceability were also detected and a suspicion of forged labels was raised. Two notifications were created by Poland to investigate the fraud angle of the cases.

Data analysis on kebab products revealed 61 cases across RASFF, AAC and the FFN in 2023. One issue was undeclared meat species such as chicken, turkey or horse. Eleven alerts had a suspicion of fraud. Some notifications were related to meat substitution with the presence of chicken meat, turkey, pork, and horse meat in kebabs.

The Administrative Assistance and Cooperation system allows member states to notify violations of EU food safety legislation which do not constitute a health risk. There was a 24 percent increase with 3,166 notifications.

The majority were linked to non-compliant fruits and vegetables, mainly due to pesticide residues, followed by mislabeling, such as unauthorized health claims for food supplements. Germany created the most notifications, followed by Bulgaria, and Austria.

The Agri-Food Fraud Network (FFN) registered a 26 percent rise in notifications, with 758 fraud suspicions. Belgium, Germany, and France notified the most. The illegal trade of cats and dogs remained a major issue. Other suspicions related to meat substitution, honey adulteration, and mislabeled olive oil.

The most notified product category was meat and meat products other than poultry. Common issues were ingredient or species substitution and misleading labeling.

Live animals (excluding pets) were the second most reported category and like in previous years, it concerned mainly horses. Fraud suspicions were divided between smuggling and forgery of mandatory documents, like animal passports and health certificates.

Honey and royal jelly remained in the top three notified product categories. The main practice notified was adulteration of honey by dilution with sugar syrups. An increase of cases on fats and oils was seen. The majority concerned quality or mislabeling, where lower quality olive oil was sold as extra virgin olive oil.

The top reported suspected fraud for fish products was substitution with lower value species or undeclared addition of water. The EU Commission has started planning an EU Coordinated Action on short weighting of fishery products. Short-weighting is when there is a misrepresentation of the weight by including any extra weight gained through various practices to the net weight. It will focus on practices such as the use of undeclared glazing, water addition, additives, and breading.

Also, 1,075 AAC notifications and 1,625 RASFF alerts were flagged as potential fraud, prompting deeper inspections or investigations by member states.

Public Health Scotland has published Scottish Legionnaires’ disease data for 2023, which shows an ongoing increase in cases and incidence.

Legionnaires’ disease is a severe form of pneumonia caused by legionella bacteria, which can be acquired if tiny droplets of water containing the bacteria are inhaled.

Symptoms can include a cough, difficulty breathing, chest pain, and a high temperature, often accompanied by vomiting and diarrhoea, and, in some cases, confusion.

The surveillance report shows that the case numbers in 2023 (54) exceeded those in 2022 (44).

Factors that may possibly explain the notification increases include changes in national testing policies; an ageing population with the presence of multiple coexisting conditions and changing weather patterns.   The increase in Legionnaires’ disease cases identified in Scotland is also reflected across Europe.

Legionella bacteria is most commonly found in water sources, in both natural and man-made environments such as air-conditioning units, jacuzzies and showers. A specific type of legionella can also be found potting compost and other composted materials that, on rare occasions, may result in infection.

Hazel Henderson, Consultant at Public Health Scotland, said:

“Legionella bacteria exposure most often occurs when a person breathes in tiny water droplets containing the bacteria. When travelling, running any showers and taps on hot for a few minutes and opening windows where possible can help minimise any risk of infection. Only a minority of people go on to develop symptoms, however, those who smoke or have underlying medical conditions are at higher risk.

“A less common type of legionella bacteria can be found in damp potting compost or mud. It’s advisable to ensure good hygiene in relation to gardening by wearing gloves, potting plants outdoors, and a mask if the workspace is dusty, particularly if indoors. It’s important to wash hands immediately afterwards, especially before eating or drinking.”

Read the annual report on Legionnaires’ disease in Scotland for 2023 here. 

The UK government is considering restricting smoking in some outdoor public areas to help cut deaths from tobacco use and reduce the burden on the NHS.

The plans are not concrete, however measures could involve banning smoking in pub gardens, outdoor restaurants, and hospital grounds. Any new ban would apply only in England, but the other devolved nations could follow suit.

When asked about media reports on the suggested ban the prime minister, Keir Starmer, confirmed that the government was considering it. He told the BBC on 29 August, “My starting point on this is to remind everybody that over 80,000 people lose their lives every year because of smoking,” he said.

“That is a preventable death, it’s a huge burden on the NHS and, of course, it is a burden on the taxpayer. So, yes, we are going to take decisions in this space, more details will be revealed, but this is a preventable series of deaths and we’ve got to take action to reduce the burden on the NHS and the taxpayer.”

The prime minister added: “It is important to get the balance right, but everybody … who uses the NHS will know that it’s on its knees.”

While precise plans for the curbs are likely to change after consultations, it is understood that ministers are in favour of many of the suggested ideas to limit outdoor smoking.

The King’s Speech at the state opening of Parliament last month promised to reintroduce legislation proposed by the previous government, which would have outlawed the sale of tobacco to anyone born on or after January 2009.

In Australia, smoking outdoors is already regulated, where bans at many outdoor spaces have been in place for two decades. Rules vary from state to state but, broadly speaking, at pub gardens and parks, designated smoking sections or zones are set up to protect non-smokers from secondhand smoke. At beaches and playgrounds, smoking is banned altogether.

Food Standards Scotland (FSS) is issuing information to consumers to help identify counterfeit vodka products following more seizures over the weekend.

The counterfeit vodka, so far recovered in local convenience stores in Coatbridge and Glasgow, was sold in 35cl bottles (commonly known as half bottles) and fraudulently labelled as Glen’s.

FSS have been working closely with the brand owner for Glen’s vodka to try and mitigate the risk to consumers.  As a result, additional information is being provided to help them distinguish between genuine and counterfeit products.

Every genuine bottle of Glen’s vodka has a laser etched lotcode applied to the bottle between the rear label and the base of the bottle.

They will also have the following markings on the base of the bottle – the highlighted three identifiers will not vary (position or detail).

A spokesperson for the Loch Lomond Group which owns Glen’s Vodka, said: “Our priority is the health and safety of the public which includes our many thousands of loyal Glen’s customers.  We are working hard to support the excellent efforts of Food Standards Scotland and the other authorities involved to address the matter urgently. We would urge any customers who suspect they may have a counterfeit product to contact their local council’s environmental health service or the Food Standards Scotland Food Crime and Incidents Unit as quickly as possible.”

As reported previously, lab results from counterfeit vodka sampled in August 2024 confirmed the presence of the chemical isopropyl.

Isopropanol (isopropyl, IPA) is a toxic alcohol not suitable for human consumption.  Ingestion of any amount can lead to toxicity and larger amounts can be fatal.  Ingested IPA will be converted to acetone and so onset of symptoms may be immediate or delayed, for up to 30 hours post ingestion.   Symptoms include nausea, vomiting and abdominal pain, intoxication, respiratory depression and coma. Cardiovascular collapse is also possible.  Anyone with symptoms should seek medical attention call NHS 111 in the first instance or 999 in an emergency.  Please be aware IPA has a strong odour and it may be possible to detect contaminated products by smell alone.

FSS has today issued a food alert for action notice to all Local Authorities in Scotland, requesting them to identify and visit relevant establishments in their area to check for counterfeit products and make businesses aware of the issue.

Gordon Mitchell, Head of Crime Operations at FSS, said: “Following further seizures of counterfeit vodka over the weekend, we need the public to be aware of any factors which may help them distinguish counterfeit products from genuine Glen’s. As well as a distinct smell, the counterfeit products are bottled differently to genuine Glen’s and the images provided will help consumers to tell the difference.

“As we do not yet know the scale of distribution of these products, but we do know the potential dangers associated with consumption, we are urging consumers once again to be extremely vigilant and to please get in touch if you have any information relating to the counterfeit vodka. We would also remind retailers that they should only be purchasing products from reputable suppliers.”

If anyone believes they may have purchased such products, we would ask you to contact the FSS Scottish Food Crime and Incidents Unit – foodcrime@fss.scot – for further advice. Do not drink any of the product and please store in a safe place to allow FSS to collect and analyse.

If anyone has any information on the manufacture or sale of counterfeit alcohol  then please contact the Scottish Food Crime Hotline (0800 028 7926) or online, in partnership with Crimestoppers. The hotline is free and anonymous.

Recently, the Friends of the Pentlands unveiled a memorial to the late John Stirling, founder of “Friends of the Pentlands” and past President and Honorary Member of REHIS.  John was a tireless enthusiast for improving the environment of the hills and increasing access for all.  The memorial takes the form of a 3-D relief map of the Pentlands and is located beside the wildflower meadow opposite Harlaw Visitor Centre.

Picture from Facebook –  John’s wife, Linda second from left with daughter Lara and son Ewan next to her.

A study published in Eurosurveillance to investigate an outbreak of Shiga toxin-producing Escherichia coli (STEC) O157:H7 in the UK identified contaminated lettuce as the most likely source of the infection, and determined that heavy rainfall and flooding may have carried STEC from animal faeces to the lettuce crops. More heavy rainfall events are expected due to climate change in the future, leading to increased impacts on health and food security.

After a large outbreak of STEC 0157:H7 was detected in the UK in September 2022, a national-level investigation was initiated to identify the source of the outbreak and inform risk mitigation strategies. Whole genome sequencing (WGS) was used to identify outbreak cases, and strongly suggested a link to a single source.

Overall, 259 cases with illness onset dates between Aug. 5 and Oct. 12, 2022, were confirmed across the UK. A national outbreak was declared in early September. Epidemiological investigations identified a UK-grown, nationally distributed, short-shelf-life food item as the source.

Patients lived in all four nations of the UK. There was a higher proportion of females sick, with 142 compared to 117 male cases. The age groups most affected were 20- —to 29-year-olds and 30- —to 39-year-olds, according to the study published in the journal Eurosurveillance.

Seventy-seven confirmed cases attended hospital for their symptoms and 75 were admitted. None of them were diagnosed with hemolytic uremic syndrome (HUS) and no deaths were reported.

Analytical epidemiology and food chain analysis suggested lettuce was the likely vehicle of infection. Food supply chain tracing identified the grower as the likely implicated producer.

Loyalty card data revealed no strong link to one type of salad leaf. Supply chain information highlighted the distribution of suspected salad products to the UK and Ireland.

A lettuce grower was directly or indirectly linked to all the food service establishments or retailers of interest. This included ten retailers, seven processors, 25 suppliers, three food services, four manufacturers, and 14 wholesalers.

When authorities visited the grower, the harvest had ended. A hazard analysis and critical control points (HACCP) plan was in place, and legislative requirements were followed; no failures were identified in storage conditions or temperature control. The grower reported that produce at the farm was exposed to standing water following heavy precipitation and local flooding.

Fresh produce growers and manufacturers have been asked to consider extreme weather and flooding as hazards for pathogens such as STEC and determine proportionate controls, including pre-and post-harvesting checks, finished product testing, and irrigation water use.

Scientists used data on rainfall and temperature, information about land use, and information about sheep locations to better understand the events that led to the outbreak and the location of the lettuce grower. Analysis of meteorological data revealed over two months of rainfall recorded in an otherwise drought-like situation in the region where the grower was located.

They found lettuce incriminated in the outbreak may have been contaminated by heavy rainfall and flooding, transporting STEC from animal feces to crops in fields.

A limitation of the study was that no microbiological sampling was done from known animal reservoirs, products, or the environment.

Adverse weather conditions occurred within two weeks of the major peak of case symptom onset dates. This was consistent with the expected time taken for fresh lettuce to make its way from farm to fork, added to the known incubation period following exposure to STEC.

A small number of illnesses pre-dated the weather event, and a few predominantly secondary case reports in late September and October 2022 were noted. 

Seven isolates of STEC O157:H7 closely related to the outbreak strain were previously reported, with three cases in 2019 and two each in 2020 and 2021.

“We hypothesize that both early and late primary cases, as well as the cases notified in previous years, could be explained by low-level environmental contamination due to the persistence of the organism in the environment,” said researchers.

For members of the Institute, notification of the Institute’s AGM is posted on the ‘Your REHIS’ members section of the website.