REHIS Journal 21/4(Winter)

Vol 21 - Number 4 Winter 2009 Environmental Health Scotland The Royal Environmental Health Institute of Scotland

3 Manor Place, Edinburgh, EH3 7DH Tel: 0131 225 6999 Fax: 0131 225 3993 Website: www.rehis.org

Officers of the Institute

President: Rod House Senior Vice-President: Alistair Thomson Junior Vice-President: Paul Bradley Past President: Colin Wallace Past President: vacant Northern Centre Chairman: Karen Foote Southern Centre Chairman: Drew Hall Northern Centre Secretary: Bob Drummond Southern Centre Secretary: Andrew McPherson Honorary Treasurer: Martin Henry Courses Co-ordinator: Martin Keeley

Members of Council

Wendy Barrie Lynsey McNair Bernard Forteath Keith McNamara Christine Fraser Alan Morrison Sandy Fraser Graham Robertson Raymond Hubbocks John Sleith Andrew Jamieson Robert Steenson Brian Lawrie Evonne Tennant Sarah MacLeod-Bonnar

Honorary Vice-Presidents

George Georgallas Stewart Maxwell MSP Robin Harper MSP Ann Marie Part Kenneth Macintosh MSP

*** Chief Executive: Tom Bell

Director of Professional Development: Robert Howe Director of Training: Graham Walker Training Adviser: Ian McGruther Training Adviser: Dr Jane Bunting

Environmental Health Scotland Environmental Health Scotland

Volume 21, Number 4 Winter 2009

The Journal of The Royal Environmental Health Institute of Scotland

ISSN 0950-3277 CONTENTS

Environmental Health Scotland is published by the The President’s View 4 Council of The Royal Environmental Health Institute E.coli O157 - My Story 5 of Scotland. Partnership in Action - A Case Study - Editor: Tom Bell Perth & Kinross Council and the Scottish Centre for Healthy Working Lives 10 The views expressed in this Journal are not necessarily Food Standards Agency News 11 those of The Royal Environmental Health Institute of Types of Insecticide Treated Nets Scotland, the publisher or the editor. Articles, news Preferred by Households in Rural and items or letters are welcomed for publication but the Urban Blantyre, Malawi 12 publisher reserves the right to edit contributions as the editor sees fit. At the editor’s discretion, items submitted Health and Safety Co-ordinating Group for publication will be peer reviewed. All material is (HASCOG) Celebrates its 75th Meeting 18 submitted at owner’s risk. The publisher cannot be held REHIS Annual Awards Ceremony 2009 19 responsible for loss or damage, however caused. An Update of a Study of the Status, Roles and Responsibilities of Environmental Copyright: All rights reserved. No part of this Health and Cleansing Officers in Scotland 24 publication may be reproduced, stored in a retrieval HSE LAU News 27 system, or transmitted, in any form, or by any means, REHIS Annual Conference 2010 28 electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher Journalism Award 2009 - Winner 29 and copyright holder. From the Courts 30 Elementary Health and Safety Training - Making it Entertaining 31 Management Committee 32 Membership, Education and Training Committee 33 Environmental Health Promotion Committee 34 SEPA News 35 News in Brief 37 Robert Howe, Director of Professional Development 38

On the cover: Colin Wallace presents Rod House with the President’s Chain of Office.

Environmental Health Scotland

THE PRESIDENT’S VIEW

announced that it is concerned at the low number of students on its BSc (Hons) Environmental Health degree course, and I have to report that REHIS is taking the opportunity to consider alternative arrangements. Whilst the situation at the University of Strathclyde is unfortunate, I see this as an opportunity to re-evaluate the education and training of Environmental Health Officers and ensure that it is fit for purpose for the 21st century, and that we continue to deliver a highly skilled environmental health workforce. Members in attendance at the AGM considered and agreed a Special Resolution directed at the Chartered Institute of Environmental Health (CIEH) Rod House for establishing an administrative region in Scotland. Despite public statements from CIEH that this was As 2009 draws to a close and we look forward into in response to requests coming from its members 2010 there are many challenges facing the working in Scotland, it is my view that there was Environmental Health Profession which will test the encouragement to members in Scotland from staff at expertise of officers serving in the public and private Chadwick Court. Officials from CIEH expressed their sectors both at operational and strategic level. desire to form an administrative region in Scotland The financial consequences of the ongoing economic to REHIS representatives on several occasions, and downturn and the inevitable constraints on public REHIS views this move by CIEH as regrettable and expenditure will no doubt test the environmental contrary to the long-standing amicable relationship, health service within our local authorities. reciprocal arrangements and mutual understanding These challenges are not new and the profession developed between elected members of both faced similar challenges in the 70s and the 80s and, organisations over many years. REHIS will continue on each occasion not only did they continue service to be the voice of Environmental Health in Scotland delivery that protected the health of the public, but and will continue to promote our profession at did so within the new frameworks which evolved international, national and local level. during these times. I am confident the professionalism The profession faces many challenges over the and expertise of Environmental Health Officers will coming year but I am confident that Environmental continue to prevail in the challenges that lie ahead. Health Officers will continue to deliver a high quality Continuing on the theme of the economic downturn service which meets the needs of local populations. it is pleasing to record that, through the good work This will be particularly important as we respond of the Institute’s Approved Training Centres, our to the next wave of H1N1 working in partnership community training courses, especially those on food with colleagues in NHS boards. safety and food nutrition, continue to be popular and the Interestingly in January 2010, REHIS through its number of certificates issued continues to rise despite forebears in public health, (the Sanitary Inspectors’ the current downturn. Association of Scotland was established on 20 January Over the past 18 months REHIS has actively 1875), is the ripe old age of 135 years and over contributed to the Short-Life Working Group on the this time our forefathers in our profession have faced Future Role of the Environmental Health Profession major crises including disease epidemics, world conflict in Scotland which was set up by Shona Robison, the and worldwide depression. Throughout our history Minister for Public Health and Sport. The deliberations we have responded to these challenges and of this Group have been delayed principally due continued to protect public health in Scotland. I am to the impact of H1N1. However I remain hopeful the confident that we will face our challenges in the Group will report early in 2010. same way and continue to protect the health of the people of Scotland. The findings of this Group will be particularly important as the University of Strathclyde has

Environmental Health Scotland

E.COLI O157 - My story by Sharon Mills

Introduction The following is the transcript of the paper anger was reserved for the butcher at the centre of presented at the REHIS Food Update Course in the E.coli O157 outbreak. Many delegates came to October 2009 by Sharon Mills. Sharon is the me at the end of the day to express their admiration mother of Mason Jones, the hitherto healthy five for Sharon and for her crusade to highlight the real year old boy who tragically died in October 2005 consequences of system failure; they, and many other within three weeks of contracting E.coli O157 delegates, asked me to thank Sharon for reminding food poisoning. Mason had eaten a school everyone that the Environmental Health Profession lunch consisting in part of food prepared in the exists to protect the health of the public in spite of the butchery premises of John Tudor & Son, Bridgend, increasing number of administrative diversions that Wales. It must have been a daunting task for are a feature of working in the public sector. On behalf Sharon to deliver this very personal address to of REHIS I take this opportunity to thank Sharon and an audience of local authority and FSA staff, her partner Nathan Jones for taking the trouble to and to talk frankly about her young son and the travel from their home in Wales to Edinburgh to share failings that led to his death. Sharon presented their story with us. her paper in a courageous and frank manner. Editor Her presentation was without bitterness and any

*** Hello. This is the first time I have ever spoken at an event such as this so please bear with me. As you can imagine I’m very nervous. My name is Sharon Mills and I have been asked here today to tell you about how E.coli O157 has affected my life and that of my family. How we live with it day in, day out and also, out of sheer loyalty to my son, how I will never let people forget why E.coli O157 is the nastiest bacterium you could ever come up against. To give you a bit of background, I thought firstly it would be best to describe in a timeline sort of format my recollection of the events leading up to my son Mason’s death from the outbreak of E.coli in South Wales in 2005. Sharon Mills with Nathan Jones and On Tuesday the 13th of September 2005, after taking Professor Hugh Pennington two of my sons, Chandler, then eight, and Mason, who (photograph courtesy of ‘Herald and Times Group’). was five, to school, I received a phone call from the Later that evening, though, he developed tummy ache school clerk to say Chandler was feeling unwell and and got quite upset with it. could I go to collect him. I recall him saying it was extremely painful. I went straight back there to be told that he had After a short time diarrhoea started and Chandler was been complaining of feeling sick but the feeling had continuously back and fore to the toilet. started to wear off so he decided to stay in school. The stomach pains got so severe that he seemed to be Later that day when Chandler and Mason came bracing himself. To me it seemed similar to a mother home, Chandler wasn’t hungry and looked very pale. experiencing labour pains. I was not immediately concerned at the time as he didn’t have much colour and did not have a very These symptoms continued through the next day in big appetite anyway. similar fashion but then on Thursday the 15th the abdominal pain became so much worse. The visits

Environmental Health Scotland to the toilet became more frequent and he was Later that day we received a telephone call from the having to go at approximately 30 minute intervals. school saying Mason was ill so his dad went to bring That evening he started passing blood in his him home. My immediate thought was that this was motions and it was at this point that I became the same as what Chandler had but I was relieved to really concerned. find that the symptoms Mason was showing were completely different. Our GPs surgery was closed at this time so I contacted the out-of-hours service. After explaining Mason had a headache and a temperature. You could Chandler’s symptoms I was told that he had probably see he was not himself. burst a blood vessel from the frequent visits to Environmental Health Officers phoned me not long the toilet. I was told to monitor the blood loss and after Mason arrived home. When I explained to them take him to see the GP the following morning but the symptoms that he was suffering they immediately to ring back if any concerns arose in the meantime. arranged for a test pot to be brought to our house. Fortunately the blood loss stopped overnight. As Chandler had not yet provided a sample they said they would call back for the two test pots the The following morning I took him straight to visit following day. That evening Mason started vomiting. our local GP. The diarrhoea and tummy ache was still ongoing at this time but it had eased slightly. The GP The following morning he did appear to be slightly gave me a test pot for Chandler to provide a sample better. I remember him playing in his bedroom and to be taken back the following Monday and requested watching TV although he did look extremely tired. that we monitor his condition over the weekend. In the evening though, he started to experience diarrhoea. Although nothing had been confirmed, my By Saturday the 17th September though the fear at this point was that they were both suffering symptoms had completely gone and the blood loss from E.coli. The two samples had been taken by the never returned. Environmental Health Officer that day and sent for On Monday the 19th Chandler returned to school testing and we were told that the results should be as he seemed much better. available in 48 hours. That same day I received a telephone call from On Friday the 23rd of September Mason started my aunt to tell me it had been announced on the to bleed from his bottom, not much at first but from radio that there had been an outbreak of E.coli. recollection it was more than Chandler. After explaining the symptoms to me it sounded I rang the EHO that had collected the samples to exactly the same as what Chandler had experienced check if any results had come through and I was told the previous week. they would check before they closed Cardiff It was reported that The National Public Health laboratory that day, otherwise I may hear something Service published a helpline number which I over the weekend. He said he would ring back but he immediately rang. I explained the symptoms never did. that Chandler had suffered and told them he was It was at this point that I started to become panicky. now back in school. They arranged for an I rang our local hospital to check how far I was Environmental Health Officer to come and see me the supposed to let these symptoms develop before following morning. taking him for medical assistance. On Tuesday 20th of September the EHO arrived and I explained that Mason had bloody diarrhoea, he brought with him two advice sheets explaining the was vomiting and that he was not eating anything. symptoms. Explaining what E.coli was and how to The advice I was given was to monitor his blood avoid the spread of the bacterium. I was also given a loss, make sure he was getting plenty of fluids and sheet of paper like a diary to write down exactly what make sure he was passing urine (which he was). Chandler had eaten the previous week. They also told me to watch out for cold hands I was asked a few questions such as if Chandler had and feet. eaten a take away meal or visited a farm. I was also They told me they would not admit him unless he was left with a further sample pot. very dehydrated. The advice seemed helpful and my Once the officer left I tried to recall what Chandler mind was slightly put at ease. had eaten and also contacted the school to get a copy The blood loss continued throughout the night and of the previous week’s menu. on Saturday the 24th of September there was not On Wednesday 21st September the two boys went much change to his condition. The blood loss was the to school. Everything was fine, with both children same and so was the diarrhoea. He was still mobile seemingly well when I left them. Environmental Health Scotland but he was very withdrawn which was unusual for and temperature. He felt his tummy but at that point Mason because he was such a lively little boy. He was he didn’t seem too concerned. still drinking water and still passing urine. There were The doctor asked if he was still passing urine and still no signs of abdominal pain or dehydration. drinking fluids which he still was but at this point his I kept ringing the hospital for reassurance. I felt at urine output had slowed down to what seemed like a such a loss. All they kept saying to me was that all trickle. The GP thought at this stage that he was OK these symptoms were typical of E.coli. to come home. He gave Mason medication and told Mason’s condition got worse through the night. me to monitor his condition and ring back should he The blood loss increased so much so that I had to become worse. put a napkin on him as it was just coming through As the hours went by he started to deteriorate. his clothes. His hands and feet started to get cold. I put thick I tried to reassure him as he started to get a little socks on him and rubbed them to see if that would scared because he did not like the sight of blood. help but it felt like holding ice cubes. His vomiting also got worse. I kept trying to reassure He started to hallucinate and he was shouting things myself too because he was not displaying the signs out which didn’t make sense. His lips were blue all that I had been advised to look out for. over. His face had gone pale and his hair was saturated I spent that night on the sofa with him. I was scared to like he had just stepped out of the shower. I knew he leave him, scared to take my eyes off him. He looked was now showing the warning signs the hospital had so weak. told me to look out for. The early hours of that morning I remember changing I phoned the GP out-of-hours service again and his nappy and there was this terrible smell coming explained his symptoms. I was told to bring him back from him. When I took the napkin off him the smell to the surgery immediately. I asked for a home visit as was so violent I had to place it in a few scented nappy he was really ill but was told it could take up to five sacks. It was horrendous and to this day I am still hours before a doctor could come. I was frightened to at a loss as to what to compare it with when I try to leave it that long. At this point he was so weak that describe it. he could not even stand. We took him back to the surgery and as soon as the second GP had seen him I felt frightened. I had no knowledge about this he said that he was extremely dehydrated and bacterium and I certainly never for one second admitted him straight to hospital. thought about losing Mason. He was taken straight to the children’s ward at our Mason managed to get some sleep that morning local hospital where they took blood and carried but my heart was pounding. I just wanted him to out various tests on him. They were experiencing show some sign of getting better. extreme difficulties obtaining any blood from him On Sunday 25th September he was very poorly as his veins had started to shut down. He was put and started to become agitated. He was still bleeding straight onto a drip and covered in a heater blanket and this horrific smell was now also coming from to warm him as he was so cold. his pores. I was feeling so helpless because my little boy was It was worse than the smell of rotting meat. At about suffering so much and there was nothing I could do. 11.45am I received a telephone call from the lab at The blood tests came back soon after suggesting there Cardiff confirming my fears that both my boys were could be renal problems. Me and Mason’s dad at this suffering from E.coli O157. I was devastated. point were in a state of disbelief. The lady asked me how they both were. I explained I kept thinking to myself, “what do they mean renal that Chandler had no longer been showing signs of problems? He’s not having an operation. I won’t let any symptoms for the last week but that Mason was you do that to him, he’ll be OK, you’re mistaken”. It quite poorly. She advised me to get a GP to check him was as if I was having a nightmare and I just wanted over immediately. to wake up. At 12.45pm we arranged for him to see the on call They arranged for Mason to be transferred to the doctor. At this point he couldn’t walk, he was just too specialist renal unit at Bristol Children’s Hospital weak and could barely lift his head off my shoulder. some 70 miles away. In the early hours of the 26th We informed him that Mason had been tested September Mason was transferred by ambulance positive for E.coli. He took his blood pressure with a nurse escort and myself. His dad followed behind in our car.

Environmental Health Scotland

Mason was initially taken to the Accident and At about 5.00pm that same day Mason started to Emergency Department, where they carried out more experience a fit. His body started shaking and his blood tests. I felt like screaming “no more, he’s had eyes started to roll. I could not take any more and enough”. He was so thirsty, wanting a drink, but I collapsed, I felt so powerless. Medical action was wasn’t allowed to give him anything. I was just told to taken which managed to get the fit under control. wet his lips. He kept saying “don’t leave without me, I spoke to the anaesthetist and begged him not mama” and I promised him I would never leave him. to operate on him, I just felt he was not well enough They then transferred him to the renal ward. He was but I was told he was too poorly to not go through placed under the care of the Paediatric Nephrology with it. Team and on arrival we were told he was in acute Later that evening he had his operation then was renal failure. After further tests were carried out he admitted to the intensive care unit. He required a was then rushed into the operating theatre for surgery ventilator and heart stimulant drugs to maintain his to insert a dialysis catheter. My mind was in a daze, blood pressure. Regular reviews were carried out by watching doctor upon doctor gather around his the intensive care team. But it was from this point that bed. I found it very difficult to get a grasp on what Mason never regained consciousness. was happening. On the 28th of September, his condition seemed He was given fluids to expand the amount in his to stabilise. His blood pressure seemed stable and circulation and for a little while he became more plasma exchange and an MRI scan was discussed like his normal self. He was even telling the nurses with me and his dad. The MRI scan was then carried he wanted some spaghetti and chips. His dad and I at out and the results came back normal. this point felt that he was over the worst and planned with him what we would do for him when he On the 29th and 30th of September he appeared to be got home. quite stable. He was kept on ventilation with plasma exchange and dialysis still ongoing. All along the Sadly our hopes were short lived. diarrhoea continued. In view of his bowel distension, His condition began to deteriorate further. He became antibiotics were also administered. very frightened and just wanted to go home. He shouted On the 1st October, his condition remained to me “mama, I’m dying”, I tried to reassure him that unchanged, all blood tests carried out seemed was not the case. satisfactory and there was no evidence of fluid I was given a leaflet at that point about HUS, a problem overload so on that day dialysis was not required. which can occur from the E.coli bacterium. I’d never On the 2nd October, he developed a blanching rash heard of it but when I read it every thing on there which started to develop on his trunk. I assumed that mirrored exactly what Mason was going through. he could be developing a reaction to the antibiotics, He was starting to get very confused. I know that I cannot take a certain type and hoped The paediatric intensive care unit was alerted to that this was the case with him and nothing else Mason’s condition and the nursing team discovered was occurring. that the catheter that had been inserted to carry out He also developed an unsightly sore on his kidney dialysis was not functioning properly. bottom due to the constant flow of bloody diarrhoea. On the 27th September there were a number of I remember him scrunching his nose up every time concerns facing the consultants: his nurse had to clean him. It must have been extremely painful. The bacterium had also affected 1. his high blood pressure indicating involvement his eyes and blocked his tear ducts, so if he had of the heart wanted to, he couldn’t even cry. 2. his reduced level of consciousness and the On the 3rd October, plasma exchange continued but neurological effects of HUS. this rash had started to spread to his little face. I felt And thirdly there were concerns on the swelling on this day though that his abdomen did not look so of the abdomen. swollen. His blood pressure was being kept maintained It was decided that a haemodialysis catheter would with the support of drugs. Dialysis was required to need to be inserted to carry out the dialysis so another remove more fluid. operation was required. That evening at 5.00pm his blood pressure began to drop. The intensive care team were concerned about an infection developing so more bloods

Environmental Health Scotland were taken for them to decide if a further course of Chandler still suffers to this day from a condition antibiotics were needed. I remember thinking to called Haemolytic Colitis which means chronic myself, “how much more can he take, why doesn’t constipation. That was caused as a result of the this thing just leave him alone?”. E.coli bacterium being confined to his bowels for We were informed by his medical team that they approximately nine weeks. would be changing the line in his neck that night as He suffered greatly and is still under the review of they thought there could be an air lock. We kissed a child psychologist who has treated him since he him goodnight at about 10.30pm; I didn’t want lost his brother. to leave him but was reassured that someone would Not only was he not allowed to see Mason when be with him constantly as there always is in an he was ill but he also had to be isolated from his intensive care unit anyway so we went back to our younger brother Cavan who was only 11 months old accommodation that had been provided for us by at the time for fear of passing on the bacterium. the hospital. In the four years since, we have been involved in a At 11.00pm that night, even though we had just left police investigation into Mason’s death: him, I felt so uneasy. Call it a mother’s instinct, but I just had to ring to check how he was. 1. a court case against the man responsible for causing the outbreak When I did the phone, which is a direct line to his nursing team, it just kept ringing and ringing. 2. a Public Inquiry into the outbreak instructed by I knew something was wrong. When someone the Welsh Assembly Government eventually answered they told me that Mason had 3. we are currently waiting for the coroner to review taken a turn for the worse and could we come the evidence and set a date for the Inquest into down immediately. Mason’s death. What was usually a two minute walk to the I have campaigned tirelessly since the outbreak hospital seemed like two hours. When we arrived we with the help of HUSH who is the UK’s only E.coli were taken straight to the family room. His intensive support group to try and increase public awareness care doctor came in and broke to us gently that Mason of E.coli O157 and to disseminate the information had run into serious difficulties and that he could die. needed to take the necessary steps to avoid infection. I felt like this was the end of the world. The question No, you cannot eradicate E.coli completely but ‘Why?’ kept going through my mind. How could he outbreaks such as these show that there is no room be so ill when all he’d done was eat his school dinner? for complacency. He was such a strong, healthy little kid. My little boy had so much to live for but he was The doctor informed us that he had needed heart killed because a rogue trader put profit above health massage as they had already come close to losing and safety when supplying meat for school dinners. him. His dad and I went in to his ward as he was being These types of deliberately negligent people need kept in isolation. As soon as I saw him I knew in my to be monitored closely or there is a serious risk that heart of hearts he wasn’t there. His eyes were slightly people will pay the ultimate price. Just as Mason open but the sparkle in his beautiful brown eyes has. What gives someone the right to play Russian had gone and all I could see was red. We sat by him, roulette with someone else’s life? held his hand and talked to him, willing him to pull I hope I have been able to put a bit of realism into through. We spent about 45minutes with him and the situation. To show how important food safety then his blood pressure plummeted once more. is and show if rules are not strictly adhered to then The intensive care team tried so hard to revive him the end results can be catastrophic. but unfortunately all attempts failed. I am here today because I will not let Mason’s At 12.30 am on Tuesday 4th October 2005, my five death be in vain. year old little boy passed away. Thank you for listening. We are absolutely devastated and always will be. FOOTNOTE:Sharon’s hope is that through positively He suffered so much and so needlessly and I could engaging with the media, with agencies and with do nothing to help him. Until you have actually seen relevant organisations and through telling her someone suffer from this bacterium, I don’t think story the reality of the worst possible outcome of you can ever fully appreciate how cruel it is. It strips lapses in food safety practice will be better the victim of their strength and dignity and slowly understood by all and will never be repeated. Editor. violates every part of their body.

Environmental Health Scotland

Partnership in Action - A Case Study - Perth & Kinross Council and The Scottish Centre for Healthy Working Lives by Anna Brown, Chartered Environmental Health Officer, Perth & Kinross Council

I have been recommending the services of the I explained that, with their support and some time and Scottish Centre for Healthy Working Lives effort, she could easily establish an effective health (SCHWL) to business owners in Perthshire since I and safety management system within the business. started working with Perth & Kinross Council and the I included this advice in her inspection report. results have been rewarding. My aim in writing this Mary took this advice on board and contacted the article is to raise awareness of the services SCHWL SCHWL Advice Line. She was put in touch with Jane can offer and to highlight the importance and benefits Duffy, one of their advisors. of partnership working. Jane explains what happened next: SCHWL was established in 2005 as part of the National Health Service. Its key target group for “It’s quite common for me to speak to clients who assistance is small and medium sized enterprises have received an inspection report from an Enforcing (SMEs) employing less than 250 employees, Authority and are unsure how to implement the with the objective of helping them identify their necessary changes. I visited the hotel to help occupational health and safety issues and offering Mary focus on what the potential risks were in proactive solutions tailored to the size and nature the business. We then worked through the systems of their business. the hotel already had in place and talked through what she had to do to make improvements. Mary As an organisation SCHWL has the same objective put a number of risk assessments into place (manual as professionals involved in the regulation of health handling activities, lone working, new/expectant and safety. With this in mind I ask, why doesn’t every mothers and young persons). I then checked these local authority have a partnership with SCHWL? It is assessments at subsequent visits, to make sure she was my experience that SCHWL has a very positive on the right track. As the hotel also regularly holds influence on SMEs, both in a direct way to the functions, I suggested Mary carry out a risk assessment businesses they assist and also indirectly, to us, for each event on an ‘as and when’ basis, something as regulators. she felt much more confident to do once she had There have been many examples of our partnership learnt how to carry out her own risk assessments.” working over the past few years, all of which have When I returned to the hotel for a follow-up resulted in a positive outcome. This case study details inspection three months later, the difference in both just one example and showcases the benefits from all management systems and general health and safety three perspectives. I hope that other local authorities awareness was exceptional. Mary had a much clearer may be encouraged to foster similar partnerships understanding of her health and safety obligations, with SCHWL and experience the benefits available and had implemented an effective and easy-to-follow both to themselves and the businesses they regulate. health and safety management system, based on Case Study the core principles of risk assessment. She took the I was undertaking an inspection of the Four Seasons opportunity to learn from the inspection findings Hotel in St Fillans, a medium sized hotel fairly and put a considerable amount of time and effort typical of many others within Perthshire. It has twelve in to achieve the necessary changes. It was very bedrooms, six chalets and one holiday apartment. encouraging to see the transformation. During the inspection I found several contraventions Mary explains her experience: and had a long discussion about the improvements “After receiving the inspection report I was initially needed with Mary, the hotel manager. Although anxious. I felt quite daunted by the requirements keen to comply, she seemed a little overwhelmed of health and safety at work legislation and with where to start so I suggested she contact the didn’t really know where to turn for assistance. SCHWL free Advice Line for some assistance.

10 Environmental Health Scotland

However I knew the responsibility was ours and I local authorities to encourage more successful needed to start somewhere so I took up the advice partnerships like this one. All our services are offered by Anna and contacted the SCHWL Advice available through our advice line (0800 019 2211) and Line. It was hard work at the beginning. There was our website (www.healthyworkinglives.com). We also a lot of work to do, but Jane was very encouraging have leaflets and example documentation available and helpful. She taught me how to carry out on request if inspectors would like to use them during a comprehensive risk assessment and keep it routine inspections to promote the free services up-to-date. One of the issues we addressed was on offer.” working at height. Although I already carried out To summarise, the assistance that the SCHWL basic training for risks such as lifting and carrying service offers to businesses should be both welcomed sharp objects, I hadn’t addressed working at height as and encouraged. We both strive for the same goal a risk in the business. By going through the whole - to reduce accidents, injuries and ill-health at work. process of undertaking a risk assessment, it drew my SCHWL complements the work we do and can greatly attention to the risks I had simply not considered. assist smaller businesses to achieve compliance with Whilst I admit I didn’t like being criticised, I am their legal obligations under health and safety law, very appreciative of the assistance I received from which not only makes workplaces safer but also the SCHWL service and feel that, without their makes our job easier. I hope sharing these experiences help, I wouldn’t have known where to start to make will encourage colleagues to influence the businesses improvements.” in their area to utilise the excellent services of Jane concludes: SCHWL. Partnership working like this can only be “I’m very grateful to Perth & Kinross Council for of benefit to everyone concerned, especially in the recommending us to the Four Seasons Hotel and current challenging financial climate. I’m really keen to generate interest amongst other

***

FOOD STANDARDS AGENCY NEWS

Results of FSAS study on presence of Anisakid suffer from infection since, although part of their worms in Scottish farmed salmon production cycle takes place in marine waters, they are not exposed to anisakid worms due to the fact In summer 2009, the Food Standards Agency in that they are fed a controlled diet of commercially Scotland published the results from a study that aimed produced pellets. to determine the prevalence of anisakid worms in farmed salmon in Scotland. The work was carried out The Agency conducted this small study to determine by the Institute of Aquaculture. whether these worms could be found in farmed Atlantic salmon in Scotland. Approximately 600 samples of Anisakid worms are parasitic worms that normally farmed salmon were collected from around Scotland live in the guts and intestines of sea mammals, but and examined for the presence of anisakid worms due to the nature of their life cycle, often infect marine by using slicing and acid digestion techniques. fish as well. Anisakid worms can cause an illness No anisakid worms were found in any of the called Anisakiasis in humans, which is characterised fish examined which suggests that salmon by severe abdominal pain, nausea and a range of farmed in Scotland are not at risk of infection from gastrointestinal disorders. This has been known to these worms. occur after eating infected fish, which is either raw or undercooked. Both cooking thoroughly and freezing This work is now being considered by the European kills the parasite. Food Safety Authority and is expected to be used, not only by the UK when developing our Wild adult Atlantic salmon are known to be commonly own policy, but also by Member States when infected with anisakid worms. However, it has long developing European legislation regarding parasites been believed that farmed Atlantic salmon do not in fishery products.

11 Environmental Health Scotland

Types of Insecticide Treated Nets Preferred by Households In Rural And Urban Blantyre, malawi by Y Samanyika (Blantyre District Health Office, Private Bag 66, Blantyre, Malawi), C Campbell (CDC, Malaria - Malawi), V Mwapasa (College of Medicine - University of Malawi) and A Grimason (University of Strathclyde - Scotland)

Abstract million) deaths in children worldwide. Around 60% Introduction: Two types of shapes of Insecticide of the cases of clinical malaria and 80% of deaths Treated Nets (ITNs) are being distributed in Malawi occur in Sub-Saharan Africa. Of the more than one and these are rectangular and conical. Informal million Africans who die from malaria each year, most reports indicate that some people were not happy with are children of under five years of age. the shape of the rectangular Government- In Malawi, malaria is still the commonest cause subsidised ITNs. of death, hospitalisation and outpatient visits in Objectives: To determine the shape of ITNs that both children and adults. It is reported that 30% of households in rural and urban areas of Blantyre district all hospital under five deaths, 40% of all children prefer to own. Specifically, the study wanted to find of under five admission and 33.2% of Out Patient out: the shape and colour of ITNs that households Department (OPD) attendance are due to malaria. in urban and rural areas of Blantyre would prefer to Mathanga et al observed that children from use; the bedding/sleeping pattern of households in households with low socio-economic status were more urban and rural areas of Blantyre; reasons for likely to have malaria parasites than those from high preferring a particular shape of ITN; attitudes/ socio-economic status (63% vs. 36%). It is also perceptions/myths/beliefs of people towards each likely that mortality rates are higher for the lower shape of ITN; and feasibility of installing the preferred socio-economic status group because they experience shape of ITN. barriers to accessing prompt health care. Methodology: This was a descriptive cross-sectional In line with the ‘Roll Back Malaria (RBM) 2000’ study involving household heads (men and women). declaration, the Government of Malawi through The study was conducted in rural and urban areas the National Malaria Control Programme (NMCP) of Blantyre district from March to July 2007. The is striving to achieve the goal of reducing by half study subjects (household heads) were selected by a the 2000 levels of malaria morbidity and mortality multistage cluster sampling method. Questionnaires in Malawi by the year 2010 and to reduce this and Focus Group Discussions(FGD) were used to burden by a further 50% by 2015. The strategies of collect quantitative and qualitative data respectively. NMCP being used to combat malaria are through the The study interviewed a total of 1,078 household heads. proper and timely treatment of cases, the promotion The study also conducted three FGD sessions. of preventive malaria treatment in pregnant women and the promotion of the use of ITNs. These strategies Findings: It was found that 80.6% of the respondents are aimed at increasing the proportion of children preferred conical ITNs with easiness to hang as the of under five years of age and pregnant women major reason for the preference and 76.0% (818) of who access effective treatment within 24 hours of the respondents preferred blue to be the colour. onset of symptoms, proportion of children of under Conclusions: The findings of this study should help five years of age and women age 15-49 years who policymakers understand the perceptions of the people sleep under ITNs, pregnant women who receive of Blantyre regarding the type of ITNs in terms of shape Intermittent Preventive Treatment (IPT, the Ministry and colour preferred. The findings should also help of Health recommends that all pregnant women policymakers appreciate that there are other dwelling should take a dose of anti-malarial drugs at least houses that neither rectangular nor conical types of twice during pregnancy to avoid malaria-related ITNs are suitable because of size (in terms of height, complications) for malaria and capacity of length and width). districts to detect increase in the malaria cases and 1.0 Introduction respond effectively. 1.1 Background As highlighted in the previous paragraph that one of the key strategies to achieve the goal is Present estimates of malaria are that approximately prevention of malaria transmission by use of 350-500 million of clinical disease episodes occur ITNs, it is therefore important to make the globally every year. Malaria causes 8% of all (10.6 ITN programme effective, by achieving high level of usage year round. 12 Environmental Health Scotland

The effectiveness of the ITNs on reduction of 1.2 Statement of the Problem malaria episodes and rate of parasitemia has been In Malawi, there are two programmes that are conclusively demonstrated in several studies in Sub- used to distribute ITNs. The first programme is the Saharan Africa. ITNs have shown to reduce sick child one that distributes subsidised ITNs through health visits (SCV) by 27% (95% CL: 2646), malaria attacks facilities targeting newly born babies and pregnant in infancy by 74% (p: <0.0001) and moderate-severe women. These ITNs are rectangular and green in anaemia by 60% (p<0.001). colour and subsidised up to 100%. The second As a result of this evidence, the focus of ITN- programme is the one that distributes ITNs in related research has now changed from proving the commercial shops. These ITNs are conical and blue effectiveness to increasing coverage and use because in colour and are not subsidised. it is not automatic that those who own nets use According to National Malaria Control Programme, them. This was observed in Togo where free ITNs the decision to distribute subsidised green rectangular distributed through a nationwide integrated ITNs was made after consulting the communities immunisation campaign showed that only 43.5% through Focus Group Discussions on suitability of of the target group slept under an ITN on the night the shape of ITNs in relation to the sleeping pattern before the evaluation survey. It was further reported of most Malawians. This method however, used an that the low use coverage was observed because the unrepresentative sample (sample was too small to evaluation survey was conducted during hot and dry be generalised to the district as well as the whole low transmission season whereby people do not like country) and qualitative data only making it more to use ITNs and there is a perception that malaria prone to selection and information bias. Though this risk is very low. However this signifies that the use was the case, informal reports indicated that some of ITNs is not constant. people were not happy with the shape (rectangular) The Government of Malawi has also started of these subsidised ITNs. They claim that these ITNs distributing 100% subsidised ITNs to pregnant women are generally laborious to fix and not economical and new born children. It is crucial to make sure with the available space in the sleeping room unlike that the ITNs being distributed are used all year the conical shaped ITNs. If this was true, it was round. Some of the reasons in Malawi found to be feared that it may affect proper utilisation of the ITNs. contributing to low usage of ITNs are creation of This study therefore was interested in determining excessive warmth during sleeping,uncomfortable the shape of ITNs that is preferred by people in breathing while sleeping under an ITN and urban and rural areas, the feasibility of installation to inappropriateness of the shape of ITNs being distributed. those who sleep on beds or mats and appropriateness Less mosquito nuisance and perception of less or no of the preference according to available space and malaria risk also contribute to low usage of ITNs in housing type by using a representative sample and the dry season in Malawi. collection of quantitative and qualitative data.

Rectangular shaped ITN Conical shaped ITN

13 Environmental Health Scotland

1.3 Justification of the Study 3.4 Sampling Results of the study will assist in making the right The study collected data from 1,078 households decision in the right shape of ITNs that will be liked from 30 EAs (36 households per EA). Thirty-six by most people. This will motivate more people to households were selected from each EA to produce own and use ITNs of their choice thereby increasing a 30 by 36 sample size. The initial plan was to ITN coverage and utilisation. As far as marketing collect data from 1,080 households but two refused. principles are concerned, it is important to provide Those who refused had similar characteristics as the the right product that is acceptable by the majority rest of the households thereby removing fears in terms of design. This should therefore be taken of selection bias. The figures of 30 EAs and 36 into account in the social marketing programmes. households per EA were used because, statistically, The results will also show the extent of suitability this is considered to be large enough for using of both shapes of ITNs in relation to the nature of normal distribution whereby scientific analysis of dwelling houses. data is valid. The extra six households per EA were added to accommodate refusals and any kind of data losses that can reduce the sample size. Three sets of 2.0 Objectives of the Study FGDs were conducted at Nselemu village in TA* 2.1 Main Objective of the Study Kapeni, William village in TA Makata and Ziyenda village in TA Kunthembwe. The study planned to To determine the shape of ITNs that households conduct four sets of FGDs but failed to complete the in Blantyre district prefer to own and which shape fourth due to financial limitations. is more appropriate to use under the prevailing sleeping conditions and house sizes. The sampling method use was multistage cluster sampling. EAs produced by the National Statistical 2.2 Specific Objectives Office (NSO) were considered to be the clusters for i. to assess the bedding/sleeping pattern of data collection. households in Blantyre district *TAs are Traditional Authorities. Malawi is ii. to determine the shape and colour of ITNs that traditionally divided into villages headed by a Village households in Blantyre would prefer to use Headman and these villages aggregate into a Group iii. to explore reasons for preferring a particular Village headed by a Group Village Headman. Several shape of ITN Group Villages form large areas which are headed by Traditional Authorities. iv. to elicit attitudes/perceptions/myths/beliefs of people towards each shape of ITN 3.5 Data Management v. to establish the feasibility of installing the Quantitative data was processed by using the ‘EPI- preferred shape of ITN. INFO version 6.0’ computer package. Qualitative data from FGDs was translated into English and re-checked for accuracy of translations. Themes and 3.0 Methodology sub-themes were identified, coded and categorised 3.1 Type of Research Study from the compiled field notes. The study was a descriptive cross-sectional study Chi-square (χ2) test was used to test significance of that used both quantitative and qualitative data differences in preferences of type of ITNs between collection methods. social statuses and location (urban and rural). 3.2 Place of Study The study was conducted in sampled rural and 4.0 Results urban areas of Blantyre district. 4.1 Characteristics of the Study Population 3.3 Study Population There were a total of 1,061 under-five children, The study population was 1,078 household heads 1,245 women of child-bearing age and 2,969 other selected from 30 enumeration areas (EAs) of rural household members in all the families. and urban Blantyre (rural 14 EAs and urban 16 EAs) Households had an average of 1.5 under-five children and some 72 female and male community members and an average of 1.4 women of child-bearing age. who participated in FGDs. Total population for all the households was 5,275. A total of 1,080 households were planned to be interviewed but 1,078 household heads accepted

14 Environmental Health Scotland to participate in the interviews. Five hundred and 19.4% (209) indicated that they would prefer twenty nine (49.1%) were from urban and 548 rectangular ones. Of all the respondents, 76.0% (50.9%) from rural. Most (81.0%) of the respondents (818) indicated that the colour of ITNs should be were men. About a third (30.7%) of the respondents blue while 19.1% (206), 4.1% (44), and 0.8% (9) managed to reach senior primary school level and indicated that the colour of ITNs should be green, another third (29.4%) secondary, 9.1% reached tertiary white and other respectively. These choices of shape education. The rest reached junior primary (20.7%) and colour were also strongly reported from the and did not attend (10.0%). FGDs. All three sets of FGDs preferred conical 4.2 ITN Ownership shaped ITNs with a blue colour. Of the 1,078 households included 742 (68.9%) had Living in an urban area does not influence choice of at least one ITN and 335 (31.1%) had none. In total conical ITNs more than living in the rural (see table there were 1,402 ITNs in the sampled households below). There is no significant difference between of which 883 (64.0%) were rectangular in shape people living in urban and rural areas as far as while 505 (36.2%) were conical in shape. Of all the preference of shape if ITNs is concerned (OR 0.83: rectangular ITNs, 98.4% (869) were green in colour 95% CL 0.61, 1.14; p=0.13). while 1.6% (14) were white in colour. On the other Similarly, owning a bed on the other hand is hand, of all the conical ITNs, 93.0% (470) were blue significantly less associated with the preference of in colour, 4.8% (24) were white and 2.2% (11) were rectangular shaped ITNs than conical shaped ITNs green in colour. (see table below) (OR 0.43; 95% CL0.32, 0.60; It was also found that 70% (370 households) of the p=0.000006) though bigger proportions of both 529 households in the urban had ITNs while 68% groups have opted for conical ITNs as opposed to (372) of 548 households in the rural had ITNs. rectangular ones. Statistically there is no significant difference in ITN 4.4 Reasons for Preferring an ITN of Particular ownership between the urban and the rural (OR 1.1; Shape 95% CL = 0.84, 1.44). There were four main reasons that were given as to It was found that of all households (438) with at least why people like the shape preference. Of the 1,075 an ITN in the urban area, 248 (56.6%) had rectangular respondents, 56.8% (611) indicated that they like ITNs and 190 (43.4%) had conical ITNs. Of all conical ITNs because they are easy to hang while households (413) with at least an ITN in the rural only 8.3% (90) indicated that rectangular nets are area, 336 (81.3%) had rectangular ITNs and only 77 easy to hang. About 11% (120) indicated that they (18.7%) had conical ITNs. like conical ITNs because they are easy to use while 4.3 ITNs in Households in Urban and Rural only 3.1% (33) like rectangular ITNs because of the Areas of Blantyre would prefer to own same reason. About 9% (102) indicated that they like conical ITNs because they provide more space inside Of all the respondents, 80.6% (866) indicated that while only 4.5% (49) like rectangular ITNs for the they would prefer to own conical ITNs while only same reason.

Preferred shape Settlement Rectangular Conical Urban 18% 82% Rural 21% 79% Mean 19% 81%

Preference of shape in relation to settlement.

Preferred shape Bed ownership Rectangular Conical Have a bed 14% 86% Have no bed 28% 72%

Preference of shape in relation to bed ownership.

15 Environmental Health Scotland

4.5 Reasons for Preferring an ITN of The proportion of households with appropriate Particular Colour sleeping rooms for conical ITNs in urban areas is Most households prefer the blue colour because significantly higher than that of rural areas (odds ratio it hides dirtiness (34.1%), it makes the room beautiful 1.6; 95% CL 0.93, 2.90 p=0.043). (9.2%) and brightens the room (7%) against 1.4%, 8.5% 4.8 Attitudes/Perceptions/Myths/Beliefs of and 7% respectively for green colour. The preference People Towards each Shape of ITN for blue conical ITN shape was also reinforced Through FGDs, it was observed that there are during FGDs. generally no beliefs connected to each shape of ITN. 4.6 Bedding/Sleeping Pattern of Households However some people have a feeling that the The average size of the respondents’ households was rectangular ITNs are for poor people and 4.8 members with an average of 2.2 sleeping rooms pregnant women. This therefore means that those per household. The lowest number of household who are not pregnant and feel that they are of members was one and highest 15 with a standard a higher socio-economic status cannot use them. deviation of 2.1. About 65% of the households had On the other hand, this could mean that distribution either one or two sleeping rooms only against an of conical ITNs will encourage the other groups average number of household members of 4.8. (non-pregnant and higher socio-economic status) to own and use ITNs. Most people feel that all the shapes This situation clearly shows that household members of ITNs promote hotness during sleeping. They also share sleeping rooms. It is often that the ones who feel that ITNs cause discomfort in breathing during sometimes may need to share sleeping rooms who sleeping. Most people admitted to have sometimes may not share sleeping ‘bed’ for reasons such as used ITNs when mosquito populations have risen to gender and age. In this case, there will be the need an extent that they disturb sleeping through biting to use more than one ITN in one sleeping room. especially in rain season. This situation then requires that the design of ITNs should be one that allows several of them (ITNs) to be used at once in the room. The design of the 5.0 Discussion ITN should therefore be one that is economical with The study clearly shows that most households the available space to enable as many people as in Blantyre, both rural and urban, prefer conical possible use ITNs in one room. shaped ITNs with a blue colour. The study has also Sixty and a half percent (652) of the households had shown that the conical shaped ITNs are suitable for at least a bed while 39.5% (425) of the households the sleeping pattern of the households in the Blantyre had no beds. district. Households prefer conical shaped ITNs mainly because of their easiness to hang. Blue colour 4.7 Feasibility of Installing ITNs of is favoured because it makes a room look bright while Preferred Shape at the same time hiding some dirtiness. Through the actual hanging of each shape of Finding that 80.6% of households prefer conical ITN in sleeping rooms by enumerators, it was shaped ITNs compared to rectangular shaped is established that it was possible to use rectangular ITNs similar to findings in the Malawi Demographic in 63.1% (680) of the households and not suitable and Health Survey (MDHS) of 2004 where it was in 36.9% households. It was also established that it reported that 43% of the respondents who did not was possible to use conical ITNs in 73.8% (795) of have ITNs at the time of the survey preferred blue to the households and not suitable in 26.2% (397) of be the colour of ITNs, 40% preferred green and 17% the households. This means that conical ITNs are preferred other colours if they are to have one. It was suitable to most households in the district rather than also observed that there were more respondents (50%) rectangular ones. The suitability was being judged who preferred conical shaped ITNs than those (40%) by looking at appropriateness of height of the roof preferring rectangular shaped ITNs. However MDHS and size of the room in relation to the fitting of the did not make an attempt to explore reasons for the type of ITN. The main reason, therefore, for some respondents’ preference. sleeping rooms not to be suitable for using rectangular ITNs was small size of the room (99.6%; N=237; This study found that there were four main reasons 95% CL 0.94, 2.93). why people like the shape of choice. The majority of the households (56.8%) preferred the conical ITNs because they are easy to hang while 11% indicated that they like conical ITNs because they

16 Environmental Health Scotland are easy to use. These proportions are against the 26.2% proportion is not considered for their best 8.3% and 3.1% for rectangular ITNs respectively. option of malaria transmission control. Findings of this study indicate that provision of a shape of ITN that the communities feel that it is easy to hang or use will have a positive influence 6.0 Conclusion on usage. Findings of the study have shown preferences of people in Blantyre on the shape and colour of ITNs Households’ membership of 4.8 is close to the that they would like to own. This is very important 4.4 finding of MDHS 2004. The mean number of because it is not good to impose on people products household members of 4.8 is high if we consider that that they do not like. This may lead to abuse of the there are only 2.2 rooms per household. This then products especially now that the rectangular ITNs are clearly shows that most household members share mostly given at 100% subsidy. Government should sleeping rooms. The National Statistics Office during take the findings of this study into consideration as 1998 also found that Blantyre has 1.25 up to over they are thinking of strategies to encourage proper 1.6 persons per room. If the people sharing the room use of the free ITNs. If the findings are considered cannot share a sleeping bed then more than one ITN then the policy to distribute rectangular shaped ITNs will be needed in one room. This situation therefore, green in colour in Blantyre will change and people requires an appropriate ITN design that will allow will be using ITNs of their choice of colour and shape, several ITNs to be used in the sleeping room at the thereby promoting proper and consistent use. If more same time. Sometimes the sleeping rooms include people are consistently using ITNs, for sure malaria some sitting rooms of which installation of the transmission will decrease thereby reducing malaria ITNs is done every night. These sleeping conditions morbidity and mortality. require an ITN shape that can easily be installed and removed. One of the shapes that can suit these conditions is conical. 7.0 Recommendations Through the actual hanging of each shape of ITN From the findings it has been established that it is in sleeping rooms by enumerators it was found that possible to use rectangular ITNs in 63.1% (680) of it was possible to use conical ITNs in 73.8% of the the households and not suitable in 36.9% households. households while on the other hand it is possible to It has also been established that it is possible to use use rectangular ITNs in 63.1% of the households. conical ITNs in 73.8% (795) of the households and This is contrary to the findings of the National Malaria not suitable in 26.2% (397). This means that the 26.2% Control Programme (NMCP) that recommended proportion of the households not suitable to conical that rectangular ITNs are more suitable in Malawi ITNs will obviously not be suitable to rectangular than conical shaped ITNs. The findings of this study ITNs as well. It is therefore recommended that: are more credible than that of NMCP because of a) Government should reconsider the shape and methodology used. The study had a representative colour of ITNs that it is distributing as one way sample that was systematically selected as opposed of encouraging greater uptake and usage. to the FGDs done by the NMCP. This study used three data collection methods. The first was that of b) Government should consider strengthening interviews to collect quantitative data. This method other methods of malaria control as it has been was complemented by the actual fixing of the ITNs established that 26.2% proportion of households as the second method of data collection. The third that are neither suitable to conical nor rectangular method was the FGDs which collected qualitative shaped ITNs. The other methods that could be data on the same subject matter. The FGDs by explored could be like the use of treated curtains NMCP only collected qualitative data from an or residual house spraying. unrepresentative sample. It is also recommended that the same study be repeated Though conical shaped ITNs have been found to in other districts so that preferences could be taken be fitting in most of the households (73.8% of the from a wide range of communities as opposed to one households), there is still the 26.2% proportion of the district only. households that are neither suitable for them nor the rectangular shaped ITNs because the sleeping rooms References were too small for proper hanging of these ITNs References are available on request. but these households still need to be protected from malaria through other means of malaria control. Malaria control efforts are, therefore, not enough if

17 Environmental Health Scotland

HEALTH AND SAFETY CO-ORDINATING GROUP (HASCOG) CELEBrates its 75th meeting by Graham Robertson

From left to right: John Davidson, Gerry Kasprzok, Martin Gibb, Steve Dunn (Chair), David Evans, Percy Smith, Graham Robertson, Vincent McBride, Lynn Crothers, Ivor Churcher and Ross Buchanan.

HASCOG members, past and present, will be Scotland, and now the Society of Chief interested to know that the Group, (a REHIS working Officers of Environmental Health in Scotland. group) passed a milestone at its last meeting in Additionally REHIS has a seat at the newly-convened October when it celebrated its 75th meeting LACoRS Health and Safety Policy Forum. equating to almost 18 years. Over that time this In the last few years HASCOG has been REHIS- sponsored committee has provided a instrumental in co-ordinating and taking forward the forum for local authority officers to come together workload that came out of the Revitalising Health with the Health and Safety Executive Local and Safety agenda, the Hampton Review, the HSE/ Authority Unit (HSE LAU) and Health Protection LA Partnership, FIT 3, LOPP and now HSE’s new Strategy ‘The Health and Safety of Great Britain \\ Be Part of the Solution’ not to mention the new S18 Standard, RDNA/GRIP, EMM, to list but a few. All that work would not be so effective without the ongoing support and assistance afforded by HSE, especially those representatives who have attended in their capacity as ELO (now with the dual role of Partnership Manager) and from LAU. So life goes on, the faces may change but, if nothing else, there is always a full, varied and interesting agenda…but there may not be a celebratory cake for another few meetings!

Graham Robertson is the Council Member with responsibility for health and safety matters.

18 Environmental Health Scotland