The significant burden of healthcare associated infection (HCAI) is affecting three residents in every long term care facility (LTCF) across Scotland, according to a report from Health Protection Scotland (HPS).

The Point Prevalence survey (PPS) of HCAI and Antibiotic use in LTCF for the elderly, published on 10 April 2018, included data from 2,147 residents across 52 care homes in Scotland, and indicates the current prevalence of HCAI in care homes is 5.9%.

Antibiotic use remains at the levels when measured seven years ago, with one in every 16 residents taking one or more at any one time, presenting a continuing threat to antibiotic resistance. This burden of HCAI and prescribing, alongside the challenges in infection prevention and control in a LTCF setting, represent a public health threat with implications for resident safety and containing the threat of antimicrobial resistance (AMR) in Scotland.

The Scottish Urinary Tract Infection Network’s (SUTIN) national hydration campaign was launched on 3 April 2018 and posters will appear in local community pharmacies across Scotland over the next two months.

The aim of the hydration campaign is to raise awareness of the wide and varied benefits of being well hydrated. The campaign’s target audiences are the general public across Scotland, particularly vulnerable groups such as the elderly, as well as staff across the health and social care and home care sector.

The campaign aims to ensure everyone is aware of the signs of poor hydration and the potential consequences. The problems associated with dehydration are still poorly recognised by not only the public but also those working in community and health care settings. 

Dehydration can be both the cause and the consequence of illness and can have significant impacts on an individual’s health.

The key campaign messages are:

• good hydration is important for all age groups and is something for everyone to consider
• the effects of dehydration may result in unnecessary treatment e.g. of urinary tract infections (UTIs) and unnecessary admission to healthcare e.g. following falls resulting in fractures
• secondary E. coli bloodstream infections caused by UTI are potentially life threatening, particularly in older people

Information resources have been developed to support the hydration campaign and will be distributed to the public and within health and social care.

On 5 April 2018, the UK government launched a campaign urging pet owners to trust their vets on the use of antibiotics. Antibiotic resistance is one of the biggest global threats with estimates suggesting it could be responsible for 10 million deaths per year by 2050, and cost the global economy $100 trillion.

Following a government strategy, launched in 2013, to tackle antimicrobial resistance, antibiotic use in farm livestock has fallen to an all-time low, but the profession is being asked to turn its attention to addressing antibiotic use in companion animals, specifically client expectation and understanding.

To help raise awareness of the campaign, the British Veterinary Association (BVA) is encouraging vets to exhibit its poster in their practices.

Source: BVA News, 5 April 2018

The Ornamental Aquatic Trade Association (OATA), working with Health Protection Scotland (HPS) and colleagues, has produced guidance to help marine aquarium hobbyists protect themselves against palytoxin poisoning.

Palytoxin is produced by species of Palythoa and Zoanthus soft corals with Palythoa species generally considered to be more toxic than Zoanthus species. However, as many hobbyists may not be able to distinguish between them, the collective term of ‘zoantharians’ is used.

The main symptoms of palytoxin poisoning following exposure either via the skin, eyes or by inhalation, include, but are not limited to, fever, cough, headache, difficulty breathing, chest pain, rapid heart rate, skin redness/rash, swelling, numbness/tingling, muscle pain, irritation of the eye, sensitivity to light and conjunctivitis.

The guidance provides advice on safe handling of corals to minimise the likelihood of coming into contact with palytoxins, as well as advice on seeking medical advice and the appropriate clean-up procedures to be followed in the event of an incident.

Further to Current note 51/4906, the Health and Safety Executive (HSE) has published the second edition of L121, ‘Work with ionising radiation: Approved Code of Practice and guidance’.

The guidance is intended for use by employers to help them comply with their duties under the Ionising Radiations Regulations 2017, which came into force on 1 January 2018.

The publication is also relevant to employees who work with ionising radiation, radiation protection advisers, radiation protection supervisors, and general health and safety officers. It can also be used by self-employed people who work with ionising radiation and have certain duties under these Regulations, both as an employer and as an employee.

The main changes since the last edition (IRR99) include the following:

• the dose limit for exposure to the lens of the eye has been reduced from 150 mSv to 20 mSv in a year
• there is a new system of authorisation for work with ionising radiation, the higher the radiation protection risk, the greater the requirements. A three-tier system of regulatory control, notification, registration and consent has replaced the previous requirement for notification and prior authorisation.
• the requirement for notification has been changed to a lower level of activity than in IRR99
• the definition of an outside worker has been broadened so that it includes both classified and non-classified workers
• there is now a requirement to put procedures in place to estimate doses to members of the public
• guidance has been clarified regarding the duties of employees to cooperate with employers in meeting the requirements of these regulations
• medical appeals by an employee are made to HSE within 28 days of the employee being notified of the appointed doctor’s decision. This has been introduced for consistency with other regulations

The Cleaner Air for Scotland (CAFS) Governance Group, the group overseeing implementation of the Scottish Government Cleaner Air for Scotland (CAFS) strategy for cutting air pollution and reducing the effect of air pollution on health, has been joined by two new representatives with interests in health, environmental science and regulation, the British Heart Foundation Scotland and Professor Campbell Gemmell, an expert in environmental science, policy and regulation.

The Scottish Government has also outlined further details on financial support that will be made for Low Emission Zones (LEZs). Over 70% of £10.8m funding in 2018-19 will go towards supporting Glasgow’s bus industry to prepare for LEZs, which is enough to support the exhaust retrofitting of over 300 buses to ensure they meet the latest environmental standards.

Source: Scottish Government News, 29 March 2018

This year's World Health Day occurred on 7 March 2018, which also marked the 70th birthday of the World Health Organization (WHO). World Health Day was dedicated to one of the WHO’s founding principles which is that health is a fundamental human right, and ‘health for all’ is a vision that the organisation has pursued in partnership with countries since its founding.

On World Health Day, the WHO called on leaders in Europe to recommit to ‘health for all’ through concerted action for universal health coverage. Many countries across the region have made great progress towards this goal but could do more to ensure that everyone has access to quality health services when and where they need them without financial hardship. Stronger focus is needed on securing financial protection especially for poorer people.

The Scottish Environmental Incident Surveillance System (SEISS) recorded the following incidents in the past week:

• On 4 April 2018, a major wildfire broke out on the Black Cuillin of Rum, in the Inner Hebrides. The Scottish Fire and Rescue Service was alerted to the fire at about 3pm. They visited the island and said there was no risk to property or those living on the island, which is owned and run by Scottish Natural Heritage. Helicopters have been used to bring the flames under control. Conservationists from Rum Deer Research, who study red deer on the island, were concerned the fire could affect their study areas and research buildings. This was reported by BBC news.
• On 30 March 2018, police set up a 100 metre exclusion zone after a man died close to a suspected chemical spill near Dumfries. The man was found at an old farm cottage in the village of Terregles and an unidentified chemical substance was spotted on the floor of the cottage. Police are treating the death as ‘unexplained’. The exclusion zone was set up as a precaution and members of the public were asked to avoid the immediate area. Inquiries are under way to establish the nature of the substance. On 2 April 2018, the exclusion zone was lifted and police have stressed that there was no risk to the public. This was reported by BBC news.

More detailed information can be found on the SEISS website, or contact either Ian Henton or Colin Ramsay at HPS on 0141 300 1100.