HPS Weekly Report
26 Mar 2019
Volume 53 No. 12
SEISS 2018 annual report published
The Scottish Environmental Incident Surveillance System (SEISS) is a national level knowledge management system, designed to provide information on a wide range of environmental incidents. The aim is to create a source of information that agencies can interrogate, in order to discover who else has had to manage incidents, what information was helpful in managing incidents and what lessons were learned.
The SEISS database holds details of incidents reported by participating agencies involving a risk to public health in Scotland, due to the release into the environment of chemical, microbiological, radiation or other physical agents.
SEISS is currently the only web based system that enables the reporting of environmental incidents across all of Scotland.
This annual report for 2018 provides a summary of the incidents that have occurred in Scotland during the past year.
Vintage gas masks and asbestos
Concerns have been raised about the sale of World War II gas masks on the internet, as they may contain asbestos, a substance that is harmful to health. Exposure to asbestos can cause diseases such as mesothelioma, lung cancer and asbestosis.
Although the risk of developing these diseases is very low (most disease is the result of past heavier and repeated exposure to asbestos, such as in industrial settings), everyone’s exposure to asbestos should be minimised at all times.
The Health and Safety Executive (HSE) has previously advised schools, for example, that all vintage gas masks should be assumed to contain asbestos (unless there is clear evidence that they do not), and they should not be worn or handled. This advice also applies to World War I ‘Brodie’ helmets.
The supply of items containing asbestos is illegal. Individuals concerned about the sale of items that may contain asbestos, including from online sales, should contact their local authority trading standards team.
New WHO recommendations to accelerate progress on tuberculosis
The World Health Organization (WHO) has issued new guidance to improve treatment of multidrug resistant tuberculosis (MDR-TB).
The WHO is recommending shifting to fully oral regimens to treat people with MDR-TB. This new treatment course is more effective and is less likely to provoke adverse side effects. The WHO also recommends backing up treatment with active monitoring of drug safety and providing counselling support to help patients complete their course of treatment.
The guidance forms part of a larger package of actions designed to help countries increase the pace of progress to end tuberculosis (TB), and have been released in advance of World TB Day. Since 2000, 54 million lives have been saved, and TB deaths fell by one-third. But 10 million people still fall ill with TB each year with many missing out on vital care.
The WHO package is designed to help countries close gaps in care to try to ensure no-one is left behind. Key elements include:
- An accountability framework to coordinate actions across sectors and to monitor and review progress.
- A dashboard to help countries know more about their own epidemics through real-time monitoring, by moving to electronic TB surveillance systems.
- A guide for effective prioritisation of planning and implementation of impactful TB interventions based on analyses of patient pathways in accessing care.
- New WHO guidelines on infection control and preventive treatment for latent TB infection.
- A civil society task force to ensure effective and meaningful civil society engagement.
The 2019 European surveillance monitoring report released by the European Centre for Disease Prevention and Control (ECDC) and the WHO, finds that TB has still not been eradicated in Europe and that challenges in timely detection, which result in ongoing transmission, and inadequate treatment are driving resistance which could lead to people suffering more from drug-resistant forms of the disease.
More information on TB and the new surveillance monitoring report can be viewed on the WHO website.
Source: WHO, 20 March 2019
Tuberculosis cases in England at lowest ever levels
New cases of tuberculosis (TB) in England have fallen to the lowest levels since records began in 1960.
Following action by Public Health England (PHE), the NHS and others, a 44% drop in new diagnoses, from a peak of 8,280 cases in 2011 to 4,672 in 2018 was recorded, with an 8.4% fall in diagnoses between 2017 and 2018 alone.
PHE is working towards the World Health Organization (WHO) goal to halve TB incidence by 2025, and ultimately eliminate the disease.
While huge strides have been made to reduce TB rates, further work needs to be done to eliminate the disease in England. The most deprived 10% of the population have a rate of TB more than seven times higher than the least deprived 10%, while people born outside the UK have a rate 13 times higher than people born in the UK. People, especially those from these communities, should be aware of the symptoms and make sure they visit their GP if they are concerned.
PHE has played a key role in driving down the rates of TB in England, working with NHS England and other partner organisations to implement the collaborative tuberculosis strategy for England: 2015 to 2020, which aims to raise awareness and tackle TB in vulnerable populations, ensure patients successfully complete treatment, and strengthen surveillance of TB rates.
More information and guidance on TB can be viewed on the HPS website.
Source: PHE, 22 March 2019
Measles in France (Val Thorens) update
French public health authorities report an outbreak of measles is continuing in the ski resort of Val Thorens (Auvergne-Rhone Alpes).
As of 13 March 2019, there have been 53 cases of measles, nearly all among seasonal workers aged 19 – 42 years. Cases linked to the outbreak have been identified in Belgium, Scotland, Denmark, and the French Caribbean island of Guadeloupe.
Travel may increase an individual’s risk of exposure to measles virus, and facilitate the spread of disease to unvaccinated and susceptible populations. Travax encourages all travellers, particularly children, to ensure that they are up to date pre-travel with UK national schedule vaccines, which includes having received two doses of a measles containing vaccine, unless they have had a prior measles infection.
Yellow fever risk assessment
Travax has issued a reminder on the importance of adhering to the international health regulations issued by the World Health Organization (WHO) when advising travellers on the need for yellow fever vaccine.
Yellow fever itself is a severe disease with a high mortality rate. The yellow fever vaccine is highly efficacious and provides lifelong immunity in immunocompetent travellers. However, yellow fever vaccine is a live vaccine with associated side effects, some of which are severe.
Health Protection Scotland (HPS) advises travel health practitioners to administer yellow fever vaccine only where there is a risk of disease or a certificate under IHR is required for country entry. A careful and full risk assessment weighing up the risks of vaccination versus the risk of disease must be made for every traveller, involving the traveller in this discussion to ensure they are fully informed.
Vaccinating travellers where there is no clinical or certificate requirement is inappropriate and could leave a practitioner accountable to their professional governing body in the event of an adverse reaction to a vaccine.
For example; anecdotal stories of travellers being asked for proof of vaccination contrary to a country’s IHR regulations is not a reason to vaccinate. Unexpected delays of greater than 12 hours are very unusual and yellow fever vaccination should not be given simply to cover this rare possibility. Instructions from a travel agent that a vaccination certificate is required should not be followed when this is not stated in the IHR.
Vaccination and certificate requirements are published on every country page on Travax.
Source: Travax, 18 March 2019
Campylobacter levels remain low across UK
The Food Standards Agency (FSA) have published data from nine of the largest UK food retailers on Campylobacter contamination for 2018 in UK-produced fresh whole chickens.
The results show that, across the retail groups, an average of 3.1% of chickens tested positive for the highest level of Campylobacter contamination from October to December 2018.
EEA publish analysis on emissions and pollution levels in water
New European Environment Agency (EEA) analysis on data reported to the European Pollutant Release and Transfer Register (E-PRTR), and under EU legislation on water, has found that direct emissions released to water bodies from Europe’s large industrial sites have decreased in recent years.
Industrial pollution transferred through sewer systems to urban waste water treatment plants (UWWTPs) has increased slightly, putting pressure on the waste water treatment infrastructure. While EU legislation tracks emissions from large industries, the extent of emissions from many small facilities remains largely unknown at European level.
The analysis focuses on the latest information for 2016, when around 3,600 industrial facilities reported at least one direct or indirect pollutant release to the E-PRTR database. Only those facilities with discharges above certain thresholds are required to submit these data.
The analysis also shows that industrial sectors with large-scale activities have a higher proportion of direct releases to water, which require more intense on‑site treatment. Pulp and paper, iron and steel, energy supply, non-ferrous metals and chemicals industry are examples of these.
Sectors with typically smaller facilities or less polluted waste water, such as manufacturing and food and drink production, tend to report higher proportions of their releases to the sewer system, often similar in pollutant-loading as releases from domestic sources.
The largest environmental pressures caused by direct releases of pollutants to water bodies comes from single large, or clusters of smaller, thermal power plants, coke ovens and chemical manufacturing plants.
According to a recent EEA assessment on the state of water in Europe, around 40% of Europe’s surface water bodies are in good ecological status, while 38% of surface water bodies have good chemical status.
Source: EEA, 20 March 2019
Challenges for achieving clean air — lessons from ten European cities
The European Environment Agency (EEA) is working in partnership with a number of European cities to better understand the challenges of implementing air quality legislation, in order to protect the health of its citizens and the environment.
A new report from the EEA summarises key findings on the cities’ progress over the past five years and highlights on-going challenges for improving air quality at a local level.
The EEA produced the new report in cooperation with 10 of 12 cities involved in a 2013 air implementation pilot project, these being Antwerp, Berlin, Dublin, Madrid, Malmo, Milan, Paris, Plovdiv, Prague and Vienna.
The report highlights the progress made and the remaining challenges that cities still have to overcome.
Another EEA report, 'Air quality in Europe (2018)' shows that, while strong policies and local actions have helped decrease levels of pollution in Europe’s cities over the past decades, most Europeans living in urban areas still suffer from pollutant levels that are above the World Health Organization (WHO) recommendations for the protection of health.
Source: EEA, 18 March 2019
UK Government requests comments on adverts for food high in fat, sugar and salt
The UK Government has launched a public consultation inviting the public to give their views on ways to reduce the number of adverts that children are exposed to that promote foods high in fat, sugar and salt.
The consultation sets out proposals to tighten advertising restrictions that will limit children’s exposure across media such as TV, online streaming and social media, in an effort to tackle childhood obesity. The restrictions have also been designed with a view to encourage industry to develop healthier alternatives.
In 2017, it was estimated that children were exposed to more than 3.6 billion TV and 700 million online adverts for foods high in fat, sugar or salt. Evidence suggests that advertising can affect what and when children eat after seeing an advert and shape children’s food preferences from a young age. This has the potential to affect their likelihood to become or remain overweight as adults.
The proposals will target foods that contribute most to children’s intake of calories and not apply to everyday staples like butter, oil or meat.
Currently, one in three children is overweight or obese and the number of severely obese children is on the rise. The proposals are part of a series of measures that will support the NHS Long Term Plan and help to halve childhood obesity by 2030.
Source: UK Government, 18 March 2019
Epilepsy Awareness Purple Day, 26 March 2019
Epilepsy Awareness Purple Day is an international grassroots effort dedicated to increasing awareness about epilepsy worldwide, with people being encouraged to wear purple and host events in support of this initiative.
Cassidy Megan created the idea of Purple Day in 2008, motivated by her own struggle with epilepsy. The goal of Purple Day is to get people talking about epilepsy in an effort to dispel myths and inform those with seizures that they are not alone.