The Human Health Impacts and Environmental Implications of Floods in Northern Ireland (Poster)

Flooding is now the most frequent type of major disaster globally. During the past 30 years, floods have resulted in 200,000 fatalities and affected more than 2.8 billion others worldwide. It should be recognised that flood events do not necessarily need to be large in scale or be physically destructive to have a detrimental impact on homes and livelihoods, as minor floods can still have potentially large cumulative effects. Estimates suggest that if no preventative measures are taken, flooding will affect 250 000–400 000 additional people annually in Europe by 2080.

Flooding has become a major problem in the United Kingdom, as demonstrated in 2007 in England which resulted in flooding of 55,000 properties, evacuation of approximately 7,000 people and 13 fatalities. The problem extends to Northern Ireland, where climate change is likely to result in higher average temperatures and more frequent extreme weather events, such as floods. In recent years, in Northern Ireland, there have been numerous flooding incidents that have caused devastation to local communities.

The environmental impacts of flooding can be quite wide-ranging, from the dispersion of low-level household wastes into the fluvial system to contamination of community water supplies. The impact of floods on human health is under-researched even though flooding has obvious direct impacts i.e. morbidity, injuries, diseases and also more indirect impacts such as mental health conditions due to the long-term consequences of flooding. This study will undertake measurements and characterisation of water contaminants, after a flooding event, with a view to evaluating the impact on water quality. It will also explore the human health impacts of floods, using surveys and interviews to investigate the physical and psychological health problems inflicted on individuals, subsequent to flooding.

The results will assist agencies to mitigate the long-term health impacts of flooding, provide beneficial information on the risk to water quality from flooding and help agencies response efficiently during the recovery stage of a flooding event, providing the community with an appropriate level of support.

Restroom Infection Control: Chlorhexidine, the final frontier (50m Lecture)

Session Description/Teaser: Pioneering award-winning (BMJ and HAI Watchdog Awards 2013) work at the Queen Elizabeth Hospital, UK has demonstrated the remarkable residual antimicrobial activity of chlorhexidine on surfaces thereby maintaining their continuous cleanliness over time. The final point of contact of cleansed hands is the pathogen-rich restroom door handle. In this context, we present a new double-blinded-randomized-crossover trial in a school setting demonstrating significant improvements in continuous cleanliness of handles during use using this simple, cheap technique

ABSTRACT: Chlorhexidine (CHG) wipes offer a cheap and effective environmental cleaning solution in specific situations. We made a chance finding during a laboratory study validating iPads for cleaning efficacy and long-term tolerance to cleaning products. We unexpectedly discovered a previously unreported, powerful residual antimicrobial effect demonstrated by CHG, that was not occurring with any other cleaning agents. Once wiped with a standard CHG swab (SaniCloth CHG 2%, PDI, Nice-pak, New York) we were unable to grow bacteria on the iPads for 6 hours despite the repeated application of high colony counts of a wide range of pathogens. Chlorhexidine has a known residual antimicrobial effect on skin, but the discovery of the effect on objects is novel. We hypothesized that this residual effect could be very important on objects that are, of necessity, repeatedly handled prior to use between sterilization episodes or disposal and that if objects could be kept clean during use this could offer a fundamental advantage (for many applications) in addition to current infection control techniques and in tandem with substantial cost savings thereby providing real and widespread patient benefit across the healthcare, social care and wider sanitary environments. We have published successful trials examining objects handled in the hospital environment (Howell et al. Eur J Anaesthesiol. 2013 May;30(5):216-21 and Cummings et al. Anaesthesia. 2013 Aug;68(8):830-4, and 4 in press or preparation). The body of work has attracted two national awards in the UK (BMJ and HAI Watchdog Awards 2013). In addition to presentation and interactive discussion of this body of work and the wider applications, we will present new data at NEHA’s 78th Annual Educational Conference from our double-blinded-randomized-crossover trial in a school setting demonstrating significant improvements in continuous cleanliness of restroom door handles during use using this simple, cheap technique.

Levels of Heavy Metals in Traffic-Related Particulate Matter along a Major Motorway in Ibadan North-East Local Government Area, Nigeria (20m Lecture)

 Background: Traffic-related particulate matter contributes extensively to ambient air pollution especially in urban centres. Hence, Populations found along major urban motorways are at higher risk of various health effects. This study was therefore designed to determine levels of heavy metals in the air along IdiApe-Iwo road motorway in Ibadan North-East Local Government Area.

Methods: Descriptive study design involving air sampling and particulate analysis for selected heavy metals was used. At all five sampling locations, levels of particulate matter (PM10) at intervals of 10, 20 and 30 metres away from the motorway were measured using calibrated fine particulate matter sampler. Measurements were done in the morning (7-10am) and afternoon (1-4pm) for 10 weeks. Filter papers obtained from the sampler from SL were digested and analysed for Lead (Pb), Iron (Fe), Copper (Cu), Cadmium (Cd), Zinc (Zn), Chromium (Cr) and Nickel (Ni) using atomic absorption spectrophotometry according to standard methods. Data were analysed using descriptive statistics, ANOVA and Pearson correlation test at p <0.05.

Results: Daily PM10 level at each sampling location were AB (100.5 ± 36.3µg/m3), IA (96.3 ± 42.1µg/m3), BA (84.6 ± 41.7µg/m3), AL (110.1 ± 48.4µg/m3), and HJ (121.6 ± 59.8µg/m3) was 4-6times above the PM10 guideline limit of 20µg/m3. The mean levels of heavy metals were Pb (161.1 ± 108.3mg/m3), Fe (2.54 ± 1.09mg/m3), Cu (0.91 ± 0.31mg/m3), Cd (52.5 ± 30.7mg/m3), Zn (0.52 ± 0.39mg/m3), and Cr (0.19 ± 0.03mg /m3). Spatial variations in PM10 and heavy metal concentrations were found to reduce with distance further away from traffic by 23.5% and 18.7% respectively.

Conclusion: Levels of heavy metals at all sampling locations along Idi-Ape-Iwo road motorway exceeded permissible guideline limits for urban centres. Periodic air monitoring of motorways should be instituted. This should be targeted at reducing traffic-related particulate matter concentrations on our motorways especially from exhaust emissions.

Development of a vocational qualification for environmental health in Saudi Arabia (20m Lecture)

The Kingdom of Saudi Arabia is embarking on one of the largest technical and vocational training upgrades in the world, aimed at dramatically increasing annual training capacity from about 100,000 students today to 300,000 by 2020, while simultaneously developing the quality of the vocational training and assessment/qualification systems. The proportion of the Saudi workforce currently receiving vocational training is less than 10%, but the Kingdom has set an ambitious target figure of 40-45%, which would bring Saudi Arabia in line with the majority of developed countries. According to the accreditation agency, Saudi Skills Standards, “getting more young people – male and female – into high quality Technical and Vocational Training is the single most important factor for success in the labour market”.

AlphaPlus Consultancy in the UK has been appointed to work for Saudi Skills Standards as part of a project team to help develop national occupational standards and qualifications for 49 occupations – one of which is ‘Public Health/Environmental Health Officer’ - people who investigate health hazards in a wide variety of locations, and will take action to mitigate or eliminate the hazards. 
This session will explain how National Occupational Standards for environmental health in Saudi Arabia have been developed and reviewed, and how these standards were incorporated into the development of a vocational qualification in environmental health. Delegates will be invited to consider how the approach could be applicable in other contexts, particularly where increasing vocational training capacity is a priority.

Designing a training programme for the wider public health workforce in Wales (20m Lecture)

Over the past decade there have been major advances in public health workforce development in Wales and the UK. The UK’s Chief Medical Officer recognised in 2001 that “most people, including managers, have a role in health improvement and reducing inequalities, although they may not have recognised this”. The Public Health Skills & Career Framework describes knowledge and competence for core and defined areas of public health, split across nine different career levels, from people with little knowledge of public health who may undertake specific public health activities under direction, through to those whose main role is in public health practice, right up to multidisciplinary public health leaders who set strategic direction and determine priorities across organisations and areas of public health work.

Consultant-grade public health posts are now open to those from non-medical backgrounds, including environmental health, and many EHPs have taken up positions of this nature. Formal recognition of the status of public health practitioners has also been achieved through the establishment of a Public Health Practitioner Register. The next stage is to increase recognition of the role of the ‘wider workforce’.

This session will consider a recent project in Wales to scope and design a training programme to address core and defined competences for the wider workforce for public health in Wales. The session will discuss the approach taken to identifying what is required, and how existing training opportunities have been reviewed for potential incorporation into a flexible programme. Findings from consultation and engagement with employers and likely participants will be considered and the final programme design presented. Delegates will be invited to consider how they could support the role of the wider workforce in the promotion and protection of public health in their context.

Education to water, an educational mobilization in the French primary school (20m Lecture)

In France, an industrialized country where access to water is easy, it is also important to teach the children and teenagers, the importance of water in the daily life, nowadays and for the future. In this context, since 2001, a multidisciplinary pedagogic action is organized by the “H2O Association” and the Rector of Academy of Clermont-Ferrand (i.e., the main institution representing the Ministry of Education in the administrative parts of France).
At the beginning of the school year, children from primary schools work on different topics about the water (i.e., water and health, water as food, water as a major component of hygiene, water as an element of industrial or energy production, water and ecosystems ...). In April, an exhibition-meeting (called "Les Cours d'Eau d'H2O") is organized over two days by the “H2O Association” and the Rector of Academy. Many partners are showing their specificity with respect to water (i.e., institutions, communities, utilities, companies, associations ...) and they are communicating about water and culture, water and environment, water and health, water sports, water sciences, water and international solidarity, water and sanitation, weather, water and energy, water saving, water and agriculture... Every professionals of water have a stand and welcomes school children. Videos, quizzes, demonstrations, materials ... are used to train children to various aspects of water. For them, it is the opportunity to exchange with professionals about all the aspects of water. A specific educational document is distributed to each children. Moreover, they must complete a questionnaire specially elaborated by the exhibitors to oblige them to visit all the stands of the exhibition. Every year, more than three thousand children participate to "Les Cours d'Eau d'H2O".
Since 2001, an educational stand is animated by the students from the Faculty of Pharmacy (university of Auvergne), to teach the children about all the aspects of water and health. The characteristics of specific tools and the pedagogic approaches (film, quiz, leaflets ...), developed by the students and used during "Les Cours d'Eau d'H2O", will be presented.

Annoyance and perception of noise in rural and urban French areas (20m Lecture)

Traffic, urban, and occupational noises are now described as major environmental problems, which can greatly interfere with health. The degree of affect - especially noise perception and annoyance - can vary between subjects, according to their occupational status, their place of life and their pre-existing diseases. These points have been investigated by a cross-sectional study performed in an urban area (UA) and in a rural area (RA) of Auvergne (France). The aim of this study was to identify the main factors affecting noise perception and annoyance.

Data have been collected with a standardized questionnaire, applied to 484 subjects (242 living in UA and 242 in RA). Subjects were asked about their socio-demographic characteristics, exposures to occupational noise and to domestic noise, present diseases and feeling of health status. Statistical analysis were performed with Fischer test, Chi2 test or Fisher's Exact Test. Logistic regression models and multiple linear regression were used to identify factors of noise annoyance (with Stata v12).  484 subjects (308 women and 176 men) were included. Comparable mean ages are observed in both population (46.2 +/- 18.9 yrs in UA - 47.7 +/- 17.4 yrs in RA), with a significant female predominance noted in UA (67%) comparatively to RA (58%). Both populations recognized noise pollution as a major environmental problem. A majority of subjects has been occupationally exposed (66% in UA - 61% in RA), but few of them have used regularly individual hearing protection (14% in UA - 23% in RA). Most people live with their family (82% in RA - 70% in UA), mainly in house in RA (76%) or in apartment in UA (74%). In the vicinity of home, noise annoyance is mentioned and it is especially associated with road traffic, building tools, airports, neighbours, restaurants/pubs, rail traffic and industrial activities. In this study, the perception and the noise annoyance is specially explained by gender (females are more annoyed by noise than males) and age (the level of noise annoyance is inversely linked to the age); place of life (UA or RA) and pre-existing diseases were less contributive.