Clay's handbook of environmental health - SILO.PUB (2024)

Clay’s Handbook of Environmental Health Eighteenth edition

Copyright © 1999 Taylor & Francis Group LLC

Clay’s Handbook of Environmental Health Eighteenth edition

EDITED BY

W.H.Bassett DMA, FCIEH Honorary Fellow, School of Postgraduate Medicine and Health Sciences, University of Exeter. Previously Chief Executive and Director of Housing and Environmental Health, Exeter City Council, UK

London and New York Copyright © 1999 Taylor & Francis Group LLC

First published 1933 by H.K.Lewis Eighteenth edition 1999 by E & FN Spon, 11 New Fetter Lane, London EC4P 4EE Simultaneously published in the USA and Canada by Routledge 29 West 35th Street, New York, NY 10001 This edition published in the Taylor & Francis e-Library, 2002. E & FN Spon is an imprint of the Taylor & Francis Group © 1999 E & FN Spon All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloguing in Publication Data A catalogue record for this book has been requested ISBN 0 419 22960 4 (Print Edition) ISBN 0-203-01631-9 Master e-book ISBN ISBN 0-203-17275-2 (Glassbook Format)

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This edition of Clay’s is dedicated to John Herbert Morris, formerly Assistant Chief Environmental Health Officer to the City of Leicester, who passed away in June 1997. A dear friend of and mentor to the editor and a colleague who passed on his extensive knowledge so effectively to students of environmental health.

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Contents

Contributors Preface Extract from the preface to the first edition

Part One Environmental Health—Definition and Organization 1 Introduction to environmental health Ian D.MacArthur What is environmental health? The principles of environmental health The Commission on Environmental Health—Agendas for Change The need for change Challenges, dangers and opportunities Agendas for change Health and sustainability International organizations dealing with environmental health Approaches to the organization of environmental health Profile of the environmental health officer References 2 Historical development of environmental health in the UK Eric W.Foskett OBE Introduction The Agricultural Revolution (1700–75) The Industrial Revolution The Royal Commission on Child Labour Edwin Chadwick The Royal Commission on the Poor Laws

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The Royal Commission on the Health of Towns The Clauses Acts and private legislation The Public Health Act 1848 The adulteration of food Ashley’s Housing Acts The General Board of Health Communicable diseases to 1900 The adulteration of food to 1900 Milk and meat to 1900 Housing to 1900 Air pollution to 1900 The emergence of a Central Pollution Inspectorate Occupational health to 1900 Constitutional and institutional developments The notification of communicable diseases Registration of births and deaths Ministry of Health Communicable diseases since 1900 Treatment of communicable diseases Housing since 1900 Food since 1900 Occupational health and safety since 1900 Air pollution control since 1900 Other forms of pollution The Royal Commission on Environmental Pollution Professional relationships The development of local government Changes and challenges International influences The European Union Postscript

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Contents References Further reading 3 The organization of environmental health in England and Wales William H.Bassett The national framework Central government departments The Welsh Office Environmental health officers in central departments The role of the central government departments Legislative enforcement on a shared basis Local authority associations LACOTS Local government ombudsman The Chartered Institute of Environmental Health The Audit Commission The European framework The local framework The environmental health control system The environmental health unit Best value Possible changes to the organization of the environmental health service Appendix 3A: Case study 1— environmental health in Bristol Robert Latnbourne Appendix 3B: Case study 2—the environmental health service in King’s Lynn and West Norfolk Robert D.Foster References 4 The organization of environmental health in Scotland Michael Halls Local government system Central government framework The Convention of Scottish Local Authorities (COSLA) The Meat Hygiene Service (MHS) Copyright © 1999 Taylor & Francis Group LLC

The Scottish Environment Protection Agency The Royal Environmental Health Institute of Scotland (REHIS) Training and qualification of environmental health officers National co-ordinating groups for environmental health Environmental health in local government Legislation applying to Scotland Financial accountability 5 The organization of environmental health in Northern Ireland Michael Joyce Local authority functions Environmental health functions The Group Environmental Health System Environmental health at government level Liaison arrangements Legislation The future References Further reading 6 Training and professional standards Paul Robinson Training of environmental health officers Training of environmental health technicians Assessment of professional competence Continuing professional development Appendix: Centres offering courses in environmental health Part Two Environmental Health Law and Administration 7 Environmental health law Frank B.Wright Sources

Contents The courts and tribunals The law relating to statutory nuisances Further reading 8 Enforcement of environmental health law Terence Moran What is enforcement? Enforcement policy Inspection Notices The cautioning of offenders Prosecution Conclusion References Further reading 9 Fundamentals of information technology and its application in environmental health Paul B.Paddock Introduction Data and information Fundamentals of information technology Major developments in information technology Management information systems and information technology The use and application of information technology in environmental health services Conclusions References Further reading Part Three Public Health and Safety 10 Health and environmental promotion Peter Allen Definition of health promotion The health of the nation Our healthier nation—a new start Health promotion in perspective WHO’s Health for All/Healthy City project

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Local authority health promotion Management of local health promotion Health and environmental promotion Sustaining change Conclusion Improving communication skills References Further reading 11 Risk assessment and risk management Liz Falconer, Norma J.Ford, Kath Ray and Denise M.Rennie Introduction Hazard and risk Risk perception Psychological theories of risk perception Cultural theories of risk Quantifying risk Risk management Risk communication Summary References 12 Pest control Veronica Habgood Introduction Legal provisions Planned pest control Pest control through design and construction Rodents Cockroaches Fleas Bedbugs Ants Flies Insects of stored products Wood-boring insects Other pests of public significance Acknowledgements References Further reading

Contents 13 The control of dogs Veronica Habgood Introduction Control of stray dogs Dangerous dogs Dog wardens Dog control Control of rabies References Further reading 14 Public safety and health Richard J.Palfrey Introduction Fairgrounds Hairdressing Acupuncture, tattooing, skin-piercing and electrolysis Pubic entertainment licences Pop festivals Safety at sports grounds Cinemas Theatres Dealing with licensing applications Liaison with the licensing justices Swimming and leisure pools References Further reading 15 Port health Peter Rotheram Development of port health Jurisdiction Organization International health control The Public Health (Ships) and (Aircraft) Regulations 1979 Health clearance of arrivals Aircraft disinfestation Ship disinfestation Shipboard sanitation International trains Water supplies Imported food control Food hygiene and safety Copyright © 1999 Taylor & Francis Group LLC

Air pollution References Part Four Epidemiology 16 Communicable disease—administration and law William H.Bassett and Roisin M.Rooney Background Present arrangements The Public Health (Control of Disease) Act 1984 Disease control measures Port health Liaison between agencies Review of the legal provisions Public Health Laboratory Service Communicable Disease Surveillance Centre Central Public Health Laboratory References 17 Food-borne disease Stephen R.Palmer and John Cruickshank Introduction Non-microbial food-borne disease Food-borne disease caused by pathogenic micro-organisms or their toxins ‘High-risk’ foods Clinical and epidemiological features The principles of investigation and control of food-borne diseases Conclusion References Further reading 18 Communicable disease control Stephen R.Palmer Introduction Organisms that cause disease The host The environment Basic concepts in infectious disease epidemiology

Contents Detecting problems Investigating problems Control The control of important diseases in the UK References Further reading 19 Environmental epidemiology Richard T.Mayon-White Introduction Descriptive epidemiology and ecological studies Clusters of disease Prevalence (cross-sectional) surveys Case-control studies Doses of environmental factors Cohort studies Intervention studies Assessment of epidemiological studies Reference Further reading 20 Non-infectious diseases Edward Ramsden MBE Background Control of materials Exposure Control programmes Conclusion References Further reading Part Five Housing 21 Housing conditions, diseases and injuries James Connelly Introduction Damp housing Cold housing Overcrowded housing Home accidents Mental health and housing Conclusions References

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22 Health and housing Ray Ranson Introduction Contemporary housing and health issues Parameters for healthy housing World Health Organization (Europe) healthy housing guidelines Appendix: Appraisal criteria for evaluating healthy housing References Further reading 23 Housing: standards and enforcement Ray Oxby Introduction The control of housing standards Dealing with unfit properties House and area improvement Renewal areas Houses in multiple occupation Overcrowding The law of landlord and tenant Homelessness Agency services Specialized forms of housing References Further reading Part Six Occupational Health and Safety 24 Introduction to occupational health and safety William H.Bassett, assisted by Brian Etheridge Introduction to health and safety enforcement The development of the modern health and safety framework The European Union and enforcement Local authority enforcement HELA Emerging trends References

Contents 25 Legislative and administrative framework Paul C.Belcher and John D.Wildsmith The Health and Safety at Work, Etc. Act 1974 Administration Enforcement European initiatives References 26 The working environment Paul C.Belcher and John D.Wildsmith Workplace stress Workplace health, safety and welfare Fire References 27 Protection of persons Paul C.Belcher and John D.Wildsmith The Personal Protective Equipment Regulations 1992 Risks to health at work Toxicity of substances Principles of protection Selection of personal protective equipment References 28 Plant and systems of work Paul C.Belcher and John D.Wildsmith Dangerous machines Types of injury Principles of machine guarding The Provision and Use of Work Equipment Regulations 1998 The Lifting Operations and Lifting Equipment Regulations 1998 Machinery protection Legionnaires’ disease Electrical safety Manual handling References 29 Toxic and dangerous substances Paul C.Belcher and John D.Wildsmith Classification of hazardous substances

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The Control of Substances Hazardous to Health Regulations 1994 (1998) Monitoring strategies for toxic substances References 30 Accident prevention and investigation Paul C.Belcher and John D.Wildsmith Causes of accidents Accident notification Investigation of accidents Accident prevention Safety policies as an aid to accident prevention References 31 Ionizing radiation Paul C.Belcher and John D.Wildsmith Types of radiation Energy transfer Effects of ionizing radiation Units Control of radiation exposure Ionizing Radiation Regulations 1985 Detection and measurement of ionizing radiation References 32 Non-ionizing radiation Paul C.Belcher and John D.Wildsmith Ultraviolet radiation Visible light Infra-red radiation Microwaves and radiofrequency radiation Lasers References Part Seven Food Safety and Hygiene 33 Introduction to food safety Andrew Hopkin Background Infrastructure The Food Standards Agency

Contents Environmental health officers and local authorities Codes of practice Home authority principle Role of the Local Authorities’ Co-ordinating Committee on Food and Trading Standards The Department of Health food hazard warning system Inquiries into food safety Food safety and Europe References 34 Food safety law Andrew Hopkin Legislative principles The Food Safety Act 1990 The Food and Environment Protection Act 1985 Deregulation and food law Food hygiene regulations Food hygiene training—legal aspects European Union legislation and proposals Appendix A: EU food hygiene directives and UK implemented regulations as at June 1998 References 35 General controls on food safety Andrew Hopkin Role of inspection Management controls The hazard analysis approach (HACCP) Food examiners Microbiological surveillance of food Method of inspection Quality assurance Food composition Sampling and examination of food Use by dates The prevention of foreign bodies in food References

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36 Food hygiene Andrew Hopkin Controls over food handling personnel Microbiological risk assessment Catering premises Outdoor catering Markets and stalls References 37 The preservation of food Andrew Hopkin Introduction Microbial food spoilage Dehydration Refrigeration Freezing Fermentation Biotechnology and genetic modification Food irradiation Processed and preserved foods Canned foods Food additives The sous-vide system for preparing chilled meals Anaerobic food packs Advisory Committee on the Microbiological Safety of Food Trends Cold chain vehicle distribution Packaging of food References 38 Food safety: controls on risk foods other than meat Andrew Hopkin Eggs Milk and milk products Ice-cream Fish and shellfish References 39 Food safety: meat hygiene Michael J.Greaves Arrangements in Great Britain Red meat Poultry meat

Contents Animal welfare Wild game Minced meat and meat preparations Meat products Blood products Animal by-products Hygiene assessment system Hygienic production of meat References Further reading Part Eight Environmental Protection 40 Introduction to environmental protection Chris Megainey Introduction The drivers of environmental protection Key environmental protection issues The battle against pollution The structure of environmental protection in the UK Some environmental protection concepts Conclusion References Further reading 41 Noise John F.Leech and Michael Squires Introduction Legal framework The Noise Review Working Party Sound and vibration Noise measurement Vibration Noise control techniques Planning and noise Environmental assessment Neighbourhood noise Construction sites Noise abatement zones Railway noise Road traffic noise Aircraft noise Copyright © 1999 Taylor & Francis Group LLC

Occupational noise References Further reading 42 Air pollution Michael J.Gittins Introduction Definition of air pollution Sustainability Instruments to control pollution Effects of air pollution Global air pollution issues UK air pollution UK legislative control Air pollution from chemical contamination References 43 Waste management Jeff Cooper Introduction Early provision of waste disposal services Background to waste collection, disposal and administration European perspectives The Environmental Protection Act 1990 Refuse analysis Refuse storage Recycling Refuse collection Litter Street cleansing Waste disposal and treatment Clinical waste Storage, collection and disposal of other hazardous waste References Further reading 44 Radon in buildings Alan Blythe Introduction Basic properties Sources of radon

Contents Distribution of radon Health effects and risks Monitoring and exposure mechanisms Standards—action levels and limits, affected areas for homes and occupational exposure Remedial measures against radon ingress Radon in water supplies Administrative and financial issues References 45 The water cycle Edward Ramsden MBE Integrated water management

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Water collection Water treatment Water distribution Domestic filtration and purification The sewerage system Trade effluent Drain testing The nature of sewage Treatment of sewage Disposal of effluent to rivers and the sea References Further reading

Contributors

Peter Allen BA, DMA, DMS, FCIEH, FRSH Head of Environmental Health Services Oxford City Council

Liz Falconer MPhil, FIOSH, RSP, MIM Lecturer University of Salford

William H.Bassett DMA, FCIEH Honorary Fellow School of Postgraduate Medicine and Health Sciences University of Exeter

Norma J.Ford BSc, MCIEH Senior Lecturer University of Salford

Paul C.Belcher BA, MSc, MCIEH, Principal Lecturer and Head of the Centre for Environmental Sciences University of Wales Institute Cardiff

Eric W.Foskett OBE, BSc (Econ.), DPA, FCIEH, FRSH Formerly Director of Environmental Health, City of Manchester, and Past President, Institution of Environmental Health Officers, London

Alan Blythe FCIEH, M.Inst.WM, DMS, FBIM Environmental Consultant Wedmore, Somerset

Robert D.Foster DMS, MCIEH Chief Environmental Health Officer King’s Lynn and West Norfolk Borough Council, King’s Lynn

James Connelly MBBS, MSc, MRC Psych., MFPHM Senior Lecturer in Public Health Medicine School of Medicine University of Leeds

Michael J.Gittins C.Eng, FCIEH, M.Inst.E, FRSH, MIOH Formerly Chief Environmental Health Officer Leeds City Council

Jeff Cooper MSc, BSc, M.Inst.WM, FRGS Producer Responsibility Co-ordinator Environment Agency London

Michael J.Greaves BSc (Hons), MCIEH Regional Manager Meat Hygiene Service York

Brian Etheridge BSc (Hons), MSc, DMS, MCIEH Head of the Local Authority Unit Health and Safety Executive London

Veronica Habgood BSc, MSc, MCIEH Senior Academic School of Land and Construction Management University of Greenwich London

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Michael Halls FREHIS, FRSH, M.Inst.WM International Federation of Environmental Health London Andrew Hopkin MCIEH, MIM Chief Environmental Health Officer Derby City Council Michael Joyce DMS, FCIEH Formerly Chief Administrative Environmental Health Officer Southern Group Public Health Committee Armagh County Armagh Robert Lambourne Director of Health and Environmental Services Bristol City Council John F.Leech BSc (Hons), MCIEH Principal Environmental Health Officer Exeter City Council Ian D.MacArthur BSc (Hons), MCIEH Assistant Secretary Chartered Institute of Environmental Health London Richard T.Mayon-White MB, MRCP, FFCM Consultant Public Health Physician, Consultant in Communicable Disease Control, Regional Epidemiologist and Senior Clinical Lecturer University of Oxford

Ray Oxby BSc (Hons), MCIEH, DMS, MIM Head of Environment North East Lincolnshire Council Paul B.Paddock BSc (Jt Hons), BSc (Hons), MPhil., MCIEH, MIOSH Principal Lecturer in Environmental Health The Nottingham Trent University Richard J.Palfrey MCIEH Principal Environmental Health Officer Exeter City Council Stephen R.Palmer MA, MB, BChir., FFPHM Director of the Welsh Combined Centres for Public Health College of Medicine University of Wales, Cardiff Edward Ramsden MBE, FRSH, MCIEH, DMA, FCIS Formerly Director of Environmental Health Services Swansea City Council Ray Ranson MA, MRSH, MIH, MCIEH Consultant in Environmental Health World Health Organization London Kath Ray BA, MA Research Assistant University of Salford Denise M.Rennie BSc, MSc, MCIEH Head of Environmental Management University of Salford

Chris Megainey BSc (Hons), MCIEH Specialist in Environmental Pollution London

Paul Robinson BA, DMS, MCIEH Head of Education Chartered Institute of Environmental Health London

Terence Moran JP, BSc (Env. Health), LLB, LLM, MCIEH, MIOA Principal Lecturer and Head of Environmental Quality Leeds Metropolitan University

Roisin M.Rooney BSc (Hons), DMS, MCIEH Senior Scientist (Environmental Health) Communicable Disease Surveillance Centre Colindale London

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Peter Rotheram BA, FCIEH, FRSH Executive Secretary Association of Port Health Authorities Runcorn Cheshire

Frank B.Wright LLB (Leeds), LLM (Leicester), FCIEH, FRSH, FRIPHH Director of the European Health and Safety Law Unit University of Salford

Michael Squires MIOA Senior Environmental Health Technician Exeter City Council

Considerable assistance has also been received from Ronnie Alexander (Chief Environmental Health Adviser to the Welsh Office), Mark Du Val (Assistant Chief Executive to LACOTS) and Rob Griffin (Principal Environmental Health Officer at the Department of Health). We are most grateful to them and all our contributors for their considerable help in preparing this edition of Clay’s.

John D.Wildsmith BSc (Hons), MSc, MCIEH Senior Lecturer Centre for Environmental Sciences University of Wales Institute Cardiff

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Preface

According to the Report of the Commission on Environmental Health: Agendas for Change, published by the Chartered Institute of Environmental Health in 1997, ‘Environmental health, having invented itself in the nineteenth century, needs to reinvent itself at the start of the twenty-first century’. This proposition, along with others made by the commission, is discussed in a new chapter which opens this edition (Chapter 1). The commission’s report is intended to stimulate a wide debate about the future focus and organization of environmental health, but new approaches to the objectives, strategies, organization and practice of the faculty have already emerged, and these are evident in many chapters of this new edition. New approaches are also reflected in the inclusion of substantial new material, including new introductory chapters for the sections on health and safety, food safety and environmental protection (Chapters 24, 33 and 40). Each reflects the wider background against which the subjects must be studied and the new concepts and approaches that have emerged over the past few years. The introduction to health and safety (Chapter 24) outlines the development of the present health and safety framework and discusses some of the principles that underpin it, including self-regulation, risk assessment, ‘so far as is reasonably practicable’, and the tolerability of risk. It also outlines the enforcement of health and safety law in other European countries. Local authority enforcement in the UK is then analysed, and this section includes information on the recent Memorandum of Understanding between the Health and Safety Executive (HSE) and local authorities. The chapter highlights the main elements necessary in a health Copyright © 1999 Taylor & Francis Group LLC

and safety enforcement policy and ends with an outline of emerging trends, including those relating to employment and accidents, small businesses and the emergence of occupational health as a priority. The introduction to food safety (Chapter 33) reflects the recent studies of the subject that have been carried out as a result of heightened public concern, and outlines the likely organizational changes that will result. These issues include: • an outline of the existing infrastructure • the James Report on a Food Standards Agency • the white paper The Food Standards Agency: a Force for Change • the Pennington Report on the outbreak of E.Coli O157 • the European Food Law green paper. The changing structures and concepts for environmental protection are also identified in the introduction to the specialized chapters in this area (Chapter 40) and this includes information on: • the present driving forces of environmental protection • transboundary pollution and the global approach • climate change • stratospheric ozone depletion • sustainability • BATNEEC (best available techniques not entailing excessive cost), BAT (best available technique) and BPEO (best practicable environmental option) • environmental assessment • the role of economic measures.

This chapter also details the structure in each of the elements of environmental protection and the current technical position on each and, in addition to the main areas, this includes contaminated land, light pollution and indoor air quality. There is a new chapter on risk assessment and risk management (Chapter 11) which identifies the principles and gives examples of their application in the practice of environmental health. The aim of this chapter is to give environmental health students and practitioners an appreciation of both the advantages and limitations inherent in the development of risk management strategies as a means of selecting environmental controls and interventions. The chapter dealing with the enforcement of environmental health legislation in the UK (Chapter 8) has been rewritten to incorporate sections on the following topics: • • • • • • • • • •

enforcement policies the enforcement concordat programming of inspections entry recording of information investigative powers notices charges for enforcement action cautioning prosecutions.

A further new chapter (Chapter 20) deals with the problems of non-infectious diseases with an environmental cause, particularly cancers. It examines the present arrangements for identifying the local epidemiological incidence and relating it to exposure to toxic materials. The chapter goes on to encourage the development of procedures to deal with this increasingly important challenge to public health. Substantial changes have been made to many other chapters, the most significant being: 1. New organizational case studies are included (Appendix to Chapter 3), this time for Bristol city council and the borough of King’s Lynn and West Norfolk. Copyright © 1999 Taylor & Francis Group LLC

2. The chapters on environmental health in Scotland and Northern Ireland (Chapters 4 and 5) have had major alterations to update the situation in those countries. 3. The new national initiatives to improve the standards of public health contained in Our Healthier Nation—A Contract for Health are discussed in Chapter 10. 4. The Imported Food Regulations 1997 have been included in Chapter 15. 5. The chapter outlining the law and administration of communicable diseases (Chapter 16) has been expanded to bring in more information about the structure and role of the Public Health Laboratory Service (PHLS) and its constituent parts. 6. The chapter on housing standards and enforcement (Chapter 23) has been substantially revised to take account of new legislation (including the Housing Act 1996 and the Housing Grants, Construction and Regeneration Act 1996) and also includes information on the proposals to amend the housing fitness standard. 7. In addition to its new introductory chapter (Chapter 33), the section on food safety has been recast and there is now a separate chapter dealing with meat hygiene following the establishment of the Meat Hygiene Service (MHS) (Chapter 39). 8. The chapter on air pollution (Chapter 42) has been rewritten to reflect current concepts, problems and solutions and now incorporates an outline of the new Air Quality Management Scheme as well as information on the relationship between air quality and road traffic. All the remaining chapters have of course been updated but, in order to create space for the extensive new material, I have had to omit from this edition the chapter on statistical method. However, the text of that chapter (Chapter 14 in the seventeenth edition) is still relevant and applicable. Chapter 2 in the seventeenth edition, international aspects, has been split and information on this topic can now be found in other parts of the book as appropriate. The text as a whole has been updated to reflect changes up to April 1999.

There are now 36 contributors, of whom 17 are involved for the first time. These authors are listed separately and we are extremely grateful to all of them for giving their knowledge, experience and time in this way. With each new edition of Clay’s we try to reflect the ongoing changes in the perception and scope of the environmental health faculty

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but, as always, I shall be very grateful for any comments since they are helpful in the planning of future editions. As in UK law, the male pronoun is sometimes used alone for ease of reading. It should be taken to refer to both males and females. W.H.Bassett Exeter, April 1999.

Extract from the preface to the first edition

Under the ever-widening scope of public health administration, and in view of the high standard demanded of students presenting themselves for the examination of the Royal Sanitary Institute and Sanitary Inspectors’ Examination Joint Board, the need has arisen for a handbook, more comprehensive and more in accord with the progressive demands of modern times, than has been available hitherto. At the request of the publishers, this volume has been prepared to meet that need. Despite the number and variety of the subjects necessarily included in a book of this character, the author has endeavoured, as far as is practicable within the limits of a single volume of convenient size, to cover the whole range of the duties of a sanitary inspector, observing due proportion in the attention given to each subject, and while dealing fully and in detail with some subjects, omitting none that is of real importance.

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The author has always felt that the subjects to be studied by sanitary inspectors are by no means of an uninteresting character. It has been his endeavour to make this book ‘readable’ and such as to rob systematic study of much of its inherent drudgery. Few things are of more practical value to executive public health officers, either in examination or in practice, than the ability to illustrate answers or suggestions by sketches. In order to assist readers in this direction, the liberal illustration of technical matters has been made a special feature of the book; every illustration being from an original line drawing in which sectional details are shown, and which the reader may reproduce or develop for himself. H.H.C. London, April 1933.

Part One Environmental Health—Definition and Organization

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1

Introduction to environmental health Ian D.MacArthur

WHAT IS ENVIRONMENTAL HEALTH? It has been said that environmental health is everything and everything is environmental health. While this adage captures the enormity of the subject and may have a resonance with those who work within the field, it does not serve as a meaningful definition. Definitions are of fundamental importance. They set out the precise scope and restrictions placed on a concept or idea. They seek to clarify and to establish a common understanding of terms. The definitions of technical terms can stem from vested interest, and in attempting to define a subject more and more closely barriers and marked sectors can develop. In this sense, the term environmental health is quite different from other definitions in that its meaning can be so wide, and in many respects it is this catch-all nature that creates unease and misunderstanding. By separating the two dimensions we can illustrate the allencompassing nature of the combined term: Albert Einstein noted that environment was ‘everything that’s not me’, and the World Health Organization (WHO) considers health to be a state of complete physical, mental and social well-being. Despite the broad challenge of these concepts several definitions exist for environmental health. In 1989, WHO defined it ‘as comprising of those aspects of human health and disease that are determined by factors in the environment. It also refers to the theory and practice of assessing and Copyright © 1999 Taylor & Francis Group LLC

controlling factors in the environment that can potentially effect health’. [1] A more recent attempt at defining the term emerged from a meeting of WHO European member states in 1993. Their proposed definition was: ‘Environmental health comprises of those aspects of human health, including quality of life, that are determined by physical, biological, social and psychosocial factors in the environment. It also refers to the theory and practice of assessing, correcting and preventing those factors in the environment that can potentially affect adversely the health of present and future generations’ [2]. This definition concludes that environmental health is in fact two things: first, certain aspects of human health; and second, a means by which to address these issues. As a concept and as a means of delivering practical solutions, environmental health provides a strong basis upon which decision-makers can work towards sustainable development. Fig. 1.1 demonstrates the interface of environmental health. It shows that it is a discipline concerned primarily with human health and it notes that humans operate in different environments: the living environment, the home environment, the work environment and the recreational environment. The figure also sets out the various stresses that can impact on any of these environments. It is from this perspective that a holistic view can be taken of human health and the environments in which people live. It has been clearly recognized that environmental

interventions. In a similar way, a basic understanding of environmental health would also prove to be a valuable asset to urban planners. Building capacities in environmental health should not be restricted to the public sector workforce. There are many employed in the private sector, and not just those in mainline environmental management positions, who recognize and build the principal precautions of environmental health management into every day business practices.

Fig. 1.1 The interface of environment health. (Source: [3].)

THE PRINCIPLES OF ENVIRONMENTAL HEALTH

health is a wide-ranging discipline that relies upon intersectoral co-operation and action. It is therefore essential that all the potential contributors to the development and implementation of environmental health programmes can recognize their role. Environmental Health Officers (EHOs) and other professionals, although burdened with a very appropriate title, cannot deal with all aspects of environmental health. Environmental health as a concept is far larger than the roles traditionally played by EHOs employed in local authorities. Many professionals in the public and private sectors make invaluable contributions towards environmental health; they may not perceive themselves as environmental health professionals, but they nevertheless perform tasks that contribute to the whole. In particular, there are many public health doctors, occupational health and safety staff, and technical specialists who need to be brought into the environmental movement in an effort to maximize the use of the human resources available. Professionals on the periphery of environmental health work would greatly benefit the system if they also understood the role of environmental health and could thus relate its principles to their work. It is becoming clear that general practitioners (GPs) will increasingly have to deal with illnesses that are largely due to environmental factors. It is therefore important that they understand the principles of environmental health and how their diagnosis and subsequent action can assist in developing effective environmental health

The development of the environmental health approach has grown organically rather than by design. However, it has demonstrated that it can bring rhetoric to life and adds considerable value to the process of improving human health and quality of life. In a world that is subject to constant and turbulent change, it is surely important to retain some sense of core values or principles as touchstones for our work. Environmental health and the mechanisms to deliver it are founded upon such fundamental principles. They do not apply simply to environmental health at the community level, where the main focus is local government. These principles apply to all levels of government and all sectors that contribute to environmental health. They relate to many government issues and depend upon the way in which governments at all levels relate and interact among themselves and with communities. This is a major challenge as many governments still fail to understand the true nature of environmental health, and therefore the significance and value of its approach. Environmental health is relevant in three time phases. It must work to repair past damage, to control present risk and to prevent future problems. The emphasis given to each phase is determined by a complex formula of factors, depending largely on an assessment of the risks and resources available. It is of course important and correct to address the most pressing issues relating to environmental health urgently, but emphasis should also be given to addressing, and so avoiding, future

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problems. This is the basis of the precautionary principle, which is becoming widely accepted in all policies and programmes and ensures that environmental health action remains at the leading edge of improving life quality of life. Principle 1 The maintenance and improvement of the human condition is at the centre of all environmental health action. A similar principle is contained in Agenda 21 [14]. The principle is a recognition that the main target of environmental action is the wellbeing of the human race and those factors in the environment, however wide, that may affect it. Principle 2 The disadvantaged groups within society are often those that must live in the worst housing with poor environmental conditions, work in the most dangerous occupations, and that have limited access to a wholesome and varied food supply. The disadvantaged do not from a single homogeneous group: different people are at a disadvantage in different contexts. For example, low income households in northern European countries may be at risk of poor health because of damp and cold housing conditions, fuel poverty and/or inadequate nutrition. This phenomenon has been clearly recognized by WHO, which acknowledges that access to the appropriate medical technology cannot in itself offset the adverse effects of environmental derogation and that good health will remain unobtainable unless the environments in which people live are health promoting. A reduction in inequality requires equal access to environmental health services and an uptake of services that relates to need. The provision of high technology services should not be restricted to certain sections of the population because of social or economic disadvantage in the others, and services should be sensitive to the needs of minority groups. To achieve this, the disadvantaged within the population will require special assistance and attention. Copyright © 1999 Taylor & Francis Group LLC

Equity is therefore a core and primary element that underpins any action on environmental health.

Principle 3 The third principle that must be satisfied to ensure effective environmental health relates to a range of governance issues that can be described as the conditions for civic engagement. The adoption of the democratic principles of government is the cornerstone to the effective management of environmental health. For example, the European Charter of Environment and Health sets out the basic entitlements of individuals including the rights of full information, active consultation and genuine participation in environmental health decisions. Democratic principles also require a two-way exchange, however. Every individual also has a duty to act responsibly in an effort to contribute to the protection of the environment. To achieve this partnership, responsible authorities must adopt a role for promoting environmental health and be responsive and answerable to the needs and desires of the communities they serve. Environmental health protection is based on a model of democracy in which experts and elected politicians make decisions on behalf of the general public. This sometimes paternalistic and frequently closed style of decision-making is a legacy of the democratic system developed in the eighteenth and nineteenth centuries and strengthened throughout most of the twentieth. But times have changed. The populous is better educated and through the mass media better informed (or misinformed) about conditions in their communities and matters of scientific and national concern. Demands have increased for greater public participation in all aspects of society. People want not merely to be represented but to participate. This is particularly true of matters that affect their health, their quality of life, and the quality of their environment, particularly at community level. The twentyfirst century will be the age of participatory democracy. Participation can promote environmental health quality because it provides a means of organizing

action and motivating individuals and communities. It enables individuals and communities to shape policies and projects to meet their priorities. Involvement in planning gives people the possibility of influencing choices about the use of limited resources. Additionally, participatory political structures are a check on the abuse of the environment, since citizens with clear rights and knowledge and access to a legal system that allows speedy redress can exercise a powerful restraint against contravention of environmental health regulations. Mobilizing communities for action has become essential, but these groups are faced with formidable obstacles in the shape of prevailing organizational and practised patterns, the attitudes that underlie those patterns, and insufficient awareness and concern. Participation is a two-way process. As well as actively taking part within decision-making processes, it is of equal importance that individuals and corporate bodies all take responsibility themselves to protect and promote the environmental health of their community. The concept of participation relies heavily on local decision-making, and highlights another important element of civic engagement, that of subsidiarity. The meaning of this concept is often lost in the jargon of political science, but in essence it requires that decisions or actions be taken at the most appropriate level. This is one of the pledges outlined in the Helsinki Declaration on Action for Environment and Health in Europe 1994. The responsibility for identifying and resolving local environmental health problems is best devolved from central government to local authorities. The involvement of non-governmental organizations and an informed public in the decision-making process is both necessary and practicable. Developing effective subsidiarity policies relies upon levels of accountability being built into the system. It would be totally inappropriate for decisions to be made at the correct level within the system without the decision-makers being accountable to the communities affected by those decisions. It is therefore important that not only are decisionmakers held accountable, but that they owe their accountability to the public. Accountability upwards to ministers can only disfranchise the Copyright © 1999 Taylor & Francis Group LLC

public affected by the decision-making, and is likely to create a feeling of animosity and unwillingness to participate in the programmes or policies thus created. Many of the problems that currently face environmental health will only be solved by communities acting as a whole, rather than as individuals. This is one of the key areas to challenge our traditional approach to solving environmental health problems, and it is certainly an area that requires research. The current global culture has developed into one of individual duty, responsibility and action. When this is accepted as the norm, it becomes difficult to instil a feeling of community and common good. It is clear then that if we are to solve some of our most pressing environmental health problems, community action must be called upon. In this sense communication and education policies become the main threads within the civic engagement principle and these will become increasingly important as technical, legal and economic management tools fail to address the root causes of the new problems we face. As the technical and financial arguments fail to win the necessary changes, ethical considerations and decisions will increasingly need to be made.

Principle 4 Another crucial element, the origins of which can be traced back to the days of Edwin Chadwick, is a practice of co-operation and partnership in pursuit of improvements in environmental health, not only between the health and environment sectors, but also with economic sectors and with all social partners. This is the principle that lies at the heart of effective environmental health management. Isolated decisions and actions cannot normally solve problems in environmental health: an intersectoral approach is needed. Intersectoral activity is at the core of good environmental health practice. Its usefulness, however, depends on how broadly it is interpreted and implemented. When intersectoral co-operation is understood to pertain only to the support of the programme of a particular sector, it fails. If interpreted and applied, intersectoral cooperation and co-ordination means that:

• the problems tackled are common ones in which all participants have a stake • not only governmental agencies but also all the public and private sector organizations and interests active in the sector are involved • policy-makers, technical and service staff and volunteers at both national and local levels have actual or potential functions to perform • various participants may play leading and supporting roles with respect to specific issues • co-operation consists not only of ratifying proposals, but also of participation in defining issues, prioritizing needs, collecting and interpreting information, shaping and evaluating alternatives, and building the capabilities necessary for implementation • stable co-operative mechanisms are established, nurtured and revised according to experience.

Principle 5 The next principle of environmental health, which cuts across all of those already discussed, is the notion of sustainable development or sustainability. In a similar way to the term environmental health, this concept does not just encompass certain issues, but requires particular ways of managing them. In the policy-making process relating to environmental health there are three particularly important threads that serve to confirm the almost overlapping nature of environmental health and sustainable development. They are: • policy integration; the bringing of environmental health considerations into all other areas of policy and the tying together of different policy fields and different levels of government • partnership; consultation with and participation by all groups in society in the planning and implementation of sustainable development policies • appropriate scale; the handling of policy at the level of government (from local to international) at which each environmental health issue itself occurs, with a bias or emphasis towards the subsidiarity principle.

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Principle 6 International communication and travel is making the world an ever smaller place. Environmental health professionals have long recognized the fragility and proportions of the planet, and that the contaminants in our environment do not respect national boundaries. Environmental health issues are truly international in their character. The world of environmental health is also small. The worldwide community of professionals who dedicate their working lives to improving and protecting the places we live in for the common good are but a speck compared with those who work to exploit and deplete the world’s resources in pursuit of wealth creation. However, the diminutive character of the world’s environmental health community brings great advantages. We can and must communicate with ease. Although our languages may be different and our heritage and culture places us in different systems, our problems and approaches are mutual. Our commonwealth of knowledge can provide us with an irresistible resource for solving many of the perplexing dichotomies we are faced with in our daily work. International co-operation and collaboration is therefore a key principle for environmental health and is one that should not be overlooked, despite the distraction of our immediate surroundings and problems.

THE COMMISSION ON ENVIRONMENTAL HEALTH—AGENDAS FOR CHANGE One of the most significant influences on the subject of environmental health in recent times has been the work carried out by the UK Commission on Environmental Health and its subsequent report Agendas for Change [4]. This commission was established by the Chartered Institute of Environmental Health (CIEH) in 1996. The CIEH recognized that the famous names of public health —such people as the Chadwicks, the Pastors and the Rowntrees—all reacted to the conditions of the industrial revolution, a revolution that created physical (and ultimately social) changes in our

environment. It was those people who created and founded the institutional structures and approaches to environmental health problems that still remain today throughout the world. Yet why should a system established in the 1800s be suitable for today’s society, a society that still bears the physical hallmarks of the Victorian age but operates in a completely different and more complex manner than any before it? The CIEH also looked towards the production of a National Environmental Health Action Plan (NEHAP) as a means of reforming environmental health services. At the 1994 European Ministerial Conference on Environment and Health, which was held in Helsinki, all countries agreed to write NEHAPs. The UK was one of the first countries to embark upon this process. The result, however, was more a report of the status quo that did not put forward any holistic vision of environmental health. While the NEHAP process has been of benefit in other parts of Europe, the CIEH saw it as a missed opportunity and looked towards the Commission on Environmental Health to fill the gap and create a new leading vision for environmental health. There have undoubtedly been significant changes and developments in both the professionals and the systems of environmental health over the past 100 years, but it was becoming increasingly clear to the CIEH that environmental health had evolved within an institutional strait-jacket, and that the structures of environmental health were now unable to reach the root causes of the ills that troubled society in the midst of an information age. It was recognized that change was needed now and that this should be a defining moment. The year 2000 represents a psychological gateway to new perspectives and understanding, the significance of which should not be underestimated. In addition to reviewing what we have achieved, history has shown that when society enters a new century, never mind a new millennium, there is a surge of activity and development in all aspects of society. The CIEH therefore considered it to be fitting that the world of environmental health should take a moment for reflection towards the end of the twentieth century to debate a vision of a new age of environmental health. It was against such a background and with the understanding that the time was right for a radical Copyright © 1999 Taylor & Francis Group LLC

rethink of where environmental health was going that the CIEH took the unprecedented decision to establish a wide ranging Commission on Environmental Health. The commission was given the following terms of reference: • to consider the principles of environmental health and their application to the health of individuals and the pursuit of sustainable development of communities • to examine the relationship between environmental health and relevant socioeconomic factors • to recommend a framework for action in the UK to reinforce and take forward the principles of environmental health with the involvement of the whole community. Under the chairmanship of Dr Barbara McGibbon, the commission consisted of 13 individuals from fields related to environmental health and environmental health management. They met a total of 7 times in 18 months to review their terms of reference, and published their report, Agendas for Change, in July 1997 [4]. It sets out a new vision for environmental health that recognizes the social, economic and environmental aspects of human activity. The new environmental health calls for different approaches that move away from regulation and control towards co-operation partnership and management. These are the tools for lasting solutions. Fig. 1.2 illustrates the new approach, which

Fig. 1.2 The social, economic and environmental axis. Reproduced from [5].

recognizes that many of the environmental health problems that face society today are created by society and can only be tackled by the whole of society taking action. It is relatively easy to get individuals to take action when it is a matter of individual health. However, the new challenge is how to get whole communities to act, not for individual benefit but for the advantage of society as a whole. The example of road transport and air quality illustrates this point well, as it is only when a complete modal shift in transport patterns occurs that air quality has a chance of improving. Individuals acting in isolation and not using their cars will not make a significant difference to air quality and will ultimately simply inconvenience those people. It will only be through working in partnership, in co-operation with the various stakeholders, that we can expect positive results. Managed solutions will be more sustainable. Agenda for Change is a wide-ranging report that contains many themes and 21 recommendations specific to the UK situation. The commission recognized that: 1. there is a strong need for the integration of public and environmental health 2. there is a need for clear local accountability in service delivery 3. that many positive contributions were being made to environmental health under the heading of ‘Agenda 21’ and ‘Local Agenda 21’ 4. that sustainable development processes provide many of the elements of good environmental health and that these elements need to be nurtured to ensure sustainable change [4].

THE NEED FOR CHANGE A healthy environment The fundamental message of the commission’s report is that human beings can only be healthy in a healthy environment. It recognizes that we cannot insulate ourselves from our surroundings— the air we breathe, the water we drink, the food we eat, the buildings and the landscapes we inhabit. Directly or indirectly, they will affect our health and well-being. These may seem unexceptional Copyright © 1999 Taylor & Francis Group LLC

statements yet they carry implications for policymaking that are far from understood. They mean, for example, that we need a far more integrated and comprehensive approach to policy formulation, one that embraces health impacts even where they may not be obvious. The problem—and one of the reasons why this integrated approach does not yet exist—is that the target seems to be constantly shifting. The relationship between environment and health is a complex one, but only recently has this complexity been recognized. In the space of a generation our attitudes to the environment, and to the illness or health it may generate, have undergone a revolution. Our mind set—our expectations and attitudes—have changed fundamentally. We think of the planet as our home and conceive of it as a unity. Hence the new global agenda, one that deals in both economic opportunities—the global market—and in environmental limits, and the costs that breaching these limits may entail. We are aware of human rootedness in the environment, that the health of the biosphere, of air and water and soil, is a vital determinant of human health and well-being. We also realize that human well-being is a complex, variable and vulnerable state, encompassing physical, social and psychological factors that are not easily separated.

The holistic approach To express such thinking, we have begun to evolve a new terminology: speaking of interdependence and interconnectedness, of the importance of a holistic perspective. From professionals, this demands a flexibility of response that may run counter to specialisms. For the public, it can mean that patience with established procedures is lower and expectations much higher. People do not merely expect that their environment should not damage their health, although they do expect that. They also increasingly expect that it should promote their health and well-being [6]. All these changes have occurred within the careerspan of an individual, roughly the time it would have taken for a person to progress from professional

education and training in environmental health to a senior position in the field. But this is not merely an issue for environmental health specialists, since the very nature of the changing agenda—the broadening of concerns, the perception of new links between previously separate areas —means that everybody working in the fields of environment and health is affected. In the 1990s, most of us recognize these points in principle. Many professionals and policy-makers no doubt try to place their work in a wider context. But at some point they come up against an obstacle. More often than not this is institutional, in the broadest sense: the fact that the framework for defining and delivering environmental health has not kept pace with the revolution in knowledge or attitudes. Where changes in the mechanism of delivery have occurred, they have often been piecemeal, inconsistent or driven by forces that have intrinsically little to do with the concept of a genuinely healthpromoting environment: cost-effectiveness theories, for example, or laissez-faire governance. We are, in effect, driving an old vehicle into a new era. The question is therefore: do we leave it to creak along, attempting the odd roadside repair, or send it back to the design shop for a complete overhaul?

The commission’s approach In considering its approach to this question, the commission identified several ways to carry out a root and branch assessment of what environmental health might mean towards 2020. It considered: looking at the characteristics of ‘environmental health’; examining the agreed schedule of environmental health interests; or examining illnesses related to environmental deficiencies or pollution. However, the lack of a simple definition of environmental health, and the complicated interactions between environment, behaviour and biology, make the whole topic extremely complex. Environmental health professionals have increasingly attempted in recent years to link what they do to what they think they ought to be doing. Hence the evolution and, to a degree, the Copyright © 1999 Taylor & Francis Group LLC

codification of various principles to guide those working in the field—a kind of philosophical underpinning of the practice of what professionals recognize as environmental health. Five major principles have been identified as key components of environmental health and have informed the commission’s approach. • • • • •

precautionary approach intersectoral collaboration addressing inequalities and inequities community participation sustainable development.

It has become clear that the majority of the forces that will shape and form how environmental health must work in the next century come from outside the worlds of the environmental or health professions. It was with this in mind that the commission concentrated on the ‘agendas’ that are driving change in environmental health. These forces include: a new interest in quality of life rather than length of life; social inequity; new attitudes to health, safety and risk; sustainable development; globalization; economic management; the information revolution; and balancing subsidiarity and the desire of direct public participation in policy-making and implementation. These and other similar issues form the complex web that environmental health as a discipline must recognize and about which it must negotiate so that it continues to have added value in the years to come.

CHALLENGES, DANGERS AND OPPORTUNITIES The challenge We are standing on the threshold of change; in many senses the run in to the new millennium will provide a defining moment for a re-think on environmental health. Environmental health has in fact been here before. A similar moment in history occurred in the eighteenth and nineteenth centuries, when urbanization and industrialization brought millions of people together in crowded, sprawling

and insanitary settlements. In response, society underwent a period of rapid change. New models for the delivery of public services were introduced— the municipal corporations of the 1830s and new the Boards of Health. A new concept of health arose: the idea of public health. New philosophies for the delivery of education and other public services began to take shape, and a new form of democracy evolved—extended suffrage, which became universal in the early twentieth century. Nearing the end of the twentieth century, we are at a comparable watershed. In the West, urbanization and industrialization are largely behind us. Our horizons are increasingly global, not merely national. We deal, typically, in symbols and abstractions, in information rather than in manufactured objects. Engineered solutions are no longer the answer (although they still have a role to play); solutions have to be managed. They also have to be discussed with those they affect. And the problems themselves have assumed less tractable, more qualitative dimensions to do with lifestyles, quality of life, and psychological health. More importantly, perhaps, the manageable, predominantly urban concept of public health that was developed in the nineteenth century has been replaced by a much bigger concept, that of the global biosphere. As a result, we are grappling with the much bigger issue of the future of life and health on earth, a question that rarely occurred to the Victorians. We are therefore living in a world that knows what it has come after but has much less idea of what it is coming before. Environmental health, having invented itself in the nineteenth century, therefore needs to reinvent itself at the start of the twenty-first. And although many of the new threats are global, the problem, and the response, will often be regional or local, even individual.

The dangers The worst case scenario for the future takes as its social backdrop a picture of sharpening inequalities, continuing environmental degradation, a decaying family and community fabric, increasing stress and the deterioration of the state in to a kind of reactive, Copyright © 1999 Taylor & Francis Group LLC

coping mechanism. Against such a background, the emphasis within environmental health would be on cure rather than prevention, hard technological solutions rather than a softer peoplebased response, and probably professional compartmentalization rather than integration, since the former offers surer career gains to individuals. If prevention does remain a low priority and the integrated planning and delivery of services is drowned out by calls for quick fixes, many diseases associated with modern lifestyles, such as cardiovascular disease and cancer, will take much longer to conquer. For example, the research needed to understand them will be slower to materialize and might well face a powerful rearguard action by well-organized industrial lobbies. The environmental impact on health is an inevitable by-product of human activity, and it is therefore the nature of that activity, and the attitudes that go with it, that hold the key. So it will be to the soft technologies—the technologies of mind, reason and social organization—that we must increasingly look for solutions. Hard ‘engineered’ technologies are at best a partial answer, at worst a diversion. The answers offered are much more difficult. They require vision, ambition and leadership; they also require debate, consensus and agreement. In the worst case scenarios described, these solutions will be more, not less, difficult to realize.

The opportunities The commission’s view for 2020 assumes first and most importantly that healthy people and healthy environments go together. This may sound a truism, but if so it is not widely acknowledged. Science and technology, together with our capacity to create artificial environments, have contrived to obscure that message and to replace it with another one: that we are somehow above nature, that we don’t need it and if it doesn’t suit us, we can change it. Over the past three decades this idea has been overtaken by events and also by a profound change in attitudes. Increasingly, we can see why it is mistaken and how and where the mistakes have been made. In effect, we are talking about a wide ranging

extension of sympathies, intelligence and sense of identity, slowly reaching and covering the rest of the biosphere. We are in the middle of this process now, so as yet it is only partial. By 2020, it will be part of the standard mental equipment of inhabitants of the urban developed world. And such people will need far less reminding that environmental health is synonymous with human health. Implicit in much of the commission’s deliberations is the conviction that the best organizational model for the delivery of good environmental health is a local one. The 2020 vision is thus of a communitybased service responding to the needs of a particular place—a real setting, not a bureaucratic abstraction. Those needs should be identified by, through and with the people that live in that place. These new structures will have a number of distinguishing characteristics. They will be flexible, inclusive and task-oriented. They will have both a community and a professional presence, but the professionals will be on tap rather than on top. They will be trained to think laterally as well as technically. They will work to secure meaningful participation, to link up organizations that had previously worked in isolation and they will be a major ingredient in the delivery of an integrated and multidisciplinary programme for a preventive approach to environmental health. Another two themes that feature in the 2020 vision are inequality and sustainability. First, urgent attention should be paid to reducing the disparities in wealth between social classes that relate so closely to disparities in environmental quality and health. The 2020 vision is therefore of a society where goods, whether they are measured in terms of monetary income or quality of life and physical and mental well-being, are much more equitably distributed than at present. The commission recognized that equality and efficiency go together. An unequal and divided society is a malfunctioning society, and malfunction carries a heavy and measurable penalty, in ill-health, in deteriorating environment and in the resulting social and financial burden. Second, is sustainability. Put simply, this relies on the assumption that we inject the health dimension, along with the green dimension, into our planning for sustainable development, even when this involves managing our lifestyles better than we do now. Copyright © 1999 Taylor & Francis Group LLC

What next? Clearly the pressures for change are now irresistible. We cannot leave the current model of environmental health in neglect; adaptation and reform are needed now. Yet to declare that the current model of environmental health is now well past its sell-by date is not enough. Nor is it enough to say what changes are needed. We also need to try and clarify how change is to come about and by whom, and in whose interests it will be effected.

AGENDAS FOR CHANGE The agendas The agendas for change identified by the commission start from the premise that quality of life is fundamental to health. Both health and quality of life are subject to serious inequalities, but both also raise questions of lifestyle, which carry important implications for the environment. In addressing the two sets of issues—individual health and the integrity of the environment—the argument starts in the particular and the personal, moves on to the environmental and the global, and ends in the social, economic, professional and organizational —the areas where solutions must ultimately be found. The agendas that draw from the principles of environmental health are listed in Table 1.1. Although presented as a list, any of these agendas could be the starting point: these are cross-cutting themes and each provides an entry point into a larger agenda.

Quality of life It has been long established that health relies upon quality of life as well as the absence of disease. Discomfort, dysfunction and dissatisfaction are primary indicators of poor life quality. A different, though related, approach is the attempt to reformulate human and social goals in terms other than the purely economic. The emphasis on economic growth is largely a product of the later twentieth century. However, in that time we have learnt that whatever its positive

Table 1.1 The agendas for change

effects, a higher economic standard of living also carries a number of negative effects on quality of life. It does not necessarily bring greater equality; it tends to degrade environments; and it does not necessarily lead to greater contentment. In fact, an exclusive concentration on economic objectives may destroy the very things—family, community, the social fabric—on which our physical and mental health relies. A number of studies over the past two decades have shown that people feel better—less stressed, more content, less aggressive—in the presence of natural landscape features: greenery, trees, water. Their mental performance improves, they feel refreshed, relaxed and reinvigorated, and with these feelings comes improved physical health. These elusive, qualitative issues probably underpin the movement of people from the cities in search of better health and quality of life. Many people of course do not have such choices.

Inequality By and large, the poorest people live in the worst housing, suffer the most degraded living environments, work in the worst jobs, have the lowest level of educational attainment, and eat the least wholesome food (and pay proportionally more for it). To say that poor environments and unhealthy lifestyles go together is not to say that they always go together, that individuals, through effort or initiative, cannot transcend them; but people born into such circumstances have the dice loaded against them. The equality issue—the gap between the haves and the have nots—has emerged as one of the dominant themes of the 1990s. This is a gap that Copyright © 1999 Taylor & Francis Group LLC

matters in human terms, and numerous examples exist of real health differentials (see An Independent Inquiry into Inequalities in Health in England (TSO, London, 1998, ISBN 0-11-322173-8)). Growing social and environmental inequality exact an enormous toll on health and life prospects. Resolving these issues will require a political commitment. Ultimately the only way to remedy environmental and health indicators of relative deprivation is a conscious and sustained drive to reduce social inequalities in all policy areas. To prioritize it in health alone condemns the initiative to futility.

Lifestyle There are two main components to the lifestyles agenda, both of which depend on the idea that there is such a thing as an identifiable Western lifestyle and that this carries implications for the health of individuals, society and the global environment. The first is that such lifestyles are unhealthy, and that they tend to reinforce social and environment inequality. And the second is that they are unsustainable—that the Western lifestyle cannot be transferred wholesale to the rest of the world without enormous damage to the biosphere. To many people, consumerism represents a lifestyle that must be curbed if the environment is to be protected. Western lifestyles make heavy demands on energy and resources and thus carry far reaching implications for environmental health. Green or ethical consumerism has proved a powerful force for change since the late 1980s. As a result, many people in commerce have been forced to reconsider how they do business and have injected the green dimension into purchasing and sales policies. Yet although the marketplace has proved capable of reform, local and national governments have also been weakened by the power of the markets. What we have gained as consumers, we appear to have lost as citizens. A major theme of the commission’s report is that to protect our health we have to protect the environment, and this will not happen unless people are prepared to become more actively involved. Healthy and sustainable lifestyles, like green consumerism, require knowledge and empowerment.

Globalization At the same time as new information technology has compressed distances, the market economy is extending its reach. The new global economy is dominated by transnational corporations and brand names that are recognized throughout the world. Its prevailing ideology is liberalization and deregulation: free trade. Contrasting strongly with the apparently unstoppable spread of globalism has been the rise in concern for the local. This takes many forms. There is a new interest in a sense of place and local distinctiveness, for example. Environmentalism has bred a radical, often passionate, attachment to particular landscapes. The global and the local are increasingly at odds with each other, sometimes in open conflict. If there are sensible alternatives to the process of globalization, they need to be explored urgently.

not necessarily in existing forms of government. There is a search for what might be called appropriate decision-making technology, for decisions to be taken at the most appropriate level. This often turns out to be the lowest level —the one nearest to those whose lives will be affected—compatible with efficiency and a strategic view. Hence, in part, the growth of interest in subsidiarity. There is talk of stakeholders and empowerment. And there is the emphasis placed on community. Yet there are also powerful ideological, bureaucratic and economic tendencies pushing in the opposite direction, towards centralization. All of these issues bear on environmental health, yet environmental health and environmental protection are still based on a model inherited from the municipal corporation and boards of the nineteenth century in which experts and elected politicians make decisions on behalf of the public. This Victorian model, often distant and lacking transparency, sometimes paternalistic, is in urgent need of an overhaul.

Democracy Information Several factors have prompted the search for a new democratic model. They include the loss of local control to the new global economy; the difficulty of reconciling long-term issues of sustainable development with short-term political preoccupations; and the development of local action around specifically local environmental or health issues [7]. A widespread cynicism also attaches to politics and politicians. Local government has been emasculated: its powers and competencies have been undermined. At the same time there is an impatience with established procedures, particularly among younger people, and a new vogue for direct action. People are also, by and large, more educated, better informed and less deferential. Over the past three decades there has been a rapid expansion of civil society—the network of charities, voluntary organizations, and campaigning and pressure groups through which much political activity is focused and directed. Cumulatively, such pressures point towards a new model for devolving power and involving people: a new model of community ownership. Although its likely shape remains unclear, there are many clues. There is demand for greater participation, although Copyright © 1999 Taylor & Francis Group LLC

One of the key features of modern society is the explosion in the volume and complexity of information and the difficulty we have in handling it. Developments in information technology—the Internet, computer databases and so on—while creating new opportunities for participation, will add to this problem of management and interpretation that applies across the range of environmental health issues. People need good quality information that is independently and expertly validated and clearly communicated with which to make their own judgements. And education in environmental health is central to understanding the information and encouraging informed individual and community action. Without that education and good quality information, the range of problems identified will grow more acute.

Integration To meet the challenges of the outlines in the commission’s vision will require new approaches

to policy-making and implementation. These will stress flexibility, teamwork, partnership and cooperation. Within and between agencies, we will require new forms of co-operation. We need multiprofessional partnerships and the involvement of the public. We need to develop local models of integration between different bodies which could then be disseminated by national government. Such local initiatives will need underpinning by enabling legislation, funding and resources. Professional staff will need to be flexible in their approach and multidisciplinary in their skills: able to see the whole picture, to see how their own function dovetails with those of others and vice versa. They must also have the knowledge and the skills to be able to involve the public in the new forms of participatory structures suggested above. This means a move away from the ‘statuteled’ nature of much of environmental health work.

Sustainable development Of all the issues that have emerged in recent years, the challenge of sustainability is probably the most crucial, cutting across traditional disciplinary boundaries, requiring new forms of management and posing questions that are fundamental to human health. Several key ideas underpin the sustainability agenda. There is the attempt to place local behaviour in a global context and to see how global concerns can be expressed locally. There is the precautionary principle, acting where proof of harm may be lacking. There is the need to think as nature ‘thinks’, in other words like a living system, in cycles and not straight lines. And there is the need to operate across organizational or specialist boundaries because it is the impact of an activity on the environment—not the successful prosecution of a specialist function—that matters. The challenge of sustainable development is enormous. We cannot talk about sustainable development without also talking about environmental health. In recent years we have seen several international and national initiatives that try to bring together sustainability and health, e.g. the WHO’s Health for All strategy and Healthy Cities project, the UK government’s Health of the Copyright © 1999 Taylor & Francis Group LLC

Nation strategy and the Local Agenda 21 process [6]. One of the priorities in environmental health must be to recognize the links between these programmes and ensure that they are managed in an integrated way.

HEALTH AND SUSTAINABILTY Principle 1 of Agenda 21, The Global Charter on Sustainable Development, states: ‘Human beings are at the centre of concerns for sustainable development. They are entitled to a healthy and productive life style in harmony with nature’ [7]. Human health is central to sustainability. Without health, sustainability cannot be achieved. With over 200 explicit references to health in Agenda 21, ranging from health care services to health and housing, the need for a co-ordinated strategy is essential. The process of preventing ill health, promoting good health and caring for those in ill health is a complex balance of social, environmental and economic factors that must be considered together and planned for holistically [6]. Although in many parts of the world health can be said to be improving, health gains are not always evenly distributed, and often small sections of society benefit while there are negative impacts on other sections. This is true for health effects locally. For instance, motor vehicles can provide benefits for users but impose health risks on others. In international terms, the burning of imported fossil fuels may provide useful power in one country while imposing health costs from pollution in another. Sustainable development requires us to look at how we, as individuals and as a society, use resources so that we can maximize the health benefits from them, now and in the future. Health is at the centre of quality of life and the well-being of future generations. Poverty, inequality and environmental pollution affect the health of individuals and communities. Health is therefore an objective, poor health an indicator of activities that are not sustainable. The challenge to the Agenda 21 process at the local level is to develop a common vision of health in which communities and health workers recognize and share the vision

so that a common approach can be agreed and the methods to achieve this vision understood. The sustainable development process is very similar to that of the environmental health approach. Both recognize that there is a range of problems (social, environmental and economic) that impinges on health and that must be addressed collectively. To do this it is important to understand the relationships between the various partners involved, such as local government, health authorities, business, communities, academe, and the voluntary sectors. It is important to understand the roles played by each participant involved in health promotion and care, and to realize that they share a common agenda. The environmental health approach and that advocated by Agenda 21 are based on a set of common principles and processes that lead to a collective objective. These principles and processes are [5]: • • • • • • • • • • • • •

equity sustainability health promotion intersectoral action community involvement and engagement local political support and ownership of decisions made international action consensus building precautionary principle partnership and participation global responsibility integrated approach supportive environments.

INTERNATIONAL ORGANIZATIONS DEALING WITH ENVIRONMENTAL HEALTH The International Federation of Environmental Health The International Federation of Environmental Health is not an organization that can directly influence domestic environmental health legislation. The International Federation of Environmental Copyright © 1999 Taylor & Francis Group LLC

Health was initiated by the then Institution of Environmental Health Officers. It was not the first attempt to create an organization linking environmental health professionals internationally. In the USA and Canada, the International Federation of Sanitarians was established in the 1960s and continued for several years before being wound up. The International Federation of Environmental Health was inaugurated in 1985 and was incorporated as a UK company in 1986. It acts as a federation of national organizations of environmental health professionals, which are full members, and as such has no individual members. It does, however, have a grade of associate members, which are mainly academic institutions that have an environmental health interest, such as organizations engaged in training environmental health professionals. The federation is a relatively new organization, but by mid-1998 it had 26 full members and 36 associate members and continues to expand. It has a wide spectrum of objectives, which include encouraging the co-operation of environmental health organizations; the exchange of information and experience; and the promotion of contact between individual members of constituent bodies. The federation endeavours to influence national environmental health policies by asking member organizations to follow policies adopted by it. Thus, the federation adopted a policy development suggested by the Swedish Environmental Health Officers Association relating to the assignment of wider public roles in environmental protection; it also adopted a policy suggested by the Californian Environmental Health Association to the effect that when governments negotiated trade agreements under GATT (General Agreement on Tariffs and Trade) there would be no undesirable environmental consequences to either party. The first policy statement, advocating support for the principles in the WHO declaration of Alma Ata, was adopted at the inaugural World Congress on Environmental Health held in Sydney, Australia, in 1988, while at the 3rd World Congress in Kuala Lumpur in 1996 the holistic principal for environmental health practice and administration was adopted.

One of the foundation concepts of the federation is that environmental health problems are not constrained by man-made boundaries. Each member organization is assumed to accept an awareness of international and global problems. There are, however, more localized issues, and to deal with these member organizations are drawn together in regional groups with the object of general local thought and action on regional issues and to keep the Federation Council aware of such regional and local problems. The regional groups are encouraged to promote the participation of the associate members. The federation aims to make effective links with international organizations such as WHO, the United Nations (UN), the European Union (EU), and the International Labour Office (ILO), and to represent a global view on environmental health issues. The federation takes the view that environmental health problems are best solved by sharing knowledge and experience and that all environmental health professionals’ organizations have much to teach each other just as they have much to learn from others.

The European Union (see also chapter 7) Two things flow from the EU’s position of regarding central government as always being the competent authority. Firstly, the channel of communication is initially from the EU to central government. The appropriate government departments receive an intimation from their counterpart directorates of new developments in the form of requests for information and comments on draft proposals. Secondly, personal contact grows up between UK civil servants and their EU equivalents. This personal contact is to be commended as it promotes confidence and informal discussion as a precursor to more detailed and serious negotiations—each side is better able to bring pressure on the other. When dealing with a development, the UK department has to be able to frame appropriate responses. This is done out of ministry technical or professional resources, or by consultation with outside bodies. Both of these processes are suspect. There is no guarantee that the information available Copyright © 1999 Taylor & Francis Group LLC

within the department is as expert as the civil service believes it to be, and an incomplete, or inaccurate, response may be generated. Furthermore, the process of consultation may be flawed by being inadequate. Departments tend to accumulate lists of people and organizations that they think must be consulted, and those lists may not represent the best sources of comment on a particular issue. Departments have, of course, a duty to make effective representation to directorates so as to preserve the UK’s interests; every other member state is similarly occupied. This means that departmental pressures on directorates have to be effective, which, in turn, demands the best sources of information. Thus the first, and possibly the most effective, means of influencing EU policy lies with the appropriate department and secretary of state. Hence, because non-civil service interests often suspect that the representations being made are inadequate, they resort to the legitimate practice of lobbying secretaries of state, ministers, MPs, and civil servants to try to make sure that their views are heard and taken into consideration. In addition, some of the pressure is also put on members of the European Parliament (MEPs), including those MEPs who do not represent a UK constituency but may be a member of a particular European Parliament committee, and EU civil servants. For example, the Chartered Institute of Environmental Health has developed strong links with a number of European civil servants. In attempting to put pressure on the EU’s legislative process, interested parties are doing no more than they do in connection with domestic legislation where lobbying to effect changes in policy is recognized as being part of the democratic process. It is fair for all views to be aired when legislation is being prepared, and not simply those that government finds convenient in supporting its case. What has to be watched is the potential for corruption and misrepresentation. There are other ways in which directorates may be influenced. Being part of an international organization, the EU’s bureaucrats are usually impressed by approaches from an international organization that presents views that purport to represent a wider picture than a purely national

one. Because of this, it is advantageous for an organization to be a member of a pan-European group in addition to belonging to domestic bodies. An interested body may make representations in Brussels of its own case, although it will need to understand that the case will probably be seen as special pleading. It is important for interested organizations to influence bodies that have similar interests so that together they can adopt a united stance on issues that affect them. Such organizations usually promote their views in print, and are prepared to promote a specific activity to secure the backing of the EU.

The Food and Agriculture Organization The Food and Agriculture Organization (FAO) is the oldest agency of the United Nations (UN). Founded in 1945, it arose out of the consideration of the problems of feeding the world population in post-war circumstances. Its headquarters are in Rome and this is an acknowledgment that the FAO walks a path pioneered by an Italian organization —the International Agriculture Institute. The FAO also had roots in the League of Nations, which in the 1930s looked at problems of nutrition and its relation to issues of health. The first director of the FAO was Lord Boyd Orr, a British biologist and nutritionist. The activities of the FAO are far reaching and include a scientific programme to develop better plant breeding, pest control, and the elimination of certain animal diseases. The principal impact of the FAO on environmental health is through its interest in animal health, and through the international control and standardization of food composition through the Codex Alimentarius. The latter influences UK legislation directly and indirectly through the EU. As noted above, the EU tries to ensure that its legislation is compatible with other international recommendations. Not all members of the UN are members of the FAO.

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The World Health Organization WHO is an agency of the UN. It was formed in 1948 in Geneva, Switzerland, following a preliminary International Health Congress held in New York in 1946. The 1946 conference took over the United Nations Relief and Rehabilitation Administration, which had been set up after the Second World War by the Allies to enable them to stabilize civil administration in areas liberated from German occupation. Critics of the former international organizations were not slow to point out their imperfections, as though perfection could easily be achieved in countries that were medically and environmentally deprived and lacking in economic resources and an experienced and dedicated civil service. The World Health Organization is independent; and its decisions, unlike those of the health organizations of the League of Nations, do not need to be endorsed by a higher authority. Its constitution is wide enough to permit it to undertake any health work within the limits of its budget. [8] One specific weakness was that earlier agencies found their work slow to be effective because each agreement negotiated had to be subject to further ratification by the government of each member state. The new constitution of WHO overcame this by taking powers to make its decisions binding on its members. That power was conceded because provision was also made for members to be able to influence the ‘legislation’ that WHO produces. Member states may propose reservations which, if accepted, are incorporated into the measure. If such reservations are not accepted and not withdrawn, the measure is not then binding on the proposers. The WHO organization operates through 11 divisions and 5 ‘offices’. From the environmental health aspect, 3 divisions—Communicable Diseases, Environmental Sanitation, and Epidemiology and Health Statistics—are of particular significance. WHO secured worldwide collaboration in dealing with certain communicable diseases through the International Sanitary Regulations 1951. These modernized and replaced the 13

International Sanitary Conventions that existed between 1851 and 1938, and it is interesting to note the designation ‘regulations’ in substitution for ‘conventions’ as an indication of the changed status of the legislation. WHO has to operate in an area in which boundaries are unclear, and in which other agencies have an interest. For this reason, WHO works co-operatively with other UN agencies, especially the FAO in respect of nutrition and zoonoses, and the ILO with regard to occupational health issues.

The International Labour Office The ILO provides a forum for the discussion of labour and other social issues, and has developed a concensus on appropriate policies and standards. It created an International Labour Code, which laid down minimum standards of national labour legislation and administration. For member countries, it provides technical assistance, expert missions, and study grants, and it has developed comparative labour statistics, methods of carrying out manpower surveys, vocational training programmes, and the rehabilitation of disabled workers. The ILO operates by adopting conventions and recommendations. The conventions are designed as model legislation which member states are expected to ratify as soon as possible. Those states that do not are expected to report annually on their actions on matters that are the subject of conventions. Recommendations are a form of authoritative guidance to members [9, Vol. 9, p. 28] A weakness of the ILO has been that it has to form conventions and recommendations in such a way as to enable the least developed countries to adopt them. As a consequence, some more developed countries decline to ratify conventions or to follow recommendations that prescribe standards that are lower than those they have already adopted for themselves. Nevertheless, the ILO wishes to ensure that when local legislation is claimed to be superior to a convention, it really is. When the Health and Safety at Work, Etc. Act 1974 was introduced in the UK, the ILO wished to send an inspecting delegation Copyright © 1999 Taylor & Francis Group LLC

there. In due course the delegation came and saw examples of the enforcement of the legislation, in both the industrial and commercial sectors, dealt with by the local authorities. The UK is usually represented at conferences and committees by senior members of the Health and Safety Executive (HSE). While the ILO was intended to satisfy many of the aspirations of the trade union movements that had developed strongly in the first half of the twentieth century (and were especially and increasingly interested in welfare and safety), it also caused some diminution in those movements’ domestic influence because of the formal contacts between the ILO and member governments. As there is a close connection between the occupational environment and health, it is not surprising to find that the early actions of the ILO were the calling of conferences to improve the health of seamen. A brief reference should be made to the apparent clash of activities in the field of health and safety at work between the EU and the ILO. Both of these organizations have an interest in the health, safety and welfare of workers, but in each case that interest is derived from different sources. The ILO’s interest stems from the fact that it has been specially created to promote better health, safety and welfare of people while they are at work, and has no prima-facie concern with the competitiveness or otherwise of the employing company. On the other hand, the EU is most concerned that no employer is able to achieve a competitive advantage by reducing the cost of health and safety activities. The stance of the EU is thus to require the achievement of a minimum standard of health and safety provision.

The UN Environmental Programme The UN Environmental Programme (UNEP), an agency of the UN, has its headquarters in Nairobi, Kenya, and regional offices elsewhere in the world. It is much less well known than it should be and appears in many ways to be overshadowed by WHO. The UNEP is particularly concerned with issues relating to the degradation of the environment, especially those that affect developing countries.

The resources of such countries in terms of trained technicians, finance and equipment are frequently inadequate. Living standards are low and result from a low gross national product, which not only keeps the people poor, but restricts their ability to earn foreign currency with which better resources could be purchased. In many developing countries, the need for foreign currency has led to the exploitation of natural resources with little regard to the geological, hydrological, biological or ecological consequences. Such countries have also been exploited by some industrialized countries, which have deposited hazardous waste materials there that cannot be dumped at home. To make the situation worse, many developing countries are in ‘harsh climate’ zones and in areas where there are frequent natural disasters. With the acknowledged transboundary effects of many environmental problems, difficulties such as the reduction of tropical rain forests not only have a local effect but also impinge on the global environment. The UNEP has responded to this and is particularly concerned with the following issues: 1. protecting the atmosphere by combating climate change and global warming, ozone layer depletion, and transboundary air pollution 2. protecting the quality of fresh water sources 3. protecting ocean and coastal area resources 4. protecting land resources by combating deforestation and desertification 5. conserving biological diversity 6. managing biotechnology in an environmentally sound way 7. managing hazardous wastes and toxic chemicals in an environmentally sound manner 8. protecting human health and the quality of life, especially the living and working environments of poor people, from environmental degradation. The possible short- and long-term effects of some global environmental changes have been discounted in some non-academic circles. For example, little thought appears to have been given to the effect on insect breeding by relatively modest increases in average temperature. The work of the UNEP Copyright © 1999 Taylor & Francis Group LLC

on transboundary and even global environmental issues is bound to have an effect on many countries, both developed and developing countries.

APPROACHES TO THE ORGANIZATION OF ENVIRONMENTAL HEALTH The organizational approach to the environmental health function differs widely throughout the world despite the fact that the tasks to be performed, particularly in the more industrialized countries, have a large measure of uniformity. Even within Europe a marked variation can be seen. The countries of the ‘new’ Europe are incredibly diverse. Their diversity relates not only to their geographical and cultural differences but also, and perhaps more importantly, to the range of social and economic conditions that prevail in these countries. As a result, the perspectives and priorities that are adopted on environmental health issues, particularly on how environmental health services are delivered, demonstrate a wide degree of variance throughout Europe. Some countries have wellestablished environmental health services that can trace their origins back 100 years or more, while others are only now developing services for environmental health work. Since the disintegration of the former Soviet Union, and the subsequent removal of Moscow’s control over some of the countries in central and eastern Europe, the international community has focused largely on the environmental damage that the former administrations had bequeathed to the newly independent states and the other countries of central and eastern Europe. To date, this work has concentrated mainly on the assessment of the actual physical environmental damage and the prioritization of direct capital investment. Economic reforms in eastern Europe will have a direct effect on the environment. The transition to a market economy from one of central control planning leads to a broad change of attitude and will give countries of eastern Europe the opportunity to begin to reform business practices. The wasting of resources that was commonplace in previous industrial practice should now be heavily resisted. The removal of subsidies on the

various natural resource commodities will provide a sufficiently large financial incentive for the introduction of good housekeeping practices and the implementation of pollution control strategies. The creation of a market economy cannot on its own be left to ensure environmental improvement, however. A mixture of economic, social and regulatory reforms is required to create a comprehensive strategy of control that can be balanced and adapted to changing circumstances while recognizing the importance of economic growth, and yet be truly effective in controlling environmental health problems. To develop such strategies it will be necessary for investments to be made in areas other than direct financing of capital intensive programmes. Investments also have to be made in the areas of education and institution building. Environmental health policies and strategies are of no value unless they can be implemented and monitored by suitably qualified and motivated personnel situated in appropriate institutions with the necessary capacities. Environmental health services are primarily charged with these tasks. Environmental health services act as the interface between policymakers and those who are the subject of the policy control. Environmental health services also have a direct relationship with the general public in dealing with their complaints and concerns in relation to environmental health issues. There is therefore a need for services to be appropriately targeted and sympathetically responsive to public needs while at the same time representing the views of the controlling authority, whether that be at local, regional or national level. In recognition of the current trends, and rather than concentrating on individual hazards, the European Regional Office of the World Health Organization (WHO EURO) is carrying out work to support the reorganization and development of infrastructures for environmental health services throughout Europe (see [10] and [11]). A survey was carried out between March 1993 and March 1994 of some 26 countries from all over the European Region to ascertain how environmental health services were organized and delivered. Copyright © 1999 Taylor & Francis Group LLC

Through this work it has become apparent that every country has established or is developing it own unique systems for the administration of environmental health. Their individuality reflects the different cultural, social and historical perspectives that mould any arm of government, and it is therefore dangerous to draw conclusions about their suitability or comparisons against ‘model’ systems. Nevertheless, some common elements can be identified, analysed and grouped into four main types of system. First, a system of services delivery that is common in many countries of central and eastern Europe is where strong central and vertical controls are retained (Fig. 1.3). Typically the ministries of health and environment have weak links at national level and are concerned mainly with their own particular area of expertise. The actual services are provided at regional level within the country through its respective regional inspectorates of hygiene and epidemiology and environment. These units have little or no autonomy and are staffed by public health doctors and engineers as appropriate. In such systems, local authorities or communes normally have little or no statutory control in respect of environmental health. The second system for the delivery of environmental health services can be found in many of the southern European countries. This system has a level of co-ordination at a regional level before services are delivered to the public. Individual

Fig. 1.3 Organization of environmental health services in Europe—approach 1

ministries still set their own agendas with weak communication and dialogue between them. They are then represented at a regional office. However, in this instance the regional office is representative of all the relevant ministries. They are then coordinated to fit in with the needs of the locality through a government appointee commonly known as the ‘prefect’ or through a ‘prefectual council’. Once more, local municipal and commune authorities have little or no involvement in service delivery (Fig. 1.4).

Fig. 1.4 Organization of environmental health services in Europe—approach 2

The third system of control for environmental health service delivery is formed by both local and nationally controlled regional offices. Local authorities deliver services relating to local environmental health problems, working within national guidelines and legislation. Regional offices of national ministries deal with strategic matters of national importance, and any matters for which the technical expertise does not exist at the local level (Fig. 1.5). The final system that can be found in Europe for the delivery of environmental health services is based upon a system of federal government. In this situation a country is subdivided into different states that are bound by a few national statutes, but generally each state can set its own legislation and systems of control and administration for environmental health control. A useful publication to assist further study of the variations in European organization for environmental health is the European Environmental Yearbook [12]. This presents a summary of information on a wide range of environmental issues in the 15 EU member states and provides a comparative study of the way in which organizations have been developed to deal with, for example, waste energy, pollution, and so on.

PROFILE OF THE ENVIRONMENTAL HEALTH OFFICER

Fig. 1.5 Organization of environmental health services in Europe—approach 3 Copyright © 1999 Taylor & Francis Group LLC

The early parts of this chapter look forward to and discuss a new vision for the environmental health function. The existing organizational arrangements in the UK are discussed in Chapter 3. What follows here is a profile of the environmental health officer’s role (EHO) as described by WHO within the present framework. Although this work is some 12 years old, the profile nevertheless gives a sound picture. Following a consultation by WHO on the ‘Role, Functions and Training Requirements of Environmental Health Officers (Sanitarians) in Europe’ in 1978, it was concluded: ‘Experience of those countries in the Region which have officers with specialized training in environmental health

who are recognized as constituting a specific profession clearly demonstrates their value. Thus it would be to the advantage of all Member states to introduce into their environmental health service staff of this kind whom the consultation called in English “environmental health officers”.’ That conclusion was followed by a further series of considerations by WHO, one of which looked at the development of environmental health manpower [13], and contained the following professional profile of the environmental health officer: 1. The environmental health officer is concerned with administration, inspection, education and regulations in respect of environmental health. 2. The numbers of environmental health officers should be sufficient to exercise adequate surveillance over health-related environmental conditions; this surveillance should include necessary monitoring activities. They must have a close association with the people in their area and be readily accessible to them, providing professional advice and guidance, and thereby gaining the community’s confidence and encouraging its participation in improving environmental health. They should be members of multidisciplinary primary health care teams delivering comprehensive health care at community level. 3. Environmental health officers act as public arbiters of environmental health standards, maintaining close contact with the community. They must at all times be aware of the general environmental circumstances in their districts, and must know what industrial hazards to health may arise there and what resources are available in the event of emergency. 4. They are professional officers capable of developing professional standards and applying them to their own work in relation to that of non-professionals involved in environmental health. Also, their role will obviously touch on aspects with which physicians, veterinarians, toxicologists, engineers, nurses and others deal in a more specialized manner. Copyright © 1999 Taylor & Francis Group LLC

5. One of their vital functions is to maintain effective liaison with other professional officers who have a contribution to make in the promotion of environmental health, e.g. with regard to water resources management, waste management, housing, rodent, insect and other pest control, and protection of the recreational environment. 6. Environmental health officers would carry out the well-established duties of sanitarians/ sanitary inspectors, including inspection of housing and food hygiene, and also monitor and control the new hazards arising from intensive industrialization, e.g. pollution by chemical and physical agents, which could harm the health of a community. 7. Even greater emphasis than in the past should be placed on the preventive role of environmental health officers in relation to environmental hazards to health. 8. They will obviously not possess the expertise of physicians in personal health, of veterinarians in animal health, of microbiologists in microbiology or of sanitary engineers in the provision of water supplies. However, they will have sufficient background and practical knowledge of these areas to understand the principles involved, and may develop some specialist expertise. They will be able to work easily with the other professionals. Their wider experience will enable them to formulate an approach on a broader base, to contribute to the decisions to be made, or to make these decisions alone in cases where they have the necessary authority. They must understand the environmental aspects of the problems that are the concern of other professionals, so that they may contribute to their solution. 9. They must be able to plan and co-ordinate activities between different professional disciplines, official agencies and authorities. They need to have continuing links with other professionals involved in environmental and health-related work. The other professionals with whom liaison will be appropriate include physicians, physicists, microbiologists, chemists, civil/building/sanitary engineers, veterinarians and lawyers.

10. In some countries and situations, the environmental health officers will initiate the collaboration; in others, they will provide the information and advice that are sought. This liaison role will extend beyond the other professionals to technicians and a range of other specialists, including those concerned with the public health laboratory services. While being able to act independently in both advisory and enforcement capacities, exercising self-reliance and initiative, they should also be able to function as members of a team with other professionals in implementing environmental health programmes. 11. In industry and commerce, environmental control specialists interpret legislation, promote and maintain standards, and solve the problems that may come to light through, for example, a system of internal control or ‘self-inspection’. 12. An important part of their functions must be to acquaint themselves with actual or potential environmental hazards and to ensure that appropriate action is taken to deal with them, e.g. to safeguard the public from the hazards associated with microbiological contamination of food and with chemical residues in food substances, and to monitor and control potential and existing environmental hazards, with the backing of strong legislation. 13. A combination of training in public health and toxicology should enable them to cope with such problems as soil pollution due to degradation-resistant agricultural pesticides, leachates from industrial wastes, fall-out from the plumes of chemical works, liquid radioactive wastes from industry and research; chemical pollution of the work environment from solvents and from dust arising from processes using silica, asbestos and lead; pollution of the home environment due to such products as cosmetics, detergents, paints, pesticides and gas used as fuel; heavy contamination of water resources by mercury, antimony, barium, cobalt and other metals due to industrial wastes, pesticides used in agriculture, etc.; and new problems in food safety such as the irradiation of food. Copyright © 1999 Taylor & Francis Group LLC

14. Environmental health officers in the public service should have the following basic functions: (a) improving human health and protecting it from environmental hazards (b) enforcing environmental legislation (c) developing liaison between the inhabitants and the local authority, and between the local and higher levels of administration (d) acting independently to provide advice on environmental matters (e) initiating and implementing health education programmes to promote an understanding of environmental principles. 15. Because of the range of functions, environmental health officers will operate in a managerial capacity and in collaboration with other environmental agencies and services. The increasing complexities of environmental health problems require a continuing development of expertise and an updating of knowledge. To maintain a leading role in dealing with environmentally related health problems, environmental health officers must be in a position to respond to challenges presented by new hazards in the environment, and exercise influence in promoting and regulating environmental health activities. Their training should equip them with the necessary expertise to act at any level—national, provincial (or intermediate) or local—or within any sector, private or public. Thus environmental health officers are trained as generalists across the range of the 15 basic environmental health activities identified above and therefore occupy a key position in the environmental health service. An important part of their functions must be to acquaint themselves with actual or potential environmental hazards, and to ensure that appropriate action is taken to deal with them. In some cases, they may have the required authority and expertise. In others, they may need to press particular agencies to take appropriate action. There will also be occasions when they will need to consult other professional officers, and to make use of laboratory and other expert scientific services. A vital part of their functions will, therefore, be to maintain effective

liaison with other relevant professional officers who have a contribution to make in the promotion of environmental health. Environmental health is very much a team concept, and this must be recognized in any organizational arrangements.

REFERENCES 1. WHO (1989) Environment and Health: A European Charter and Commentary, WHO, Copenhagen. 2. CIEH (1995) The UK Environmental Health Action Plan—A Response by the CIEH, Chartered Institute of Environmental Health, London. 3. MacArthur, I.D. and Bonnefoy, X. (1998) Environmental Health Services in Europe— Policy Options, WHO, Copenhagen. 4. CIEH (1997) Agenda for Change—Report of the Environmental Health Commission, Chartered Institute of Environmental Health, London. 5. WHO EURO (1997) Sustainable Development and Health: concepts, principles and framework for action for European cities and towns, World Health Organization Regional Office for Europe, Copenhagen.

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6. LGMB (1996) Health and Sustainable Development—Local Agenda 21—Roundtable Guidance, Local Government Management Board, Luton. 7. WHO (1997) Health and Environment in Sustainable Development—Five Years After the Earth Summit, World Health Organization, Geneva. 8. Brockinton, W.F. (1952) The World Health Organization, Pelican, London, p. 210. 9. Encyclopedia Britannica (1980 edition), Encyclopedia Britannica Inc., Chicago. 10. WHO (1995) Concerns for Europe’s Tomorrow, WHO Regional Publications, European series No. 53, WHO, Copenhagen. 11. WHO (1998) Environmental Health Services in Europe—An Overview of Practice in the 1990s, WHO, Stationery Office, London. 12. IES (1991) European Environmental Yearbook, Institute for Environmental Studies, Doc Ter International UK, London. 13. WHO (1987) Development of Environmental Health Manpower, Environmental Health series No. 18, World Health Organization Regional Office for Europe, Copenhagen. 14. UN (1992) Earth Summit. Agenda 21: The United Nations Programme of Action from Rio, UN Department of Information, New York.

2

Historical development of environmental health in the UK Eric W.Foskett OBE

INTRODUCTION The history of the development of environmental health control in the UK is long and complex. Any brief version cannot contain the wealth of detail that is available, and so the course traced here is that of streams of developments and important landmarks. Environmental health is concerned with any effect by any environmental factor on human or animal health. Initially, concern was limited to those factors that were easily discernible as affecting human health, but as the environment became better understood, it was recognized that the role of environmental health should be expanded. It is not possible to assign a specific date from which problems relating to environmental health emerged. While this study has to have a beginning in time, it must be understood that the need to control the environment in the interests of health has been evolving for a long time, and it continues to evolve as a consequence of man’s occupation of the planet. For the purpose of this study, it is possible to divide the evolution of environmental health control into four time zones to which some dates can be assigned. These are no more than convenient, relatively imprecise, time boundaries because many important events straddled those boundaries and, in many cases, there were parallel streams of different activities in the same time scale. Copyright © 1999 Taylor & Francis Group LLC

The first of these periods may be regarded as being about 1750–1850; the second 1850–1900; the third 1900–45; and the fourth 1945 to the present day. A historical perspective is important. A knowledge of what has happened in the past, and how and why changes came about, will make it easier to understand the present position. If the present position can be understood, it may be possible to make some intelligent forecasts of future developments. In attempting to understand what has happened, and why it occurred, it is important not to make value judgements of past events based on present day knowledge and attitudes, for, in the last two centuries, social philosophies and scientific and technological knowledge have undergone many changes. What is common knowledge or practice today was largely unknown or unacceptable 150 years ago. Indeed, it may well be that the fourth boundary proves to be inaccurate, and that boundary may, in the future, be understood to have been drawn at some time in the 1980s, meaning that this study was written at the beginning of the fifth period. The conditions in the UK that have led to a system of environmental health control may be thought to be exaggerated or overemphasized, but the entire period is very well documented with numerous literary sources to be consulted. These sources are to be found in the reports of numerous inquiries, in political writings, in

newspaper reports, and in contemporary literature.

that grew up around a mill, or they could retreat to the growing towns.

THE AGRICULTURAL REVOLUTION (1700–75)

THE INDUSTRIAL REVOLUTION

It is common to associate the increasing need for intervention in the environment in the interests of health with the onset of industrialization. There is truth in this except that what is usually termed ‘the Industrial Revolution’ was preceded by an ‘Agricultural Revolution’ that contributed greatly to the movement of population from the country to the towns. Agricultural improvements introduced by Charles Townshend, Thomas Coke, Jethro Tull, Robert Bakewell and others in husbandry, the breeding of better livestock, the introduction of farm machinery, and the enclosure of land, reduced the demand for agricultural labour, and the dispossessed workers migrated, mainly to the towns. For those who remained as farm workers, their lot was usually a very low living standard characterized by housing that was damp, overcrowded and with few amenities. The greater productivity resulting from the Agricultural Revolution improved workers’ diet a little, and made some contribution to a slow decline in the rural death rate. Nevertheless, work on the land, often in bad weather, was unremitting toil for scant wages. Disease ravaged the family. The children were especially vulnerable but, for the adults, poor nutrition, excessive child-bearing, a poor domestic environment, and exposure to the elements while working contributed to a low life expectancy. As towns expanded and became more remote from their supply hinterland, it became increasingly difficult to provide a satisfactory food supply. The situation was ripe for fraudulent substitution, and for food to be adulterated. Doubtless most of the rural population would have preferred to remain in the hamlets and villages, but when they had to move they had few options. They could go to the small, often remote, villages in the hills where the presence of water power had induced the establishment of a textile mill, or to other villages Copyright © 1999 Taylor & Francis Group LLC

The documentary evidence of environmental conditions is graphic. Accounts written in the first third of the nineteenth century relate to conditions created to cope with urban population increases due to the very high birth rates and the influx of people into the towns during the preceding 50 or so years. The pace of industrialization quickened with the development of the steam engine, which enabled factories, and especially textile mills, to be set up in more favourable locations than villages on hillsides adjoining swift running water. With this transition came many environmental evils. Machinery enabled production to be vastly increased with economies of scale to be grasped. As factories increased in size and complexity, they needed more workers, who had to be housed nearby because, in the absence of public transport, they had to be able to walk to work. The need to house workers close to the factories resulted in street after street of small, ill-constructed houses. There was little provision for drainage or refuse disposal; water supplies were inadequate and usually grossly polluted. To add to these unfavourable conditions, the houses were overshadowed by the tall factories and they were polluted by smoke, grit, and dust from both the factory furnaces and domestic fires emitting low level smoke. The bad environmental conditions were matched by the poor social conditions. Even though the working hours were very long, wages were low. As a result, workers suffered from malnutrition, and their poor physical condition was made worse by the ill-ventilated factories and, in some textile mills, the high temperatures and humidity. In addition to the adverse working conditions, there were few sanitary amenities within the factories. For many workers, factory practices involved working with dangerous machinery, and fatal or disabling accidents to workers were common.

If the adult workers suffered from bad working conditions the lot of the children was even worse. Child labour was often considered an essential factor in production. There was always work a child could do and there was a place for them in the mines and in the mills. Indeed, children in textile mills and pottery factories often worked longer hours than the adults as they stayed to clean the machinery at the end of the day, or arrived earlier than the adult workers to ensure that the latter could start full production as soon as possible. Children started to work at an early age and, in textiles especially, they formed part of a team. Adults who could not take a child with them might find work hard to get and, where the shortage of children was acute, mill owners imported children from poor law institutions as apprentices. The general social and economic conditions in the early nineteenth century have to be viewed against a background of, initially, an unreformed parliament, an inadequate local government system, and a political philosophy that permitted, in the name of individual liberty, all manner of what would now be considered to be social abuses. Because of the political and economic views current at the time, there was no political will to make deliberate attempts to ameliorate the conditions endured by most urban workers and their families. In the first decades of the nineteenth century there was a considerable political ferment urging change, but almost always in vain. The people whose lot warranted improvement had little individual political influence, and the ability to organize to bring political pressure to bear was a skill still to be learned. Nevertheless, their plight was noticed, and many politicians and philanthropists adopted causes with which they sympathized, and fought for changes using their social and political connections. In the more populous areas, groups of people emerged who became interested in the welfare of their fellows, and they supported inquiries and investigations. Physicians, such as Thomas Perceval of Manchester and James Currie of Liverpool, visited slum areas and reported what they had found. Environmental disadvantage was not uniformly spread. There were many districts that were Copyright © 1999 Taylor & Francis Group LLC

comparatively salubrious, even though few adequate sanitary amenities were available. Some of the more prosperous boroughs spent money improving parts of their areas but, in many instances, improvements were carried out by improvement commissioners appointed to implement, in a defined locality, environmental improvements specifically authorized by a private act of parliament, the cost being defrayed by a ‘rate’ levied on the householders in that area. In 1795, a contagious disease swept through children working at a mill near Manchester, and the local justices of the peace took what action they could to prevent a recurrence. Early in the nineteenth century there was the first move towards improving the conditions of some juvenile workers. Sir Robert Peel, himself a mill owner, introduced a bill that became the Health and Morals of Apprentices Act 1802. This: passed with little or no opposition. Its chief provisions may be summarized as follows. The working hours of apprentices were limited to 12 a day. Night work (by apprentices) was to be gradually discontinued and to cease entirely by June 1804. Apprentices were to be instructed in reading, writing and arithmetic, and a suit of clothing was to be given yearly to each apprentice. Factories were to be whitewashed twice a year, and at all times properly ventilated; separate sleeping apartments were to be provided for apprentices of different sexes, and not more than two were to share a bed. Apprentices were to attend church at least once a month…All mills and factories were to be registered annually with the Clerk of the Peace. The justices had power to inflict fines of £2 to £5 for neglect to observe the above regulations. [1] That summary indicates clearly the nature of the environmental conditions in textile mills. To enforce the Act, the local bench of magistrates had to appoint two of their number, one of whom had to be a clergyman, to inspect mills. The Act was of little value. Strictly, it only applied to ‘apprentices’ and not to children whose parents consented to their working in the mills, and, in

effect, the Act was an extension of the still existing Elizabethan poor law system. Sadly, at that time, the forces pressing for change realized that they could not hope to improve working conditions, especially hours of work, for adult workers, and their best chance lay in an improvement in the terms of child labour. At least Peel’s Bill showed that some of the worst environmental conditions had been recognized. Although the first census was taken in 1801, the statistical picture of the times could only be achieved by analysing data derived from bills of mortality and the register of baptisms, neither of which were very good sources of data. While the compulsory registration of births, marriages and deaths was started after 1836, it was to take 50 more years to secure the notification of some communicable diseases. Using the above sources, an attempt was made in about 1835 to compare infant mortality. Over a century, there appears to have been some improvement in the mortality rate, but in 1829 disease was still killing children under five years old at a rate equivalent to about 30% of the number of children born that year. The ‘diseases of infancy’ were, for many years, to take a great toll of young people. The social conditions, especially of poorer people, left most of the population vulnerable to the ravages of communicable diseases, especially tuberculosis, scarlet fever and smallpox. By the beginning of the 1830s, there was a great deal of social unrest, especially over long working hours, the insanitary and dangerous conditions in work places, poverty and bad living conditions. The pressures that had led to the Health and Morals of Apprentices Act 1802 were supplemented by other forces but, in the economic and political climate then prevailing, rapid change was unlikely. In 1819, the Factory Act was amended, but in a short period of time there were moves to change that too. The agitations for the reform of parliament and local government were close to bearing fruit. The Reform Act 1832 changed the composition of parliament, and this was followed by the reform of the existing municipal corporations in 1835. Copyright © 1999 Taylor & Francis Group LLC

Unfortunately, there was no perceived need to provide a comprehensive local government system. In late 1831, cholera was introduced to Great Britain, the disease being imported from mainland Europe through the port of Sunderland. By the spring of 1832, cholera had spread to many towns and cities. In London, 5275 people died, with a mortality rate of almost 50%. Overall, a total of about 22000 people died out of a population of 14 million. Cholera is usually thought of as a tropical disease, but here the disease was manifesting itself in the cooler months of a temperate climate: Conditions in all the large towns were, at this time, very favourable to the spread of cholera. Much of the drinking water came from wells in the towns themselves in close proximity to cesspools. Even when piped water supplies existed, the water was often taken from rivers grossly polluted by human sewage…No one realized that the drinking of polluted water was dangerous, and indeed even at the end of the century there were still a few die hards…who refused to believe that drinking water was an important vehicle of infection. [2, p. 67] While this comment describes the state of the country’s towns and the standard of scientific knowledge, it can also be emphasized that there was no adequate government machinery to deal with such an outbreak.

THE ROYAL COMMISSION ON CHILD LABOUR The major social issue of the 1830s related to factory work, and the crucial aspects were hours of work and safety. There was general support for the reduction of children’s hours and for a 10-hour day for adults. When a parliamentary bill to secure this was narrowly defeated, a ‘Royal Commission on Child Labour’ was set up to enquire quickly into the national position so as to assuage the anger of the working people. Edwin Chadwick, recently appointed to public office as an assistant poor law commissioner, and

rapidly promoted to full commissioner by virtue of the excellence of his work, was seconded temporarily in 1833 to be chief commissioner for this Royal Commission. Chadwick and a small number of close colleagues steered this inquiry, but the field work was done inadequately by assistant commissioners appointed through political patronage. Because the government demanded early action, Chadwick wrote the report personally. The report’s recommendations pointed to fundamental changes in the industrial health and safety scene, and laid down important principles that were followed in later legislation. Central to the problem was reducing the hours that children could and adults did work. In promoting a solution that enabled adults to work long periods of time while reducing the hours allowed for a juvenile, Chadwick argued: Why not reduce the hours of children even more drastically than the 10 hours’ limitation suggested by the operatives—so drastically that two sets of children could be used to work against the normal adult day. In this way child labour would be used but not overworked: at the same time no reduction in the adult hours need take place. [3, p. 80] Chadwick proposed that the Act should be enforced by a centralized inspectorate, the members of which would have wide powers, be salaried, and would act as a board and, by meeting at intervals, would produce some degree of uniformity of action. The Factory Act 1833 empowered the inspectors to enter premises and to require the fencing etc. of dangerous machinery and the provision of sanitary conveniences. The inspectors had powers to require a satisfactory system of schooling for all children employed in the mills, and this was the first compulsory school system. Chadwick’s report was generally accepted, but he was never consulted about its implementation.

EDWIN CHADWICK Born in Manchester in 1800, Chadwick went to London at an early age, there trained as a lawyer, and became involved with the followers of Jeremy Bentham who was a radical thinker and the father of the ‘utilitarian’ school of philosophy. Chadwick became a major exponent of Bentham’s theories, and came to know others in Bentham’s circle, some of whom became close working colleagues. The work done on the Factory Act 1833 was a diversion from the task that was to result in Chadwick being a major influence in the development of environmental health administration.

THE ROYAL COMMISSION ON THE POOR LAWS The poor law administration in Great Britain had not been significantly changed since the reign of Elizabeth I. By the 1830s, its administration was uneven and amateur, and it was costing the poor ratepayer too much. Hence it had to be reformed, and in February 1832 a ‘Royal Commission for Enquiring into the Administration and Practical Operation of the Poor Laws’ was appointed. Through the persuasion of his friend, Nassau Senior, who had been appointed a commissioner, Chadwick became an assistant commissioner with a remit to do a field study and to report. Assistants were supposed to submit a summary of their findings; Chadwick, typically, submitted a report on his research, his recommendations and indicated the philosophy on which those recommendations were based. It [Chadwick’s contribution] was no Selection of extract but a complete Report, very long, (onethird of the entire volume was his) brilliantly executed; and working up to six clearly formulated and practical conclusions. [3, p. 103] The Commission was prepared to ask Chadwick to draft proposals to be incorporated into the commission’s report, but a view was taken that it would be unfair to take advantage of his work without appointing him a full commissioner. This

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was done, and Chadwick was launched on a long, distinguished career as a reformer. Although Chadwick had made a name in connection with the poor law reform, his lasting reputation came out of what was to be his life’s best work. After the initial report on the poor law, progress on the reform was hindered by political procrastination and personal animosity, with the result that Chadwick was virtually excluded from the continuing discussions. Because of his painstaking methods, Chadwick had looked at the causes of poverty, and from his investigations into the living conditions of the working population in England and Wales he could hardly have failed to understand the connection between poverty and ill health and an insanitary environment. This inquiry was initiated by the government following a resolution in the House of Lords, the Poor Law Commission being instructed to carry out that investigation. By 1841, the report on the enquiries and the conclusions that Chadwick was drawing were almost complete but, because of political pressures, he was instructed to drop the report. However, political control changed shortly afterwards and he was required to complete the report. When it was completed, there was again political interference and, on the grounds that it would cause offence, the government refused to publish it as a government report, but Chadwick was allowed to print it under his own name as his personal view (The Sanitary Conditions of the Labouring Population of Great Britain). It was a brilliant success and the King’s printer produced many more copies than was usual for such a publication, with 10000 being distributed free of charge. There had been previous reports with which Chadwick had been associated, and which had centred on the improvement of houses. Before he completed the 1842 report, Chadwick had changed his views, and the report advocated a shift from the improvement of houses themselves to the improvement of their external sanitation and drainage. Furthermore, it proposed a system; house drainage, main drainage, paving and street Copyright © 1999 Taylor & Francis Group LLC

cleansing were now to be considered as integral parts of a single process mechanically motivated by the constant supply of water at high pressure. [3, p. 211]

THE ROYAL COMMISSION ON THE HEALTH OF TOWNS Following further political pressures for legislation to make sanitary reform possible, and in order to prepare the way, a ‘Royal Commission on the Health of Towns’ was set up. The general principles of his [Chadwick’s] Report were not to be questioned by the Royal Commission. Instead the Commission was to demonstrate the various means of applying these principles [3, p. 123] The Commission was instructed to follow Chadwick’s plan of action and it heard reports about the sanitary conditions in 50 of England’s largest towns in which about 18% of the total population lived. The Royal Commission submitted reports to parliament in 1844 and 1845, but when a bill was introduced it was so heavily criticized that it was abandoned. Much of the opposition to the proposed legislation came from the Health of Towns Associations and similar bodies. London’s Association, founded in 1844 and created by Chadwick’s friend Dr Thomas Southwood Smith, was supported by many of the day’s most eminent politicians. It had as its objectives the dissemination of knowledge of the evils arising from the existing insanitary environment.

THE CLAUSES ACTS AND PRIVATE LEGISLATION By 1847, similar associations had been created in many of the more populous cities and towns. Many of these towns had already established the practice of promoting private legislation to enable them to carry out improvement to their areas. Because

similar powers were being sought, parliament enacted The Town Improvement Clauses Act 1847. This Act set out clauses that local authorities could incorporate into their own legislation and, as such clauses had already been approved, opposition to them was unlikely when new Bills containing them were introduced into parliament. The city of Liverpool had pioneered environmental and public health legislation in its 1846 Liverpool Sanitary Act. This Act took powers to abolish some local bodies, such as the Commissioners of Sewers, and gave Liverpool’s council sole powers to deal with drainage, paving and cleansing, etc. It also gave the council powers to appoint an officer of health, an inspector of nuisances, and a surveyor. Dr William H.Duncan, a distinguished local physician who knew Chadwick, Southwood Smith, and William Farr was appointed as the officer of health, and Thomas Fresh was given the post of inspector of nuisances. The duties of the Medical Officer of Health are set out…and they are drafted as widely as possible. Under a later section [of the Act] the duties of the Inspector of Nuisances are defined, and it is clear that he was to be an officer of the Council independent of the Medical Officer of Health but compelled, by the nature of his functions, to co-operate closely with him. [4, p. 36] Although Chadwick was very much aware of the non-medical skills required in providing a sanitary environment, his 1842 report contained a recommendation that it would be good economy to appoint an independent medical officer to ‘initiate sanitary measures and reclaim the execution of the law’ [4, p. 37]. The Liverpool Act became law in late 1846, and Dr Duncan took up his appointment as officer of health in January 1847.

THE PUBLIC HEALTH ACT 1848 There were further delays in making statutory provision for sanitary reform and, by 1848, there was no positive sign of progress until a cholera Copyright © 1999 Taylor & Francis Group LLC

epidemic intervened—the country had experienced previous epidemics of cholera and the memory of the death toll was fresh. The fear of cholera made the need for sanitary reform more urgent. The measure placed before parliament in 1848 was far reaching as it had to create a code of sanitary legislation and an administrative machine to carry it into effect. As the Bill went through its parliamentary stages, it was pruned and watered down. Wide opposition was generated and on many grounds, some of which reflected a fear of losing a vested interest or the reduction of personal rights. So as to get some measure on the statute book, the government appears to have surrendered to almost all the opposition. Even Chadwick argued for dropping the Lord’s smoke clauses to placate manufacturers who might, otherwise, have jeopardized the whole Act [3, pp. 324–5]. The Bill, passed against a background of fear and the turbulence of the Chartist movement, was the first major public health legislation. The Act gave mainly permissive powers for the formation of local boards of health. It empowered the appointment of paid officials and there was a statutory duty requiring local boards of health to appoint a surveyor, inspector of nuisances and an officer of health. This latter post, statutorily protected, was available only to qualified medical staff. The 1848 Act vested responsibility for all sewers in the local boards of health. It became illegal to build a house without drains, a sanitary convenience, and an ashpit. All streets in a board’s district had to be cleansed. Except for private streets, all streets had to be paved and drained. Slaughterhouses and common lodging houses had to be registered with the board, and cellars with ceilings less than 7 ft high were prohibited from use as dwellings. Powers were also given for cleansing filthy houses. Because of the complex pattern of authorities existing in London, the Act, which was to last for five years, did not extend to the city or the metropolitan area of London. It established a General Board of Health, which was to have oversight of local boards of health, but this board suffered one particular defect in that its president

was not necessarily a minister accountable to parliament for its activities. When the General Board of Health was set up, Lord Morpeth, who had been the parliamentary pilot, became its president and Chadwick the paid commissioner. The third commissioner was Lord Ashley who was a well-respected philanthropist. Southwood Smith, who had been a mainspring of the healthy towns movement, was made the chief medical inspector under the Nuisances Removal and Diseases Prevention Act of 1848, which was enacted to give operational powers not provided in the Public Health Act 1848 and was a response to the threat of cholera. The 1848 Act was permissive and could be adopted by the then local authorities, which could create a local board of health. Previously, those authorities that had wished to improve environmental conditions in their town had had no central authority to advise them; they now had the General Board of Health. The board could compel the establishment of a local board of health in exceptional local circumstances, such as if the death rate exceeded 23 per 1000 in 7 successive years or if, on a petition by 10% of the ratepayers, an enquiry by a superintending inspector reported that a local board was desirable. The cholera epidemic, which coincided with the 1848 Act and the establishment of the General Board of Health and local boards of health, was protracted and widespread. It started in Scotland in October 1848 after ravaging Europe, and by June the following year it was in full force; it was very severe in London, the Midlands and parts of Wales. There were 53293 deaths in a population of about 15 million [2, p. 68].

THE ADULTERATION OF FOOD Mention is made above about the adulteration of food partly as a consequence of the enlargement of the cities and towns and their isolation from what had been their ‘door step’ sources of food. Even before 1800 there had been an increasing tendency to adulterate food. Much of this was a fraud on people rather than a means of injuring their health but, while the adulteration of, say, Copyright © 1999 Taylor & Francis Group LLC

bread with alum fell into this category, there were some forms of adulteration that were positively dangerous. The analytical skills needed to detect such adulteration were scarce, although some chemists practised in this field. One of these was Frederick Accum, a skilled and well-known scientist. He undertook analyses over a long period of time, and in 1820 he published A Treatise on Adulterations of Food and Culinary Poisons. This was the first time that the issue had been discussed openly and objectively [5, p. 101]. Sadly, Accum later left to live abroad to avoid humiliation for a trivial offence. Further publications of a less authoritative nature appeared from time to time to keep the issue alive, but in 1848 a book by John Mitchell (quoted in [5] and see also [5], pp. 106–108) largely resumed where Accum had left off. There was little public awareness of food adulteration, and no public body had power to deal systematically with it.

ASHLEY’S HOUSING ACTS The various enquiries carried out into environmental conditions in the first half of the nineteenth century had all shown dramatically the bad conditions under which people lived. The survey that resulted in Chadwick’s 1842 report The Sanitary Conditions of the Labouring Population in Great Britain was matched by Engels’ Condition of the Working Class in 1844 [6]. Engels is thought to have derived much information from earlier surveys. Housing conditions per se were bad, and there was much overcrowding; many people shared houses and many lived in cellars. At the time that Liverpool secured its Sanitary Act 1846, 7668 cellars were inhabited by about 30000 people [6] out of a population of 370000. Because of the low income of working families, many were unable to rent separate accommodation, and common lodging houses and houses in multiple occupation were common [4, p. 230]. In 1851, despite the difficulties associated with such shared dwellings, two Acts, promoted by Lord Ashley,

gave powers in respect of lodging houses. The first of these, the Common Lodging Houses Act 1851, gave controls over common lodging houses which laid the foundations for later forms of control; the second Act, the Labouring Classes Lodging Houses Act 1851, gave powers to the then local authorities to create common lodging houses as a means of reducing homelessness. Later, having become Lord Shaftesbury, Ashley admitted that his legislation had had little practical support.

THE GENERAL BOARD OF HEALTH Strictly, the Ashley Housing Acts fell into the second time phase, and it is necessary to look again at the General Board of Health. The board was created by the Public Health Act 1848 which, itself, had a life of only five years. Under its three members, the board was very active in attempting to establish a public health system. Inevitably, it created opposition as it conflicted with vested interests and, under Chadwick’s influence, it had centralizing tendencies. Many of the Board’s alleged faults were commonly ascribed to Chadwick, who became regarded as an evil genius guiding it. Because of the Board’s unpopularity, the government failed to secure its renewal at the end of its five-year life. The Public Health Act 1848, however, survived. Chadwick and Southwood Smith both retired from paid employment in 1856, but although Chadwick continued to be an influence for many more years, he never again held public office. A new General Board of Health was set up in 1853 under the presidency of Sir Benjamin Hall. He appointed an advisory body which included Dr Neil Arnott, John Simon and William Farr. Simon was later appointed as the Board’s salaried medical officer and, when the Board was disbanded in 1858 and the duties transfered to the Privy Council, John Simon became the Privy Council’s medical officer, and began a career of immense importance in the development of the public health service.

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COMMUNICABLE DISEASES TO 1900 A significant feature of nineteenth century social life was the impact of communicable diseases such as cholera, diphtheria and scarlet fever. There was an interrelationship between the incidence of such diseases, poor domestic environments, and the inadequacy of the sanitary infrastructure. The incidence of communicable diseases was great, the mortality rate very high, and there was little understanding of the causes of such diseases and the mechanics by which they were spread. Indeed, the actions proposed by Chadwick and others were based on the ‘miasmic’ (noxious vapours) theory of the spread of disease. The Public Health Act 1848 was followed by a massive cholera epidemic, and there was a further major visitation by the disease in 1853–4, when the first General Board of Health had fallen into disfavour. Nevertheless, those two outbreaks saw the beginning of the better understanding of the disease and how it was spread. John Simon formed views on this but the major advances were the work of John Snow. It is difficult…to appreciate the full measure of Snow’s achievement, since what he proved seems so obvious, but…the climate of opinion before the days of bacteriology was completely different from that of the present time. Then, and for many years afterwards, the miasmic theory of the origin of infectious diseases was the one which was most generally believed. The theory was that soil polluted with excrement or refuse of any kind gave off an atmospheric ‘miasma’ which was the cause of certain epidemic diseases. There was nothing specific about it, and indeed it was commonly believed that one disease could change into another; for example even after the clinical distinction between typhoid and typhus had been made, it was commonly believed that one could change into the other. The ‘miasmatic’ theory was that on which the early movement for sanitary reform was based. [2, p. 68]

The results of Snow’s first enquiries into the transmission of cholera appeared in a pamphlet in 1849 after the second epidemic. He continued his work in the later outbreak, also making use of the statistical material prepared by William Farr of the Registrar General’s office. Out of these investigations came further publications recording his findings and conclusions, the practical importance of which he demonstrated in the celebrated Broad Street pump. In this 1854 incident, the cases of cholera in a population served by contaminated water drawn by that pump dramatically declined when its use was discontinued by the removal of the pump handle. Although Snow was not able to demonstrate the causative organism (that was left to a German bacteriologist, Robert Koch, in 1883), he rightly argued that a primary source of infection was consuming water polluted by infected faeces. Snow further demonstrated that propagation through the consumption of infected water was not the only method of spread, and he described the classical methods of disseminating such diseases through bad personal and culinary hygiene. Simon’s and Chadwick’s belief in the miasmatic theory was understandable in the light of contemporary medical knowledge, but the reforms they promoted were appropriate in laying the foundations for the improvement of public health. Cholera returned in 1866 as an epidemic disease, but other infectious diseases, especially those related to social conditions, were of continuing importance, especially during the last three decades of the nineteenth century. Diphtheria was important, and scarlet fever frequently left severe and permanent complications. Records show that the two diseases were often confused in the years following the onset of industrialization, possibly because of the common symptom of a sore throat. After about 1830, scarlet fever became virulent again, having manifested itself in a milder form for several years. Up to 1856, returns of scarlet fever and diphtheria were combined, and Simon said that diphtheria was unknown to the vast majority of British doctors until 1855. In 1860, Duncan, writing of Liverpool experience, said that diphtheria was Copyright © 1999 Taylor & Francis Group LLC

of minor importance, and that if it was a new disease it had only appeared about three years earlier. In 1863, the annual death rate from scarlet fever was about 4000 per million children under the age of 15 (a note on John Simon, see [4] p. 42). After the two diseases were distinguished, scarlet fever remained the more significant until about 1885, when diphtheria became more common. It remained a major cause of infantile deaths for 60 years. Although the mortality rate from scarlet fever, and to a lesser extent diphtheria, declined, the incidence declined at a slower rate. The virulence of haemolytic bacteria of the genus Streptococcus seems to have declined, but other factors may also have been important. The decline antedated modern chemotherapy, but slight improvements in housing, including a reduction in overcrowding, and slightly better dietary regimes may well have been contributory factors. The incidence of most communicable diseases was greatest in the sections of the community that were poorest in terms of housing, nutrition, wealth and leisure. Tuberculosis was a disease that affected all classes. It was endemic, but its incidence was greatest in poorest areas where housing was bad, nutrition poor because of poverty, ignorance, or social habits, and where workers laboured in damp, dusty, or hot conditions and the work necessitated long, excessive hours of strenuous toil. After about 1850, the incidence of tuberculosis declined continuously. There was no useful drug to combat the disease but rest, reduced stress, improved diet and fresh air were held to be curative and, from the last quarter of the century, sanatoriums providing treatment on these lines were built.

THE ADULTERATION OF FOOD TO 1900 While chemistry was more advanced in the midnineteenth century than medical science, little was done to follow the work of Accum in 1820 until almost the middle of the century, when John Mitchell showed that there had been a continued increase in food adulteration.

Food at that time was seriously adulterated, and it was discovered that the public had become accustomed to the flavour of such foods and liked neither the flavour nor appearance of unadulterated food. Some pioneers, such as the emerging cooperative societies, which aimed to provide a fair service (including pure food) for their members, met strong consumer opposition, and one society experienced such difficulty in selling unadulterated tea that it employed a lecturer to tell its members what good tea was really like! Mitchell’s work induced an active response, and much publicity, especially through articles published in the Lancet. Following public pressure, parliament appointed a select committee to enquire into food adulteration. The facts that were unearthed made parliamentary action inevitable, and resulted in the Adulteration of Food Act 1860. The Act disappointed radical reformers, and evidence suggests that it was a failure. It gave no sampling powers to local authorities, but allowed the appointment of public analysts to deal with suspected food presented by private citizens prepared to pay for the analysis. The position created by the 1860 Act was clearly unsatisfactory, and it was unlikely to achieve the reforms that were desired. In 1860 it was exceptional for there to be legislative interference in the free working of the economy, but the 1860 Act was a breach in that dike. In the decade that followed, there was a persistent stream of criticism, and demands were made for more effective safeguards. In 1868, proposals were made to amend the 1860 Act. Those intentions met with obstruction and delay, and not until 1872 was the law amended by the Adulteration of Food, Drink, and Drugs Act 1872. Progress towards a satisfactory code was being made slowly. The 1872 Act made it an offence to sell food, drink, or drugs that were not of the ‘nature, substance or quality’ demanded by the purchaser, and this has been the basis of all later food control legislation. The Act gave limited powers to appoint public analysts, but its most important provision was to permit inspectors of nuisances, as well as private individuals, to acquire samples of food for analysis. This power resulted in systematic and increased sampling of foods, Copyright © 1999 Taylor & Francis Group LLC

and a marked increase in the number of cases of food adulteration being detected. Despite the improved legislation, the 1872 Act still had some deficiencies, and a select committee was appointed in 1874 to examine how the 1872 Act was working. Out of its findings, the Sale of Food and Drugs Act 1875 was passed. The 1875 Act, although amended and extended later, formed the basic legislation followed in later revisions of the law. Some important issues had to be decided on appeal to the High Court, including the reversal of the judgement that an inspector purchasing a sample for analysis could not be prejudiced. Much of the adulteration at that time, such as the addition of water to milk and spirits, was fraudulent rather than a danger to health—provided that the water was pure! The public analysts had a crucial role. The Society of Public Analysts was formed in 1874, and most practitioners were members. It published its proceedings, gave a stimulus to analytical chemistry, and developed new tests and standards of purity. In particular, the society played an important role in establishing the limits beyond which an article of food would be regarded as being adulterated, and many of its recommended standards achieved statutory recognition.

MILK AND MEAT TO 1900 For urban populations, the supply of milk and meat has always presented problems. For many years, the main source of milk for town dwellers was cows kept in sheds within the built-up area. For the supply of meat, the practice was to buy animals at country sales, drive them into the towns and slaughter them in small, back street slaughterhouses. Back street cowsheds and slaughterhouses were conducive to the transmission of disease and the creation of serious nuisance. Cattle closely confined in insanitary sheds were very susceptible to disease. Tuberculosis, in particular, could be transmitted to those who drank the milk. Furthermore, in an age when food adulteration was extensively practised, milk was adulterated by the fraudulent addition of water. For residents near to the cowsheds there were

nuisances from odours, flies and the disposal of manure. The coming of the railways made possible the rapid carriage into the towns of rurally produced milk, and this was the prime cause of the decline of the town-kept cow population. Slaughtering animals in the small, urban slaughterhouses created nuisance from noise, odours, flies and the disposal of the by-products of slaughter. For many people the trade itself was repugnant. The recognition of the potential for nuisance and the sale of diseased meat led to the early regulation of the trade by some of the growing towns. The Manchester Police Act 1844 gave powers to control the slaughtering of animals to prevent nuisance, for the licensing of new and the registration of existing slaughterhouses, and for the appointment of slaughterhouse inspectors who had power to inspect not only slaughterhouses, but also meat and other foodstuffs. The 1844 Act also showed that, at that time, there was no concept of an impartial and uncorrupt administration, as inspectors appointed under the Act were required to make a statutory declaration that they would act honestly. A similar local Act in 1846 gave Manchester Borough Council powers to licence butcher’s and fishmonger’s shops. Although the Sale of Food and Drugs Act had been passed in 1875, its provisions were augmented by the Public Health Act 1875, which authorized medical officers of health and inspectors of nuisances to inspect food exposed or deposited for sale; it gave powers to seize unfit food; and it made provision for the named officers to enter slaughterhouses and premises used for the sale of meat, so that animals slaughtered could be inspected.

HOUSING TO 1900 Reference has already been made to Lord Shaftesbury’s 1851 Lodging Houses Acts. These Acts had little impact. Despite the poor conditions under which most of the population lived, it was not until 1868 that there was further significant legislation. That Act and a subsequent housing Copyright © 1999 Taylor & Francis Group LLC

statute in 1879 (both designated as the Torrens Acts) made changes that enabled local authorities to deal with individual insanitary houses. While these were useful powers, they did not permit local authorities to deal with areas of bad housing. Some areas of bad housing were demolished under commercial pressures. With no security of tenure, possession of a tenanted house could be obtained easily by the owner, who would sell if he had a favourable offer from a developer or a railway company wanting access to a town centre. The first statutory powers to deal with areas of unfit houses were obtained by the city of Manchester in private legislation in 1867. Further social pressures resulted in legislation in 1875 and 1879, which permitted local authorities to deal with areas of insanitary houses by clearing them and redeveloping the sites. Of the two Acts, collectively known as the Cross Acts, the first, the Artisans and Labourers Dwelling Improvement Act 1875, allowed councils to deal with unhealthy houses by buying the land and buildings for the purpose of improvement. Councils were allowed to build houses or let the land for building subject to schemes having special regard to providing accommodation for the working classes. Where owners refused to sell land, provision was made for compulsory purchase. There was an interesting connection between the Cross Act 1875 and the Public Health Act 1875, for the latter gave powers to councils to make building by-laws. Progressive local authorities adopted such by-laws, and were thus able to have some control over the building standards for houses built to replace the insanitary dwellings that had been demolished. Although some legislative provision had been made, the operation of the Torrens Acts and Cross Acts was expensive, and many local authorities showed little initiative in tackling insanitary housing conditions in their areas. Because of public pressure, parliament appointed two select committees of the House of Commons in 1881 and 1882, and the Artisans Dwelling Act 1882 resulted. Despite this and the efforts of the Local Government Board, progress was slow, and public opinion reflected this. In 1884, a Royal Commission

was appointed to inquire into the housing of the working classes. A number of very distinguished people served on that Commission, and it heard evidence from such prominent public figures as Lord Shaftesbury and Chadwick, who appeared as president for the Association of Sanitary Inspectors. Out of the work of the Royal Commission came the Housing of the Working Classes Act 1885. The Act required local authorities to use the powers they already had with regard to insanitary housing in order to achieve proper sanitary conditions of all dwellings in their district; it gave powers to make by-laws to deal with houses let in lodgings, and required the supervision of tents and vans used for dwellings. With tenure pattern for housing being heavily dominated by rented dwellings, it is important to note that some charitable trusts both provided ‘working class’ houses and managed their properties with some enlightenment. In this regard, Octavia Hill (granddaughter of Southwood Smith) pioneered better housing management and, in particular, worked with the tenants of houses to improve their living standards. In 1890, housing legislation was consolidated in the Housing of the Working Classes Act 1890. In terms of practical housing administration, the Act had three main parts dealing with unhealthy areas and improvement schemes, unfit dwelling houses, and powers for local authorities to provide lodging houses. This Act, both consolidating and pioneering, provided the administrative procedures and concepts that were followed in subsequent revisionary housing measures. Although the housing legislation noted was enacted with good intentions, it was flawed to the extent that to implement it required local authorities to spend considerable sums of money which they had to raise themselves. At this time, local authorities were traditionally careful spenders of their revenue, and only in rare cases was there to be found a zeal for improving the local housing. Some of the large northern industrial towns engaged in longer term plans and were enterprising in finding legal authority for carrying out their plans of improvement.

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AIR POLLUTION TO 1900 By the early 1850s, air pollution was still a major problem in London and the large cities. There was an increasing number of factories that burned coal, and the population continued to grow, which resulted in a rise in air pollution from coal-burning fires. The growth of mining, metal and chemical industries in the rural areas created air pollution in the countryside. There was little effective control of air pollution in terms of either legislation or field enforcement. However, the situation was changing gradually, and failure to secure legislation focused attention on the problem. Simon tried to secure some provision for smoke control in the city of London and eventually succeeded in 1851. While this measure applied only to the city, there was strong pressure for the powers to be extended to the whole of London. In 1852, a petition to parliament resulted in the promotion of an appropriate Bill to control smoke in London. The opposed Bill was pruned to meet the demands of critics, but it emerged as the Smoke Nuisance (Metropolis) Act 1853. There was a bonus for this success in that the prime minister, Lord Palmerston, insisted that the Act should be properly enforced. Out of the defence arguments arose an interesting concept. …the danger now was whether or not the defendant had used best practicable means… This formula, so common it became abbreviated to b.p.m., persists to this day…it began as a great obstacle to the enforcement of clean air laws, it evolved into an indispensible prescription for their effective enforcement. [7, p. 74] There were further improvements to smoke control in the Local Government Act 1858, and the Sanitary Act 1866, but despite the power in the 1866 Act, local sanitary authorities were unable to reduce the smoke burden. There were three reasons for this failure. Some local powers under the Act were flawed by faulty procedural requirements; the fines imposed by magistrates were often derisory; and any improvement in industrial air pollution was

offset by the increased pollution from the additional dwellings built to house the growing population.

THE EMERGENCE OF A CENTRAL POLLUTION INSPECTORATE After about 1830, the alkali industry grew rapidly and large quantities of acid were discharged, despite the fact that by 1836 a remedy for this was known. Many plants in the chemical industry produced not only visible smoke, but also invisible fumes, which were dangerous to health and damaged the fabric of buildings and plants. Such emissions were fairly localized and usually came from plants situated in rural areas. In 1862, this issue was brought before the House of Lords and a ‘Select Committee was appointed to enquire into the injury resulting from noxious vapours evolved in certain manufacturing processes and into the law relating there to’ [7, p. 21]. The prime mover in this, Lord Derby, was anxious not to make the issue one of landowners versus factory owners, but he wanted to discover whether legislative control was possible. The select committee, advised by more skilled experts than had testified to earlier inquiries, reported very quickly. It recommended that there should be legislation enforced by independent officers free of local control and influence. A Central inspectorate could ensure consistency, exchange information in control technique, and acquire an expertise that would not be possible amongst officials acting for a score or more Local Boards of Health, Boards of Guardians and the like. [7, p. 22] The bill, introduced in 1863, fell short of the recommendations of the select committee, but it did create an inspectorate within the Board of Trade, and thus gave victory to the centralists. The Bill was opposed but was enacted as the Alkali Act 1863, and this made provision for the first Alkali Inspectorate.

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The Act was a landmark. It confirmed the view that central government should take action to protect the public from noxious vapours; it allowed, for the first time, for inspectors to enter factories to protect not the workers, but people and property outside; the inspectors were to be experts from the beginning, would serve a central department and would be insulated from local interference. The 1863 Act was to last for only five years; but it was renewed, the inspectorate became established and its role was gradually expanded. It devised methods of working that became characteristic of its operation—patience and few prosecutions. In the 1880s attention was being focused on industrial smoke in urban areas, and on domestic smoke in London. The struggle for clean air involved combating the argument that control action was not justified because smoke had not been proved to be injurious to health, although previous work had shown a correlation between smokey fog and mortality: in 1880, the Hon. F.A.R.Russell had published a book on London fogs in which he showed that they increased mortality; but because the effect was slow and diffused throughout the population, it received little attention.

OCCUPATIONAL HEALTH TO 1900 Much attention had been focused on the lot of the factory worker, and especially the juvenile employee; less note had been taken of the conditions under which shop workers laboured. Many shop premises were ill ventilated, overcrowded with stock, and had very limited welfare facilities. Shop assistants worked very long hours and had limited facilities for refreshment or rest. In very many larger shops, the assistants lived on the premises in attics over the shops. In 1873, an attempt to limit hours of shop work failed but, because of pressure, a House of Commons committee looked at the position in 1886, and declared that the long hours worked normally were ruinous to health, especially to young women. Three hundred London doctors petitioned parliament to support the Bill before

it. The Shop Hours Act 1886 limited the working hours of young people to 74 per week including meal times. This Act was short lived and a further parliamentary committee examined the position. Although the 1886 Act had failed, similar provisions were made in the Shops Act 1892, but even that Act was flawed and had to be amended in 1893 and 1895. One group of workers whose practices were changed as a consequence of industrial development were the farm workers because of the introduction of mechanical aids. These increased productivity but could be extremely hazardous, and specific legislation had to be introduced to give protection against some of the more dangerous machines. As central government became aware of its inability to supervise the expanding number of premises that should be visited, intervention in industrial activities had to be increased. At first, the difficulty was met by increasing staff, but the Workshop Regulation Act 1867 brought most manual workers under supervision and, experimentally, local authorities were involved. The experiment lasted for four years, and was then abandoned. The reasons for the failure were that the powers given to local authorities were impracticable to work, and local authorities, on the whole, failed to administer the Act satisfactorily. In some cases there was deliberate inaction, and in others local influence adversely affected the local inspectorate. Thus, the Factories Act 1871 enacted simply ‘it shall cease to be the duty of the local authority to enforce the provisions of the Workshops Acts 1867–71 and it shall be the duties of the inspectors and subinspectors of factories to enforce the provisions of these Acts’ [1, p. 230]. For some years, the enforcement of occupational health law was unsatisfactory. This was partly the consequence of changes in the legislation, which failed to provide either comprehensive powers or an efficient administrative system. Even the changes made by the Public Health Act 1875 caused confusion. By 1891, further factory legislation was required. Local authorities were again involved in occupational health issues, and in the Factory Act Copyright © 1999 Taylor & Francis Group LLC

1891 they were made responsible for the sanitary conveniences in factories and for cleanliness, ventilation, overcrowding and limewashing in workshops. Local authority inspectors were given the same powers for their duties as factory inspectors under the principal Act. In making this change, central government rehearsed all the arguments for not using local authorities but decided, on balance, that they had the staff and the local knowledge that was required. Local authorities were required to notify the factory inspectorate of workshops found within their area. From the evidence available, it seems clear that local authorities performed rather better under the new Act, but still not well enough, and an 1895 Act required them to report back to the factory inspector on action taken to deal with complaints from him. This and other changes in local government attitudes led to a more vigorous enforcement and the employment of specialist officers to do the work.

CONSTITUTIONAL AND INSTITUTIONAL DEVELOPMENTS A notable year for legislation that involved environmental health issues was 1875. In many ways, the Public Health Act 1875 was one of the most important statutes of the century, for it contained specific provisions to improve public health, and it created an administrative framework within which local government was to develop in the following century or so. Following the Public Health Act 1848, the public health service experienced many difficulties in establishing itself and, in particular, it never enjoyed the political protection of a high-ranking minister Even when John Simon was responsible to the Privy Council for the public health service, the situation was little improved despite his enthusiasm, administrative skills, and incisive reports. After considerable pressure, agreement was reached in 1868 for the appointment of a Royal Commission to examine the problems of sanitary administration. There was a change in government,

and the incoming Liberal administration appointed a Royal Commission in 1869. It was to examine the sanitary circumstances in England and Wales but excluded London, and it was to look at central as well as local organization. Simon had strong views about what was needed —a strong central administration overseen by a minister, a system of local, allpurpose sanitary/ public health authorities, and comprehensive new public health legislation building on experience and responding to contemporary need. Simon was not to see all of these achieved, despite the recommendations of the Royal Commission’s report in 1871. That report was accepted fully, and out of it sprang three Acts of Parliament. In many ways, the most important of those three Acts was the Local Government Board Act 1871. This established the Local Government Board, which became responsible for poor law and public health functions, and other relevant ancillary activities. Under the Public Health Act 1872, an attempt was made to simplify the system of local authorities by mapping out areas for which a local authority would be created to exercise within its area all the Sanitary Acts, thus creating urban and rural sanitary authorities. The Local Government Board was also empowered to create sanitary authorities for ports. While the Local Government Board was an important step in the creation of a comprehensive local government system that would enjoy specific parliamentary support, there were other factors to note. It was significant that the proposal for the 1869 Royal Commission was acceptable to the government, and to the opposition, which had initiated the proposal. Thus it was probable that future legislation would be easier to achieve because of an informal concensus of view. Perhaps of greater significance was the change in informed public opinion towards issues of social importance, and with the weakening of laissezfaire influences interventionist policies became much easier to introduce and defend. Political power was shifting from centre and rightist bases, towards a somewhat more radical stance which underpinned the desire in influential quarters to extend the franchise into the lower middle classes. Copyright © 1999 Taylor & Francis Group LLC

In practical terms, the third Act, the Public Health Act 1875, made the greatest impact. This Act provided a comprehensive range of environmental health powers dealing with local authority areas and powers, sewage, drainage, water supplies, nuisances, offensive trades, the protection of food, infectious diseases, highways, street markets, slaughterhouses and the making of by-laws. The Act of 1875 was drafted with some vision. Its provisions gave substance to an administrative system that was flexible and amenable to extension, and it made possible the very great progress made in the last quarter of the century in improving the sanitary circumstances of the country. In 1876 the Sanitary Institute of Great Britain was founded. This organization was initiated by a distinguished group of people, including Chadwick, and was dedicated to the exchange of knowledge and to the examination of candidates for professional qualifications in surveying and as inspectors of nuisances. It later became the Royal Sanitary Institute, and is now the Royal Society for the Promotion of Health. For many years, it continued to examine sanitary inspectors, but later formed part of the examining body known as the Royal Sanitary Institute and the Sanitary Inspectors Examination Joint Board. The Royal Society of Health continues to have a diminishing interest in the overseas qualifications of environmental health officers. In 1883, the Sanitary Inspectors Association was founded as an amalgamation of smaller local bodies, and the organization has continued, using various designations, to expand in membership and influence. It currently operates under a Royal Charter as the Chartered Institute of Environmental Health. Its first president was Chadwick, and while formerly the members of the Institute were all qualified environmental health officers, other grades of membership are now open to people holding some approved qualification appropriate to environmental health practice.

THE NOTIFICATION OF COMMUNICABLE DISEASES A flaw in the Public Health Act 1875 was its failure to create a system for the notification of cases of

infectious diseases. This was a long perceived need and medical officers for areas where communicable diseases were most prevalent —the densely populated inner cities—had recognized the impediment to epidemiological enquiries caused by the lack of the information that notification would provide. Some local authorities took private act powers that enabled them to require notification of some diseases. Fourteen years were to elapse before a general notification requirement was attempted. In 1889, the Infectious Diseases Notification Act was passed which allowed local authorities to adopt powers to require notification. This was an inadequate measure, but it remained for a decade until supplemented by the Infectious Diseases Act (Extension Act) 1899, which required all sanitary authorities to adopt the 1889 Act. This listed 11 diseases that had to be notified to the sanitary authority and, furthermore, it empowered the Local Government Board to list other diseases by order. Although the notification of communicable diseases was not compulsory until near the end of the century, various powers existed that allowed local authorities to act to prevent such diseases, but the lack of knowledge of all cases clearly hampered satisfactory control. In this context, Frazer wrote: The system of notification…has proved to be of the greatest possible value to medical officers of health in dealing with epidemics because early notification is vital to prevent further cases arising [4, p. 181] The compulsory notification of specified communicable diseases was consolidated in the Public Health Act 1936. Subsequently, further diseases were added to the list either by regulations or, notably, by the Food and Drugs Act 1938, which required the notification of food poisoning. There was a further consolidation in the Public Health (Prevention of Disease) Act 1984. The control of communicable diseases at ports of entry was a feature of the early development of public health (see Chapter 15). Copyright © 1999 Taylor & Francis Group LLC

REGISTRATION OF BIRTHS AND DEATHS Apart from the 10-yearly census, public authorities had few authoritative statistics to guide them. A select committee of the House of Commons was appointed in 1833 to investigate the position with regard to births and deaths, and from their recommendations came the Births and Deaths Registration Act 1836. The objectives of this Act were to establish the General Register office, to appoint a Registrar General, and to institute a system of registering all births and deaths. Before that date, the only statistics available were to be culled from parish registers. The reputation achieved by the Registrar General’s office in the next 40 years was mainly due to Dr William Farr, who was appointed as compiler of medical statistics. His work was pioneering and his reports were fundamental to the development of epidemiology and demographic studies. Farr’s appointment is believed to have been due to Chadwick, and Farr is numbered along with Chadwick, among the great pioneers of public health.

MINISTRY OF HEALTH Noted above was the formation of the Local Government Board. Because of subsequent developments and extensions in the public health and poor law services, the Board was identified as being a less than satisfactory administrative machine. The formation of a Ministry of Health had been advocated for many years by various people for a variety of reasons. By 1918, it became obvious that changes had to be made in public health administration and, in 1919, the Ministry of Health was established to take over the functions of the Local Government Board and other duties. It was made responsible for some social services and most activities that had a health connotation, although a notable exception was the retention of the occupational health service by the Factory Inspectorate. The first Minister of Health was Dr Christopher Addison, later associated with housing legislation.

COMMUNICABLE DISEASES SINCE 1900 Although there were no further epidemics of cholera, other communicable diseases continued to be important in the first half of the twentieth century. The virulence of scarlet fever appeared to decline after about 1883, but it is difficult to assign a reason. The disease with which scarlet fever was most associated, diphtheria, was, however, to remain a serious cause of infant mortality until the 1940s. There was a slow decline to around 300 deaths per million children under 15 per annum in the period 1921–5, and that remained a plateau until 1940 when immunization virtually eliminated the disease. Although antitoxin was first used to treat the disease in 1895, and a satisfactory immunization regime was available in 1923, it was not utilized until 1940. Subsequently, a continuous immunization campaign has kept the disease under control with only the occasional case arising. One communicable disease that was a potent cause of infant death was summer diarrhoea. The incidence and mortality rate had already been declining for 20 years, but in 1911 there were still 31000 deaths of infants under 1 year due to diarrhoea; by 1931 this had been reduced to 11705. There was medical controversy about its cause, and the state of bacteriological science at the turn of the century was such that it could throw no positive light on the causes or the mode of transmission. The best opinion took the view that it was flyborne, and this was an opinion well supported by the fact that the disease was prevalent in summer when flies bred in back street stable middens, and that the disease declined when the horse ceased to be a major form of transport. There were other factors in reducing the disease’s incidence, such as higher standards of domestic hygiene and baby care. For tuberculosis, a ‘social’ disease, both the incidence and the mortality rate continued to fall, although there were temporary distortions in the pattern in both the time and place of cases. The environmental conditions imposed by two world wars and economic depression encouraged Copyright © 1999 Taylor & Francis Group LLC

continued decline. Factors that have contributed to the improved circumstances include better nutritional standards, improved domestic hygiene, better occupational hygiene, reduced working hours with less physical stress, reduced overcrowding and better housing conditions. Immunization against tuberculosis has played a part, as has the more recent (post-1945) availability of chemotherapy. Nevertheless, there have been some disturbing trends in urban communities with a high proportion of ethnic populations, or where there is poverty. Immigrants may be at especial risk where they arrive from areas where there has been no chance to acquire natural immunity and where, on arrival, dietary changes and poor housing may be contributory factors. The elimination of smallpox in 1980, following the WHO campaign, has been a relief to public health workers. Two varieties of smallpox have been the cause of epidemics in the UK. Although for many years smallpox was epidemic in Britain it is probably true that since 1914 major smallpox has always been exotic though it has not always been possible to prove this as source tracing has not always been successful. [2, p. 56] The public health control of smallpox developed because it was a serious disease with a high mortality rate. The control encompassed vaccination, notification, isolation, and effective disinfection regimes. After 1906, the incidence of Asiatic smallpox—variola major—dropped to negligible proportions, but variola minor continued to be a serious problem, with 70000 cases in the UK between 1925 and 1931. The elimination of smallpox as a human contagious disease represents a triumph for international control and co-operation. It is ironic that probably the last cases of smallpox occurred in the UK, the home of vaccination, through the accidental release of laboratory specimen viruses. The incidence of communicable disease does vary and illnesses have different importance at different times. In the 1980s and 1990s, sexually transmitted disease was emphasized with the spread

of HIV (human immunodeficiency virus and AIDS (acquired immune deficiency syndrome). Cholera became more widespread internationally, and the risk of importing cases through air travel was important. Domestically, meningococcal meningitis became increasingly common, and there was a high degree of awareness of the risk of importing rabies. Also important have been outbreaks of Legionnaire’s disease and food-borne disease due to Listeria.

TREATMENT OF COMMUNICABLE DISEASES The high incidence and mortality of communicable diseases in the nineteenth century reflects the poor domestic environment of most people, a low standard of medical and nursing care because medical science had yet to make its major advances, and the lack of drugs to treat the diseases. That the position gradually improved was due to the provision of drainage, safer water supplies, better refuse disposal, improved housing, and better diet. Significant discoveries concerning the causative organisms of many serious diseases were not made until the last quarter of the nineteenth century. Modern chemotherapy may be said to have started in 1910 when Paul Ehrlich discovered Salvarsan (arsphenamine) and made the treatment of syphilis possible. Perhaps the next important step was the introduction in the 1930s of the sulphonamide drugs, which were a product of the dyestuffs industry. These transformed the treatment of many diseases, as did the introduction of penicillin, originally discovered by Sir Alexander Fleming in 1928, and later isolated and developed by Ernst Chain and Howard Florey during the Second World War. In the post-1945 period, the development of new drugs and antibiotics has proceeded apace. Perhaps beginning with vaccination against smallpox, introduced by Edward Jenner in the late eighteenth century, there have subsequently been major advances in dealing with communicable diseases by the development of immunization regimes. Vaccination gives protection against Copyright © 1999 Taylor & Francis Group LLC

infection, and modern thought is still that ‘prevention is better than cure’.

HOUSING SINCE 1900 At the turn of the century, the basic housing legislation was still the Housing of the Working Classes Act 1890, although amending Acts were passed in 1900 and 1903. Despite this legislation, the standard of housing for poorer people left much to be desired, although there had been some slum clearance and house building in London and northern cities. A feature of the growth of the built environment was that not until 1909 were there any provisions for town planning. The planning powers in the Housing and Town Planning Act 1909 were permissive for local authorities, which showed little enthusiasm to exploit its provisions, although some did. The provisions, permitting the control of land use, were intended to act as a brake on unrestricted development and had little regard to amenity and community interests. House construction was subject to little control because of the inadequacies of building by-laws. As far as housing was concerned, the 1909 Act amended the Housing of the Working Classes Act 1890, and made it mandatory in all districts. It prohibited for the first time the erection of back-toback houses, which were still being constructed in some northern industrial cities. The Act also recognized that public utility societies, such as building societies, could be responsible for house building. The relationship between planning and a satisfactory built environment had long been recognized. In 1898 Ebenezer Howard published his seminal work, Tomorrow, a Peaceful Path to Real Reform, which advocated the building of new garden suburbs that were self-sufficient and isolated from other suburbs by a green belt, but with easy means of communication between them. Howard, a practical person as well as a philosophical theorist, was the driving force of the Garden Cities Association, and he witnessed the successful founding of Letchworth Garden city in 1902. The ‘new town’ movement developed largely from Howard’s initiatives.

There was a further Housing and Town Planning Act in 1919, but the housing provisions of the 1909 and 1919 Acts were repealed by and reenacted in the Housing Act 1925. Because of the shortage of houses and promises made to servicemen returning from the First World War, attempts were made to stimulate house building, and powers were taken in the Housing Act 1919. The shortage of houses is indicated by the fact that nationally in 1911, 9.1% of the population lived at a density of more than two per room, and by 1921 the census showed that this had risen to 9.6%. With the aid of government subsidies, 176000 houses were built under the 1919 Act by local authorities at considerable cost. Further Housing Acts in 1923 and 1924 were designed to continue the stimulation of house building, but at a less extravagant rate of subsidy. This legislation was successful, and by 1927 an annual output exceeding 270000 dwellings was achieved. These 1920s Housing Acts were designed to stimulate house building, but they did little to address other housing problems, and the much amended and extended 1890 Act was no longer able to meet current needs. In view of this, the existing legislation concerning the repair, maintenance and sanitary condition of houses was consolidated by the Housing Act 1925. By the late 1920s, it became apparent that much remained to be done to deal with the unsatisfactory housing situation. Building houses for sale rather than for renting was more profitable and the output of rentable houses declined. It was estimated that there were several million insanitary houses: The outside estimate…was 4000000 but …that would depend upon the definition of a slum. In other words, a slum is what the Medical Officer of Health of the District believes to be a slum. What was beyond doubt, however, was that the slum evil in many of the industrial towns, especially London, Liverpool, and Glasgow was of vast dimensions, and that much harm to the Public Health was being caused by the delay— inexplicable to many people—in dealing with Copyright © 1999 Taylor & Francis Group LLC

this problem as a matter of the greatest possible urgency. [8, p. 60] The Housing Act 1930 was the government’s response. It was not a fully comprehensive measure as it omitted to deal with overcrowding, but it made provision for the clearance of insanitary housing, and it prescribed procedures to be followed to make clearance and improvement areas. It required housing accommodation to be provided in advance for those to be rehoused, and created the principle that compensation should not be payable in respect of unfit houses. With regard to the proposed improvement areas, which were envisaged as being large areas of houses and other properties, local authorities were empowered to demolish or repair unfit dwellings, buy land and demolish buildings so as to leave a developable site. Local authorities had to deal with overcrowding, which parliament failed to define. The concept of the improvement area was directed against urban decay. While local authorities used the clearance powers widely, they were reluctant to experiment with improvement areas. The Housing Act 1935 made changes in the procedures for dealing with redevelopment, although this was little used. The Act did, however, tackle the problem of overcrowding by defining it. It required local authorities to survey all houses below a given rateable value and to certify the number of people allowed to dwell in such houses. Local authorities were also empowered to deal with overcrowding cases of which they became aware. The Housing Act 1936 consolidated previous practical, as opposed to financial, housing legislation, and considerable slum clearance and repair activity was stimulated. The Second World War brought virtually all housing activity, slum clearance, and new building to a stop. What repair resources were available were diverted to dealing with war damage, so that there was little routine maintenance of houses. At the end of the war, housing was in extreme stress. Physically, the housing stock had been depleted by air raids; many houses had drifted into unfitness because of lack of maintenance; few of the formerly unfit houses had been demolished;

and very few new houses had been built. Sociologically, the position was exacerbated by the effective demand for higher housing standards; by the abandonment of houses perceived as being unfit for habitation; and by the increased rate of household formation. The housing question became important politically and sociologically, as well as from the aspect of public health. It became apparent that future action would have to encompass the removal of unfit housing, the elimination of overcrowding, and the repair and improvement of the housing stock. In the years after 1948, there was a succession of Housing Acts designed to promote competing political programmes for house building, slum clearance and improvement. The Housing Act 1949 made the first provision for the improvement of houses through grant aid although, in the light of subsequent developments, this was an experimental and meagre approach. The Housing Act 1954 required local authorities to survey all the houses in their district to determine which dwellings were unfit for habitation. These surveys revealed the magnitude of the task. In the big cities, the rate of unfitness was staggering. In Birmingham, 16% of all houses were judged to be unfit, in Manchester 33%, and in Liverpool 43%. The Housing Act 1957 was a fundamental restatement of housing law that made significant changes to the law relating to repair and clearance of unfit properties. For the first time, England and Wales were given a statutory definition of what constituted a fit house, and that definition was wide enough to permit a liberal interpretation of what constituted unfitness. Prior to that the standard of unfitness had to be related to the general local standard of housing; the new definition applied nationally and allowed districts where housing standards were low to bring their housing gradually up to the national level. The Housing Act 1964 contained important provisions relating to the supply of water to houses and the possibility of grant aid in that regard. Attention began to focus on other aspects of housing that could affect human health, such as the improvement of houses, the universal provision Copyright © 1999 Taylor & Francis Group LLC

of standard amenities, and the upgrading of whole areas by the repair and improvement of the houses and softening of the external environment. The Housing Act 1969 was largely the legislative outcome of the report of the Denington Committee (Our Older Homes—a call for action). It suggested the need for a fresh approach to house improvement, and emphasized the impact a bad external environment had on housing. Out of this legislation came the concept of the general improvement area. It was, of course, impossible to discuss housing except by understanding what constituted a satisfactory house. While the Housing Act 1957 had set out a standard of fitness, it did not address such questions as space and amenity. In 1953, a working party was set up under Parker Morris to inquire into, and make recommendations for, standards of accommodation in houses. The report from that working party was well received, and the standards it promoted were widely adopted by local authorities and better house builders. However, at a later date, in the interests of financial economy, these standards were less well observed. In the 1970s and 1980s, there were further Housing Acts. Most of these were designed to liberalize and stimulate the repair, renovation and, especially, the improvement of houses individually and in areas. With the Housing Act 1974 came the concept of the housing action area, where the intention was to provide minimum repair and improvement to houses that were of poor standard and likely to be included in clearance proposals within 10 years. This was an imaginative approach to the challenge to provide early improvement of living conditions in houses that were approaching the end of their useful life. Sadly, the impact of inflation on building and improvement costs made the schemes impracticable except to a standard of repair and improvement to ensure a 30-year life. This Act also made radical, and enhancing, changes to the improvement grants schemes, and initiated a decade of great activity in the rehabilitation of houses. The Housing Act 1980 was designed to tidy up the provisions for house improvements, but it also made radical changes to tenure patterns,

including the power of tenants of local authorityowned dwellings to purchase the houses at substantial discounts. This was a right denied to tenants of rented houses in other ownership. By the early 1980s, it was realized that the postwar housing legislation needed consolidation, and this was achieved in the Housing Act 1985, which drew the threads together but made few changes. The main object of the Housing Act 1988 was to alter, again, the pattern of tenures. The main thrust of the previous decade had been towards increased owner-occupation of houses, and houses sold out of the rented stock for owner-occupation obviously diminished the rented sector pool, which caused difficulties. By introducing new forms of tenancy, it was hoped to induce more owners to put houses into the pool for renting, but this did not occur. The Act also introduced a scheme to create housing action trusts in which it was hoped that large, run-down council housing estates would opt for management by such trusts, which were promised liberal support denied to local authorities to enable them to deal with their own houses. It had also become apparent that the liberalization of the house improvement scheme had led to much grant aid being given for properties not in the greatest need of repair and improvement, and the Local Government and Housing Act 1989 aimed to redress that balance. There was also a great need to make the improvement grant system less cumbersome to operate. The 1989 Act addressed these problems, making radical changes in housing law, including a new concept of the fitness of a house, the nature of grants available (but retaining the concept of a mandatory grant), and provided for the testing of an applicant’s ability to contribute to the cost. These new provisions and procedures made most local authorities revise their private housing sector activities. Further revisions were made in further housing legislation in 1996. (See Chapter 23.) In the 1980s there was a significant shift in political opinion in respect of public involvement in housing policies, from considerations of the health and welfare of house occupiers, to financial and sociological aspects. Local authority tenants Copyright © 1999 Taylor & Francis Group LLC

were empowered to buy their houses, thus introducing enclaves of private property into monolithic, council-owned estates. It gradually became very difficult for councils to build new houses to enable them to continue to provide rented accommodation. Increasingly, the private sector and housing associations were entrusted with the provision of rented housing, while the drive towards increased owner-occupation encouraged private house building. The statutory overcrowding provisions remained, but were largely ignored as being irrelevant in the post-war era, with most local authorities working to their own higher standards. Throughout the industrial period, dwellings used for multiple or common occupation have been a problem. Multiple occupation continued as a serious issue in many towns and, although grant aid became available for improving such properties, many continued to be grossly unsatisfactory. There was much pressure by interested groups to secure legislation that would permit more effective control. The worst housing provision has always been considered to be the common lodging house. In the inter-war years, the privately owned common lodging house run for profit virtually disappeared; those that remained were frequently owned by charitable organizations and were developed on almost institutional lines. In the 1970s and 1980s, the situation changed as a number of smaller properties were adapted. This was usually done by a charitable body to provide sheltered accommodation for small groups of socially vulnerable people. In addition, former commercial premises were often adapted as night shelters for people who would otherwise sleep in the open. The common lodging house remains a social and public health hazard, but one that often needs a compassionate approach, although there is now no separate housing legislation dealing with them.

FOOD SINCE 1900 Although local authorities had had powers to inspect food for many years, it was becoming apparent that some control over the premises in

which food was handled was required if clean and safe food was to be available. The Public Health Act 1925 introduced the first powers to deal with food premises and, although the requirements were modest, they extended to water and washing facilities and cleanliness in certain food premises. A start had been made on the road to better food hygiene. By 1920, large-scale adulteration of food had ceased, although there were foods that were easy to adulterate, a typical example being milk. The basic law with regard to food adulteration had remained unchanged since 1875, and clearly needed to be consolidated. This was done in the Food and Drugs (Adulteration) Act 1928, which was to remain in force for a decade. The Act neither re-enacted the food safety provisions of the 1925 Public Health Act, nor included supplementary food safety powers. The Ministry of Health advised through Memo 36/Foods how the Act was to be operated. A similar ministry memo (Memo 3/Foods) laid down inspection standards with regard to meat. Some local authorities understood that their powers to deal with food-borne diseases and insanitary conditions in food premises were inadequate and, especially in the 1930s, through private act legislation, they took some regulatory powers of registration of some types of food premises and their occupiers. The Food and Drugs Act 1938 was both consolidatory and innovatory. It had three main parts: the protection of food supplies, the sampling of food and drugs, and the control of certain food premises. It made provision for the inspection of food and for the control of some premises in which food was handled. It gave the ministers powers to make regulations in respect of the registration of some food premises and some practices of food handlers. It reaffirmed sampling procedures and the provisions with regard to warranties, and it made possible the control of such premises as slaughterhouses, knacker’s yards, cold stores and markets. Regrettably, the new Act did not come into force until after the outbreak of the Second World War, but although its full implementation was delayed, especially with regard to the potential Copyright © 1999 Taylor & Francis Group LLC

advances in food hygiene legislation, the war period was particularly active and productive in terms of food control. Faced with food shortages, a rationing and food control system ensured that the diet of the public was better than it had ever been. To ensure that food was the most nutritious available, a considerable number of regulations were promulgated, and most of these later found a place in permanent food law. The 1938 Act made provision for ministers to introduce regulations on a variety of topics related to food safety, and in 1955 the first regulations designed to provide a food hygiene code were introduced. These were for general application to food premises, and were followed by comparable regulations for docks and warehouses, market stalls and delivery vehicles, and slaughterhouses. These were timely because in 1954 the meat trade ceased to be subject to control. The slaughterhouses that had been closed by the policy of concentrating slaughtering facilities were able to apply for the renewal of their licences, but very many failed to achieve the standards required and remained closed. After the 1938 Act had been passed there were numerous changes in the food industry and its practices, especially in the replacement of small factories and shops and the development of larger scale production, distribution and retail units. There was a need for the modernization of the core legislation. This was achieved in the Food and Drugs Act 1955. Much food control law was contained in regulations that could be easily changed but, nevertheless, that law continued to lag behind developments in food technology and retailing, areas that were perpetually responding to market forces to meet changes in taste and lifestyle. After the 1955 Act, there were many updating amendments to existing food law, particularly to the regulations, as attempts were made to meet current needs. Other developments were to come. After the experiences of the period between 1920 and 1945, there was a view that food adulteration was a solved problem. After about 1950 the industry changed to the large scale processing of food, which resulted in a lowering of compositional standards.

The post-1945 period saw a major increase in the number of cases of food-borne diseases. While notified cases of food poisoning have increased significantly, much attention has been focused on unnotified incidents. Enquiries into causes and effects have suggested that changes in diet and dietary and social habits were major causes. Also implicated was poor food hygiene, which resulted in a call for more public information and training of food handlers. The increasing importance of good food hygiene brought the realization that it was difficult to act swiftly and decisively to deal with food premises that were so insanitary as to pose a serious risk to health. In 1971 the city of Manchester took powers in the Manchester Corporation Act 1971 to enable its environmental health officers to close insanitary food premises by direct application to the courts. The value of this power was clear and the Food and Drugs (Amendment) Act 1976 gave similar, but less rigorous, powers to local authorities generally. The Manchester powers, slightly modified, were applied to the other nine metropolitan district councils in Greater Manchester when, countywide, local act legislation was consolidated. There was pressure from all sides to review the food law and in 1977 the ministers asked for the views of interested bodies on how the food law should be amended or recast. Many organizations, including the Institution of Environmental Health Officers, responded. However, no action took place except to find parliamentary time to produce the Food Act 1984, which consolidated the existing law but made few changes of significance. From 1973, the whole issue of food legislation was complicated by legislation from the European Economic Community (EEC), as it was then called. By the time the UK joined the EEC there had been a great deal of legislation, including laws relating to food, that had to be accepted as it was. After 1973, the UK was able to participate in the discussions that preceded further food legislation, but was always at a disadvantage because Continental systems of food control were very different from those in the UK. There followed Copyright © 1999 Taylor & Francis Group LLC

a considerable flow of statutory instruments converting EEC directives into UK law. From the 1970s into the 1980s, the many organizations that had an interest in food legislation continued to press for amending legislation. This was met with little success until, after a series of food safety incidents, central government conducted a survey of views and issued a white paper on food safety. In due course, the Food Safety Act 1990 was passed. This legislation provided some satisfaction for those who had been pressing for change. However, although the Act conceded many principles that had been urged upon the government, the actual fulfilment of those principles was to be met largely by regulations. Control through statutory instruments has important advantages as they are easier to amend or extend, but they are also normally the means of writing in the detail to clothe the principles in the legislation and, as such, may fall short of real expectations or needs.

OCCUPATIONAL HEALTH AND SAFETY SINCE 1900 Factory law was reviewed, extended and consolidated by the important Factory and Workshops Act 1901, which was divided into 10 parts covering many aspects of industrial employment. For many years, the work of the Factory Inspectorate had been increasing, and it had been difficult to do enough inspections. Despite the indifferent performance of local government in the health and safety duties assigned to it, it was considered imperative that its role should be extended. As a result, local authorities were made responsible for sanitary accommodation in all factories, and for creating a more effective system for dealing with ‘homework’. When the Shops Bill was before parliament, there was opposition to bad working environments and excessive hours. In 1910, Hallworth and Davies said that a large number of shop assistants in London worked all their waking hours on most days of the week [8, p. 64]. At a drapery store employing about 30 assistants, the staff worked

until at least 10 pm on five nights of the week: ‘They were herded at night into a dilapidated house in one of the neighbouring mean and dirty streets and, although they seldom left the shop before 10 o’clock at night, they had to be in the dormitory by 11 o’clock’ [8, p. 64]. There was an unsuccessful attempt in 1909 to give shop workers some of the health protection that factory workers had, and there was a wish that the legislation, not then usually an environmental health function, would be enforced by the Factory Inspectorate. However, the Shops Acts 1912 and 1913 brought consolidation of the law and some improvement. But the law was still insufficient and inadequately enforced, and this demonstrated that shop workers’ conditions, like those of the factory workers, were being improved in a piecemeal fashion. The legislative position remained unchanged until the Shops Act 1934, which introduced important changes. It controlled the hours of work for those under 18 years of age, and for the first time it introduced health and welfare provisions for workers in shops and those in offices attached to shops. Shop working hours were to be enforced by Shops Act authorities (county and county borough councils). The welfare provisions, which included sanitary and washing facilities, heating and ventilation, facilities for taking meals and the provision of seats for female workers, became the responsibility of sanitary authorities (rural and urban districts, municipal boroughs and county boroughs). Up to this time, environmental health officers had had a declining interest in work involving workshops as such places decreased in number and became factories in which, as officers, they had much more limited responsibilities. The Shops Act 1934 changed this, and there was a renewed interest in occupational health. On the whole, the work of the local authorities under the welfare provisions of the 1934 Act was so well done that it was later to lead to a greater involvement in occupational health and safety. Although better provision was made for shop workers, there were still many non-industrial workers who had no occupational health protection at all, and this was to remain the case for some Copyright © 1999 Taylor & Francis Group LLC

time. In 1946, the government set up an interdepartmental committee, chaired by Sir Ernest Gowers, to look at the needs of non-industrial workers. The Gowers Committee reported in 1949, and its report had a delayed, but important, impact on occupational health and safety legislation. The consolidating Shops Act 1950 owed little to the influence of the Gowers Report. The Factory Act 1951 was a consolidation of previous legislation, and it met the perceived need of the industrial worker. However, it gave little further protection to land workers or those in non-industrial employment. Post-war developments in agricultural practices, machinery and the chemical control of weeds and pests posed a substantial threat to the health and safety of the workers involved. The first occupational health legislation that implemented recommendations of the Gowers Committee was the Agriculture (Safety, Health and Welfare Provisions) Act 1956. The enforcement of this Act was entrusted mainly to the Agricultural Inspectorate and not to local authorities, whose role under this Act was equated with their, then, limited duties under factory legislation. The Offices Act 1960, a private member’s bill, followed Gowers’ recommendations. The Secretary of State could make regulations, after consulting interested bodies, prescribing standards for offices. However, such regulations were never made, probably because other measures were being prepared, and the Offices Act 1960 was never put into operation. In 1963 the Offices Shops and Railway Premises Act was passed. It excluded many non-industrial workers, but it did cover offices and wholesale and retail premises. Most enforcement duties were assigned to local authorities, and records of local authority activities were subsumed into national statistics. Factory inspectors had some concurrent powers, and Superintending Inspectors of Factories had oversight over local authority work to ensure uniformity of practice and standards of enforcement. Under this Act, regulations were made prescribing health and safety standards. Environmental health officers, to whom the local authority role was largely assigned, were

experienced in the hygiene of buildings, and the administration associated with legislation, but they needed to learn new skills in ergonomics and the safe operation of powered machinery. When the Bill was before parliament, there was opposition to it being made a largely local authority function. In theory it is easier for a central authority to achieve common standards of performance and enforcement, and there can be little opportunity for local influence to minimize the scale of activity. But central authority is never likely to have the local knowledge of the pattern of the problem; or to be subject to the constant probing of the elected members of councils responsible for enforcement; or to have an inspectorate that is as sensitive to local cultural patterns and traditions as it should be. In contrast, centrally organized inspectorates can invest heavily in specialist skills and supporting scientific staff. The 1963 Act was important to local authorities in respect of their involvement in the enforcement of occupational health and safety, and it gave them an opportunity to make a mark. Although this Act was a large step forward, it still did not protect all non-industrial workers, and the law needed further extension. Legislation to protect workers had been developed on an ad hoc basis with separate inspectorates for different working environments, and there were gaps and overlaps in jurisdiction. It was obvious that the system needed a radical overhaul to enable it to deal with changes in technology, patterns of trade and commerce, lifestyles and public expectations. It was clear that conditions within the workplace could affect the public outside it. Processes were often hazardous to the worker on the shop floor and to others in and outside the factory. Many thought that in order to promote safety, healthy working conditions and to avoid prosecutions for infractions of the law, improved education and training were needed. Others urged co-operative efforts to reduce hazards, improve health and replace coercion and confrontation. In 1970 a Committee of Inquiry was set up under the chairmanship of Sir Alfred Robens to review the system of securing health and safety at work. It reported in 1972 [9] and it recommended the following. Copyright © 1999 Taylor & Francis Group LLC

1. A more united and integrated system to increase the effectiveness of the contribution to the health and safety at work made by the state. 2. Conditions for more effective self-regulation by employers and employees. 3. A Health and Safety Commission with an executive arm to be called the Health and Safety Executive. 4. A continued enforcement role for local authorities which would ultimately be responsible for most of the non-industrial sector. The committee also laid down two other principles: no self-inspections or dual inspections were to be undertaken. The recommendations of the committee found expression in the Health and Safety at Work, Etc. Act 1974, which brought six significant changes for environmental health authorities. Their role was to be expanded and the officers they appointed to administer the Act would have concurrent powers with Health and Safety Executive officers. Thirdly, the subordinate role given under the 1963 Act was removed, and the local authority inspectorates were given equality of status with those of the Health and Safety Executive. Additionally, the changes required local authority inspectorates to recognize the Health and Safety Executive as the commission’s administrative machine, and to support and cooperate with the Health and Safety Executive field staff. The sixth change was in the administrative procedures. Although these brought new concepts to environmental health departments, they were readily and advantageously adopted. The new creation was not perfect. Environmental health officers felt aggrieved at the time, because continued Crown immunity meant that they were excluded from inspecting civil service establishments (except those of the Health and Safety Executive), and they could not deal with premises occupied by other local authorities that were located in their area. It was also recognized that environmental health officers would need additional skills. Factory inspectors saw local authority officers as a challenge, an attitude later exacerbated by civil service retrenchments.

There was an unsubstantiated fear that local authority elected members would interfere with their officers’ operations. The civil servants were ill informed about the local government system, its traditions, training, and capacities and the practical achievements of the environmental health service. These were matched by a similar misunderstanding in local government circles of the civil service role, qualifications and training. If the two major arms of enforcement were to work harmoniously to produce an effective national system with uniform standards of performance and enforcement a system of liaison had to be introduced. Nationally, a liaison committee, Health and Safety Executive/Local Authority Committee (HELA), representing the Local Authority Associations and the Health and Safety Executive was established as a forum to discuss problems, especially in the field of common standards, information exchange, statistics and developments, and to make recommendations for changes perceived to be necessary. The HELA set up subgroups to have regard to training, standards of enforcement and statistics and, in 1984, a Local Authority Unit was established. This unit, designed to give local authority views open access to the system and to harmonize practices and approaches, was staffed, in part, in technical aspects, by environmental health officers and factory inspectors. It has been responsible for developing uniform standards and raising the local authority profile in this important work. Locally, a senior factory inspector is appointed in each Health and Safety Executive area to act as the local Enforcement Liaison Officer, whose remit is to assist in the solution of local demarcation and technical problems, and to call periodic meetings of local authority counterparts for discussions and exchanges of experience. The local authority role was defined in the Health and Safety (Enforcing Authority) Regulations 1977. It was always the intention to extend the local authority role and, in 1983, discussions started with the object of revising these regulations. But despite agreement between the officers engaged in this task, there was considerable delay in new regulations (Health and Safety (Enforcing Authority) Copyright © 1999 Taylor & Francis Group LLC

Regulations 1989) being promulgated, and the changes made were less extensive than had been originally envisaged. The Health and Safety (Enforcing Authority) Regulations 1998 have now replaced those of 1989 and widen the local authority role (see Chapter 25).

AIR POLLUTION CONTROL SINCE 1900 This period is characterized more by a better understanding of the problems of air pollution, the emergence of air pollution monitoring, and the growth of organizations committed to securing improved air quality, than by improvements in pollution control legislation. The emergence of pressure groups arguing for powers to deal with polluted air began at the turn of the century. By the 1880s, the relationship between air pollution, fog formation, and increased mortality had been accepted. In London and other big cities, choking winter fogs were commonplace. A Fog and Smoke Committee, an organization that had the practical help of many distinguished people, was established in London in 1880. However, the precise causal relationship between air pollution and ill health had still to be defined. The political difficulty of controlling domestic smoke was also understood, and the Fog and Smoke Committee was determined to try educational means to overcome the problem. In 1882, the Fog and Smoke Committee became the National Smoke Abatement Institution, which developed into a powerful lobby but was replaced in 1896 by the Coal Smoke Abatement Society. While this organization was primarily a London body, which for some time employed its own smoke inspectors, similar organizations were also formed in northern industrial towns. Manchester, in many ways the cradle of the clean air movement, had a special subcommittee to research into air pollution. In 1909, it became the headquarters of the Smoke Abatement League of Great Britain, which was an amalgamation of a number of societies including Manchester’s own Noxious Vapour Abatement Committee. It is important to emphasize the interest that these local societies had generated, and how they recognized

that the strength of a unified organization was more likely to be an effective pressure group. Although there were now two national organizations, the League sought the co-operation of provincial local authorities leaving London to the Coal Smoke Abatement Society. The First World War restricted the activities of the two major groups, but they resumed their campaigns after 1919. The Coal Smoke Abatement Society continued its pressure on politicians, and this led to a Ministry of Health Departmental Committee in 1926 and, later, the Public Health (Smoke Abatement) Act 1926. This Act was of minor importance in dealing with the smoke pollution burden, but it marked the increased interest in air pollution, and led to changes in the attitudes of central government. There were some interesting developments in the 1920s. In conjunction with a London environmental health officer, E.D.Simon, a leading industrialist, politician, and former Lord Mayor of Manchester wrote a book entitled The Smokeless City [10]. Apart from showing that the significance of domestic smoke was understood, the book makes clear that fuel and appliance technology that could have reduced air pollution from domestic fires was already available. Although the positive relationship between air pollution and ill health had still to be established, in 1923 Dr James Niven drew attention to the air pollution in Manchester, the diminished sunlight and the high incidence of pulmonary and other diseases. The increasing interest in air pollution during the mid-1920s induced central government to consider providing local authorities with advice. When the Alkali Inspectorate declined to be involved, it was decided that the task of collecting information should be given to one of the three Ministry of Health officials. Ministry minutes of the day recorded resistance to the idea of promoting further smoke control measures. It was considered that the public was not ready for measures as no causal connection had been established between polluted air and ill health. Whoever wrote that was unaware of the documented circumstantial evidence that showed a clear correlation between smoke, fog and increased mortality. J.C.Dawes was then selected to be the advisory officer. He was a refuse disposal expert, an Copyright © 1999 Taylor & Francis Group LLC

environmental health officer by profession who later became president of the Institution of Environmental Health Officers from 1938 to 1952. In 1929 the Smoke Abatement League and the Coal Smoke Abatement Society amalgamated to form the National Smoke Abatement Society (NSAS). The League, based in Manchester, had appointed a full-time secretary, and the amalgamation was a positive move forward. Fortunately, the new body was able to retain the services of many of its prominent lay members who worked for the cause of clean air, and the support of environmental health professionals. It was recognized that smoke control was mainly the province of environmental health officers and their support for the movement for clean air was crucial. It was, however, a lay member of the NSAS who produced the seminal concept of the smokeless zone. Charles Gandy, a Manchester barrister, conceived the idea. Manchester City Council, long committed to clean air, supported the concept. From about 1928, some local authorities began measuring air pollution. Although the equipment then available was relatively crude, it did at least yield measurements that could be used as evidence and be compared over different time periods and geographical areas. Despite this and other research, practical action had to be delayed until after the Second World War. In 1946, the city of Manchester was able to secure, in a private Act of Parliament, powers to establish a smokeless zone. Other authorities, encouraged by the NSCA, took similar powers. The new powers took some time to implement, and it was not until 1954 that Manchester had its first smokeless zone. Local authorities became more interested in air pollution control and appreciated the transboundary nature of smoke pollution. This recognition made it easier to establish local committees to co-ordinate local smoke abatement, and some of these organizations were successful and long lived. Despite the increasing pressure, little had been done by central government to give adequate powers to local authorities to deal with smoke, especially domestic smoke.

In December 1952, London, as a consequence of persistent temperature inversion, suffered a particularly dense and persistent fog that had disastrous consequences in terms of human mortality. Later statistical analyses suggested that the mortality in excess of the normal death rate was in the order of 4000 people. Under pressure, the government appointed a committee under a prominent industrialist, Sir Hugh Beaver, to investigate the problem and make recommendations. The committee made rapid progress, but there was more pressure, and a private member, Gerald Nabarro, approached the NSAS for a draft Bill and other assistance. That Bill failed, but the pressure on government was so great that it adopted a similar Bill and, during its passage, Nabarro acted as the principal spokesman on amendments suggested by the NSAS. The Beaver Committee was aware that much needed to be done, but there could be no quick solution. The aim would be to secure an 80% reduction in air pollution in the heavily populated areas over 10–15 years. The new legislation in the Clean Air Act 1956 embodied principles that had been proposed for years by bodies pressing for clean air and by the authorities responsible for controlling air pollution. Air pollution from industrial coal burning plants was less of a problem because the economies achievable by the proper combustion of the fuel had made companies install adequate plant and operate it with skilled engineers. The new legislation proposed to deal with domestic smoke by adapting the smokeless zone principle into smoke control areas, in which all premises would be subject to some control. The control over industrial premises was already available, but domestic premises would be required to be able to burn smokeless fuel. Although the grant was only to be 70% of the cost of the change, that level was chosen to reflect the fact that the new appliances would be much more efficient and burn less fuel. No grant was available for commercial premises, which nevertheless had to comply. The new interest in air pollution control caused a re-examination of the powers of the Alkali Copyright © 1999 Taylor & Francis Group LLC

Inspectorate and local authorities. The Beaver Committee had urged that the central and local inspectorates should work closely together, and the subsequent closer contact brought better cooperation and improved working arrangements. Many of the larger authorities argued that they could be responsible for all air pollution control, but in the end they were left with responsibility for a few installations while some of those they had previously been responsible for were transferred to the Alkali Inspectorate. Three large local authorities were allocated control over three smallsized power stations. One effect of the Clean Air Act 1956 was a major increase in the monitoring of air pollution by local authorities, and the development of a national survey assisted by these local authority statistics. When the UK became a member of the EEC, it was required to meet the air pollution standards set down by it, and this necessitated a rearrangement of the monitoring activities.

OTHER FORMS OF POLLUTION Originally, the investigation into air pollution was directed against the products of the combustion of coal, but after about 1970 there was increased interest in other gaseous pollutants, especially those emanating from internal combustion engines. A keen public interest began to develop in all forms of pollution, and this found expression in the control over the deposition of hazardous wastes. The first control was exercised in the early 1970s by the then equivalent to the district council through a licensing system. Pressures for more effective law persisted, and the Control of Pollution Act 1974 was passed as a consequence. This Act was designed to give better control over various forms of pollution, including air pollution and the pollution of land. This coincided with the reorganization of local government, and the duty of dealing with hazardous wastes was given to ‘waste disposal authorities’ which, in England, were the county councils. The anti-pollution movement grew increasingly strong, and there was much public pressure for protection from environmental pollution, including

noise pollution. As a result, the Water Act 1989 was passed bringing in new measures to control water pollution. The Environmental Protection Act 1990 gave measures for the control of other forms of pollution. The objectives of the 1990 Act included the creation of an integrated national pollution inspectorate, which would involve local authorities in the control of certain scheduled industrial processes. The Act also strengthened the controls for dealing with the disposal of waste on land. The pressures for more comprehensive environmental control included very considerable international pressure for action to be taken to deal with pollution problems that had transboundary effects, such as the pollution of international water courses, and the acidification of rain by the emission of sulphur gases from the combustion of fossil fuels. There was great interest in global warming, the rise in carbon dioxide levels, and the use of chlorofluorocarbon compounds.

THE ROYAL COMMISSION ON ENVIRONMENTAL POLLUTION Royal Commissions of Inquiry are one of the prestigious ways by which the UK government institutes a formal inquiry into a particular topic. It is carried out by a body of distinguished people who, while not necessarily experts in the particular topic under review, are capable of mounting a sustained and penetrating inquiry by means of examining papers and listening to oral evidence from expert witnesses. Most Royal Commissions are appointed for a single task, but the Royal Commission on Environmental Pollution is a standing commission that has undertaken a series of investigations into issues of pollution, publishing an authoritative report after each inquiry.

PROFESSIONAL RELATIONSHIPS The Public Health Act 1848 required local boards of health to appoint an ‘officer of health’ and an inspector of nuisances. Both were separate Copyright © 1999 Taylor & Francis Group LLC

appointments and, in this the Act followed the Liverpool Sanitary Act 1846. The duties of neither office were prescribed, but those of the medical officer of health were influenced by advice from the local government board. Following the Public Health Act 1872, the local government board made a series of orders prescribing qualifications, appointment, salaries, and tenure of office of medical officers of health and inspectors of nuisances. The duties of the medical officers of health in London were defined in 1891. In 1910 the Sanitary Officers (Outside London) Order defined medical officers’ duties and it applied also to inspectors of nuisances. The conditions of office and tenure of medical officers and sanitary inspectors were prescribed by the Public Health (Officers) Act 1921. That Act required that their dismissal could only be with the consent of the minister, and it also required that the term ‘inspector of nuisances’ be replaced with the designation ‘sanitary inspector’. Between that date and 1974, various other orders of a similar kind were promulgated, and these had the effect of requiring public health inspectors to work under the general direction of the medical officer of health. In 1955, the designation was changed to public health inspector by the Sanitary Inspectors (Change of Designation) Act 1955. The current designation of environmental health officer began to be adopted about 1970, and became accepted as the designation after local government reorganization in 1974.

THE DEVELOPMENT OF LOCAL GOVERNMENT Environmental health control has been associated with local government for many years; indeed, it would be true to say that local authorities grew out of the original environmental health authorities. The history of local government is a specialist topic, and all that is recorded here are the steps that created the local government bodies to which reference is made in past, and some existing, environmental health legislation.

The Public Health Act 1848 established local health boards. The Public Health Act 1872 created the sanitary authorities, which would be responsible for all sanitary functions within their areas. The Public Health Act 1875 created urban and rural sanitary districts, with the former comprising either municipal boroughs, local government districts, or an Improvement Act district. Rural sanitary districts were the responsibility of the Board of Guardians. The Municipal Corporations Act 1882 created a modernized form of municipal borough, and the Local Government Act 1888 set up county councils and county boroughs. This Act also created the London County Council and, with 32 metropolitan boroughs, replaced a wide miscellany of former authorities. Urban District and Rural District Councils emerged from the 1894 Local Government Act to replace the urban and rural sanitary districts. After the Public Health Act 1872 the local government board could approve the establishment of Port Sanitary Authorities and assign functions to them. Furthermore, under the Public Health (Ports) Act 1896, the local government board was empowered to invest Port Sanitary Authorities with duties in respect of communicable diseases. The Local Government Act 1929 reformed the poor law system. It abolished the Boards of Guardians and vested their social and medical work in county councils and county boroughs. There were major changes in the pattern of local government in London and the Midlands in the 1960s. In the Greater London area, 34 London boroughs were set up to take over the functions of a large number of smaller authorities, and London boroughs had powers similar to those of county boroughs except that some did not become education authorities. After a long deliberation by the Redcliffe-Maude Committee, proposals to change local government to a series of single-purpose authorities were not accepted by the government, and the Local Government Act 1972 was used to create a new system. The 1300+ councils in England and Wales were reduced to about 400 shire districts. Metropolitan counties were created to cover London and six other conurbations. Additionally, Copyright © 1999 Taylor & Francis Group LLC

36 metropolitan district councils were established by amalgamating a number of authorities. Constitutionally, these councils were very similar to the former county boroughs and, indeed, in most cases a former county borough formed the core of a new metropolitan district. The shire districts had limited functions but were responsible for housing and environmental health, but the metropolitan districts were ‘all purpose’ authorities. A comparable system of regional and district councils was created for Scotland. One consequence of the 1974 local government reorganization was that conventional environmental health administration continued in two main streams. In many cases environmental health sections of multidisciplinary health departments became autonomous departments dealing with environmental health and peripheral issues. In others the environmental health function was combined with other activities, such as housing, in which the new combined department was often headed by an environmental health professional. In this type of development the environmental health function was sometimes subsumed into a technical services department. One of the features of the development of environmental health law in the 100 years prior to the 1974 reorganization of local government was that local authorities promoted private act legislation in which enhanced environmental health powers were incorporated. When central government promoted public health legislation the environmental health provisions in private Acts of Parliament, which had been tested in practice and proved to be practical, were often made the basis of general public health legislation. The Local Government Act 1972, the basis of the reorganization, provided that the former private act legislation was to be consolidated on a countywide basis. The result of this was that the residents of many local authorities that had been absorbed into new authorities enjoyed a wider protection through the new consolidating acts than had previously been available to them. In 1986, the Greater London Council and the six metropolitan counties were abolished. Functions that could not be returned to district councils were assigned to ‘residuary bodies’. The Greater London Council and the metropolitan counties had no

environmental health functions other than the disposal of refuse. Further measures to reorganize local government took place in the 1990s. Some former county boroughs resumed their ‘all purpose’ status, and this was also accorded to some large district councils that had resulted from amalgamation. Reorganization in Wales and Scotland made the provision for local government to be the responsibility of ‘unitary’ authorities, each of which was an ‘all purpose’ authority. In all cases the environmental health function remained with local government at the lower tier. There are some instances where an internal reorganization located the environmental health function with the planning activity, and this does, at least, mean that the care of the environment, especially the built environment is the responsibility of a single department and, usually, committee.

CHANGES AND CHALLENGES However, 1974 was the beginning of almost continuous change, some of which affected environmental health practice. The factors that brought these changes were numerous. There was increasing public awareness of, and involvement in, environmental issues, and although environmental health might claim a primacy because of its concern for human health, other streams of activity also claimed a place in the protection of the environment. Because of the economic policies of central government, local government activities were constrained by financial and legislative moves. The conventional environmental health function remained, on the whole, with local authorities, but financial constraints on councils led to structural changes and resource reductions that often resulted in further amalgamations of the environmental health team with other activities. Government policies were directed to greater use of private sector resources and to centralization. Local authorities were compelled to allow private companies to tender for such activities as refuse collection and removal. The duty to oversee this primary environmental health activity remained Copyright © 1999 Taylor & Francis Group LLC

the function of local government. In many authorities, environmental health professionals had the responsibility for the day-to-day organization of this service but tended to be confined to specifying the level of service and monitoring the overall performance of the contractor. Simultaneous with the local government reorganization in 1974 came the allocation to local authorities of extensive functions under the provisions of the Health and Safety at Work, Etc. Act 1974. Central government did this in the face of fierce opposition because local authorities had done well in administering the welfare provisions of the Shops Act 1934 and the Offices, Shops and Railway Premises Act 1964. Further, the expenses that local government would incur in such enforcement activities would be a charge on local budgets and not on that of a central government department. This was really the first time that environmental health professionals had had to work in an arena dominated by a centralized organization and with the expectations that enforcement standards equivalent to those of the central inspectorate would be achieved. At last local government was able to participate in high level consultations on standards. Other considerations led to the creation of other centralized organizations that operate in fields that were either partly or wholly the province of environmental health professionals. While the movement had some clear political advantages in a climate that looked unfavourably on local government, there were other forces at work. Environmental control in the round was being influenced by advancing knowledge and the need for scientifically knowledgeable bases: field observation needed the support of science and was needed to furnish information to fuel further scientific advances. Such a system could conform better to a national pattern than it could to local needs. Being a member of the now renamed European Union (EU) also placed pressures on government, for as knowledge advanced there was a considerable interest in achieving uniformity of both reaction and monitoring. The Environment Act 1995 led to the creation of the Environment Agency, a centralized nondepartmental public body. In it are vested the

National Rivers Authority, H.M.Inspectorate of Pollution, Waste Regulation Authorities and some functions formerly in the domain of the then Department of the Environment. A number of environmental health professionals were employed by the merging bodies and continued to serve as this new organization could properly be regarded as having high level specialist environmental health functions. The Environment Agency is now responsible for flood defences, water resources, fisheries, navigable waters (rivers and canals), recreation and conservation, and in respect of pollution control for water quality and water pollution, radioactive substances, standards and licensing for controlled wastes, mine water pollution and reporting on the management of contaminated land, although this latter is still a local authority task. Air pollution control remains within the local authority domain and there are three main areas of action: • traditional nuisance control (dark smoke from chimneys), approval of boiler plant and chimney heights • control of pollution from designated processes (Part B processes) where constraints are imposed by guidance documents issued by the Department of the Environment, Transport and the Regions (DETR) • air quality management, which requires local authorities to establish whether any part of their area is subject to air pollution such that specific standards would be exceeded by 2005, the Secretary of State having reserve powers to act in default. The stages required as these are part of the National Air Quality Management Strategy, which is both following and leading EU legislation, are: — carrying out of assessments — using data obtained to model and implement counter measures, if necessary. In some cases, centralization was seen as the answer to the perceived failings of local government and pressures to imitate European solutions. For example, the meat inspection service was integrated into a national service because of a perception of Copyright © 1999 Taylor & Francis Group LLC

local government inadequacies despite the very long service rendered by local government in this field. A long-standing environmental health function was thus lost from local control to a centralized agency which, at least in its early days, did not meet the expectations aroused by centralization. For many years it was perceived that the central government approach to food control and safety and hygiene standards lacked a balance between the needs of the producer and the consumer. These shortcomings, together with a serious incidence of animal disease and a rising rate of food-borne disease, mean that there are plans to establish a Food Standards Agency, which will oversee food production and distribution in the widest sense, provide a scientific foundation for the food industries and monitor the enforcement performance of those agencies appointed to ensure that the prescribed regulatory provisions are carried out. In the field of food control there was, after much delay, a revision of the legislation, which reflected the increased importance of food safety. The Food Safety Act 1990 demonstrated this principle and made provision for its application by giving ministers extensive powers to make regulations. It seems clear that there needs to be a balance struck between the need in many environmental health activities to have a central point of scientific reference, the need for some activities to be carried out by specialists in that field, and the need for very local environmental control; such a balance is extremely difficult for a centralized body to furnish economically. Environmental health professionals are trained to take a holistic approach to environmental health problems as the interplay of environmental health situations means that only such an approach is appropriate; this then allows decisions to be taken about which specialist professional help is required.

INTERNATIONAL INFLUENCES Most of the legislation discussed in the preceding pages has been the consequence of the internal recognition that there was a need to deal with

specific problems, but it is important to understand that because environmental health problems are no respecters of national boundaries there are some issues that need an international dimension. One of the first problems to be faced internationally was the control of some important communicable diseases. As we have seen earlier, to some extent public health control in the UK was the direct result of a series of epidemics of cholera, a disease with a high mortality rate that is not indigenous to the British Isles and that affected all social classes. Most of the diseases that attracted attention were also characterized by their relationship to the movement of people: there is no recorded case of a communicable disease passing from one community to another faster than a person could travel. Between 1851 and the late 1930s, a series of International Sanitary Conferences took place in an attempt to prevent the transmission of exotic diseases. (Note that the term ‘sanitary’ was then used to denote something appertaining to health rather than its modern connotation, which relates to the removal of body wastes.) The usual procedure was for the conference to produce a convention (a form of treaty) after negotiations, and while that convention was signed by all the countries attending the conference, it had to be formally ratified by each government before it became binding. The first conferences took place because there was a genuine desire to make some progress but they were hampered by a lack of epidemiological knowledge. Later conferences were apprised of the latest advances in medical knowledge, but usually disregarded it. The importance of a public health system that could deal with the problems of imported disease was recognized in the UK and appropriate powers were enacted in the Public Health Acts 1872 and 1875. Port Sanitary Authorities were established and they were assigned the powers necessary for their work by the Local Government Board. By the mid-1870s the old concept of quarantine was being challenged and medical inspection was recommended in its place. This view was adopted by the 1874 International Sanitary Conference in Vienna. The 7th International Sanitary Conference Copyright © 1999 Taylor & Francis Group LLC

was held in 1892, also in Vienna, and produced the 1892 Sanitary Convention, which focused attention on cholera. This formed a useful starting point for effective international public health control, although a further conference (in Dresden in 1894) was needed to ensure that countries that had signed the convention notified each other of any cases of cholera they had. The British response was to enact the Public Health (Ports) Act 1896, which enabled the sanitary conventions to be observed. Further, the Local Government Board gave Port Sanitary Authorities powers under the provisions of the Infectious Diseases Prevention Act 1889. Regulations were made dealing specifically with cholera, yellow fever and plague, quarantine was abandoned and medical inspection procedures were prescribed. An 11th conference was held in Paris in 1903, and this resulted in the addition of plague to the list of ‘convention diseases’, but also produced the concept of a permanent international health organization. Thus, in 1907, of the Office International d’Hygiène Publique was set up in Paris, creating a worldwide system of reporting infectious disease. The new organization laid the foundations for a further conference in 1911/12. The sanitary convention that resulted from this conference added yellow fever to the list of convention diseases, and in addition to refining the processes for dealing with plague and cholera replaced the provisions of conventions signed in 1892, 1893, 1894, 1897 and 1903. In 1923, the League of Nations set up an office in Geneva to complement the work of the Paris office, and within 2 years it was producing weekly epidemiological reports of the world position relative to the incidence of the convention diseases. A further conference in Paris in 1926 added typhus and smallpox to the convention diseases, and the reaction of the UK was to produce the comprehensive Port Sanitary Regulations 1933. A major international conference in Paris in 1938 was notable because for the first time serious attention was paid to contemporary medical knowledge and the problems of travel by road, air and sea as it was now known that it was possible to import diseases during their incubation period.

The Second World War precluded further consideration of the issues raised by the 1938 conference. After operating through a series of healthrelated international organizations, the United Nations (UN) formed the World Health Organization (WHO) in 1946 to signal effect. It did away with the need for every country to ratify the conventions, which tended to make their implementation very slow, because the WHO was invested with the power to make regulations binding on every state that was a member. Wide consultations were required, but in 1951 WHO produced the International Sanitary Regulations, to be effective from October 1952. The UK revised its law relating to domestic control through the Public Health (Ships) Regulations 1979, the Public Health (Aircraft) Regulations 1979 and the Public Health (Control of Diseases) Act 1984. In dealing with world health problems, WHO does not confine itself to publishing measures that member countries should follow but embarks on practical health programmes, one of which, through international co-ordination and co-operation succeeded in eliminating smallpox. One of the more recent manifestations of the global nature of environmental health problems was the establishment of the International Federation of Environmental Health in 1985 (see p. 14).

THE EUROPEAN UNION Earlier in this chapter reference was made to the possibility of tracing the development of environmental health law, and hence practice, in a series of phases, but it was also speculated that the four periods noted might, with hindsight, be increased to five; without question, a fifth period would include the influence of the EU on British environmental law and practice. It should be remembered that the present EU has developed from an organization that was primarily centred not on health issues but on economic welfare, and it might be wondered why Copyright © 1999 Taylor & Francis Group LLC

an organization driven by economic considerations should have such an impact on environmental health. The reason for this is that there are environmental health considerations in many commercial activities, and because the EU is activated by commercial considerations it is bound to involve environmental health. A simple case will illustrate this. One major concern of the EU is for the economic environment of every member to be equal. Thus, if the particular issue is metal smelting, common enough in industrial communities, then every enterprise that is engaged in it must comply with the same standards of fume emission. Now, while metal smelting may be a commercial activity, the effluent fumes are an environmental health matter, and the EU, rightly, takes steps to ensure that all smelting plants operate to the same rules both as far as production is concerned and also in respect of the protection of the workers and the general public.

POSTSCRIPT Although this chapter is long, it affords only a brief introduction to the way environmental health control has evolved. Most of the topics covered here are treated in more detail elsewhere. From the account given it should be apparent that, while there has been a continual stream of environmental health legislation, there have been some periods (1875, the 1930s, 1974, and the 1980s) when developments took place simultaneously in several streams of activity. Experience also suggests that changes only come as a consequence of pressures on government, and such pressures are now tending to arise from the public rather than from official sources. Environmental health has always been in the lead in ‘social’ legislation and has thus tended to reflect contemporary political and economic thinking. Because of this, environmental health law has been the subject of the impact of deregulation and provides good illustrations of the conflict between the need to provide adequate protection and a perceived need to reduce the burdens of compliance.

REFERENCES 1. Hutchins, B.L. and Harrison, L. (1911) History of Factory Legislation, P.S.King & Son, London. 2. Gale, A.H. (1955) Epidemic Diseases, Pelican, London. 3. Finer, S.H. (1956) The Life and Times of Sir Edwin Chadwick, Methuen, London. 4. Frazer, W.M (1950) A History of Public Health, Ballière, Tindall & Cox, London. 5. Burnett, J. (1960) Plenty and Want, Pelican, London. 6. Engels, F. (1968) Condition of the Working Class in 1844, Allen & Unwin, London. 7. Ashby, E. and Anderson, M. (1979) Politics of Clean Air, Clarendon Press, Oxford.

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8. Hallworth, J. and Davies R.J. (1910) The Working Life of Shop Assistants, National Labour Press, Manchester. 9. Robens Committee (1972) Safety and Health at Work, Cmnd 5034, HMSO, London. 10. Simon, E.D. and Fitzgerald, M. (1922) The Smokeless City, Longmans, London.

FURTHER READING Brockinton, W.F. (1952) The World Health Organization, Pelican, London. Frazer, W.M. (1950) A History of Public Health, Baillière, Tindall & Cox, London. Haig, N. (1987) EEC Environmental Policy in Britain, Longmans, London.

3

The organization of environmental health in England and Wales William H.Bassett

THE NATIONAL FRAMEWORK The environmental health function in England and Wales is mainly operated at the local, community level through the unitary (single-tier) local authorities in London (London borough councils), in the metropolitan districts and in the non-metropolitan areas, including the whole of Wales. Elsewhere, in the remaining two-tier areas, it is the district council that is the environmental health authority, although county councils undertake some environmental health work, principally refuse disposal and food composition and labelling. There are proposals to create a new London authority to which some environmental health functions may be attached, e.g. London-wide air quality, but this is at an early stage of consideration. The proposals are contained in the white paper A Mayor and Assembly for London: the Government’s Proposals for Modernizing the Governance of London [1], and were supported by a referendum in May 1998.

CENTRAL GOVERNMENT DEPARTMENTS There is no single ministry responsible for the whole environmental health function, although the Department of Health is the focal point for the Copyright © 1999 Taylor & Francis Group LLC

broader public health activity, and also for the health-related aspects of environmental health. Within the organization of the Department of Health is the office of the Chief Medical Officer, who as well as having medical officers and scientists under his control, has a Chief Environmental Health Officer and several environmental health officers to advise on these issues. With the change in government in 1997, a new position of Minister of State for Public Health was created in the Department of Health. The minister appointed has responsibility for health promotion and public health issues, both generally and within the National Health Service (NHS). In addition, it is proposed to establish a Food Standards Agency (FSA) to be set up under the aegis of the Department of Health. Primary legislation is required but it is hoped that the FSA will be operational by 2000. Food issues currently dealt with by the central departments will then be dealt with by the FSA (see pp. 538–45). Responsibility for the various facets of environmental health is divided between different central departments. The main areas of division are as follows. 1. Department of Health (DoH) (a) broad overview of health effects of environmental issues, including microbiology and toxicology of the environment

(b) communicable disease control (c) health promotion (d) food safety and hygiene through the FSA (when created) and Meat Hygiene Service (MHS) (e) NHS, including hospital catering, nutritional therapy and environmental aspects. 2. Department of the Environment, Transport and the Regions (DETR) (a) housing (b) waste management (c) environmental protection, including recreational water and air and noise pollution (d) drinking water through the Drinking Water Inspectorate (DWI) (e) sewerage and sewage disposal (f) building regulations (g) by-law approvals, e.g. dog control (h) occupational health and safety through the Health and Safety Commission (HSC). 3. Ministry of Agriculture, Fisheries and Food (MAFF) following the establishment of the FSA (a) pest control (b) animal health and welfare (c) some responsibility (with the FSA) for animal foodstuffs (d) Pesticides Safety Directorate (PSD), an executive agency of MAFF (e) Veterinary Medicine Directorate (VMD), an executive agency of MAFF. 4. Home Office (a) by-law approvals, e.g. law and order including prohibition of the consumption of alcohol in specified public areas (b) licensing (c) Sunday trading.

THE WELSH OFFICE The position in Wales is different in terms of the organization of central government departments and the way in which the environmental health function is handled. The Welsh Office is a separate and independent government department. It reproduces, in microcosm, all the Whitehall departments, but there Copyright © 1999 Taylor & Francis Group LLC

are some notable variations. In line with arrangements for Scotland and Northern Ireland, the parliamentary head is the Secretary of State for Wales, who is a cabinet minister, and is assisted by two parliamentary undersecretaries. The head of the civil service in the Welsh Office is a permanent secretary, who has direct responsibilities for finance and establishment. Two directors head up the remaining operational groups. Somewhat like Whitehall, there is a separation of agriculture, particularly animal health, which is under one director, while the housing, environmental protection and health groups are under the other. Curiously, responsibility for management of the NHS in Wales is a direct responsibility of the permanent secretary, although the health professional group, headed by the Chief Medical Officer, has a direct input into its operation. The confusing management structure disguises the essence of the Welsh Office operation, which benefits from most departments being housed under one roof. While there is a Welsh Office presence in Whitehall, the bulk of the permanent staff are housed in Cathays Park, Cardiff. Unlike the London operational departments, which are separated both physically and by ministerial control, there is dayto-day contact between the civil servants of the Welsh Office across all of the divisions and groups. As a result, co-operation between the sections responsible for health, protection of the environment, agriculture, housing and finance is a lot easier than it is between the central departments in Whitehall. The Welsh Office currently has a small environmental health division consisting of a Chief Environmental Health Adviser and a deputy, but with a direct reporting line to the Chief Medical Officer. It is based in the Health Profession Group in Cardiff. Because of the cohesive structure, it is able to operate across the departmental boundaries to a great extent. There are, however, some limits to the Welsh Office operation. A number of services are subject to influence from Whitehall departments. For instance, the food safety element of the agriculture department is generally handled directly from London, and the Treasury has just the same pervasive influence as it has in other government departments.

These arrangements will change with the implementation of the proposed Welsh Assembly. ENVIRONMENTAL HEALTH OFFICERS IN CENTRAL DEPARTMENTS The effectiveness of the formulation and operation of environmental health policy within the English system depends upon the particular environmental health interests of each government department. The environmental health officers in the Department of Health are mainly concerned with food safety. They are to be transferred to the FSA with only a small residual presence to be left in the DoH. In other parts of Whitehall where environmental health policies are considered and legislation is formed they have had less influence. Environmental health officers are currently employed at the Health and Safety Executive (HSE) and in the Inspectorate of Pollution (part of the Environment Agency), and secondment from local authorities occurs from time to time at the DETR. There is a need for the appointment of environmental health officers to other central departments, particularly to the DETR, to deal with the functions of those departments that fall within the remit of local authority environmental health officers. In 1990, an environmental health officer was appointed by the Communicable Disease Surveillance Centre at Colindale (part of the Public Health Laboratory Service).

government may issue a command paper, commonly known as a ‘white paper’, which indicates the broad lines of legislation that the government intends to introduce. It is thus a statement of intent to introduce legislation. The issue of consultation and command papers is not required in the process of legislation, but is often used by government as a way of gauging support for a proposed measure.

Administrative Each central department advises local authority environmental health departments about the implementation of legislation and particular issues of concern to the government. This is done through the issue of ministerial circulars or through the local authority associations. There is also the very important need for each department to maintain close liaison with local authorities and their representative bodies in order to obtain information about environmental health issues generally. The arrangements include contact on a regular basis with the local authority associations, and with the Chartered Institute of Environmental Health (CIEH) acting on behalf of the profession. Through these contacts, local authorities at both elected member and officer levels are able to influence government policy as implemented through its legislative and advisory programmes, and to keep the government advised generally on the state of environmental health.

THE ROLE OF THE CENTRAL GOVERNMENT DEPARTMENTS Monitoring Legislative The drafting and processing of statutes, subordinate legislation and statutory codes of practice relating to environmental health is undertaken by the relevant central government department. Once the government has decided that there is a need for a change in the current legal provision, it may well issue a consultation paper (sometimes called a ‘green paper’), which will seek the views of interested people and agencies. Having considered the results of such consultation, the Copyright © 1999 Taylor & Francis Group LLC

For the monitoring role of the Audit Commission see p. 68. In some circumstances, central government has established direct monitoring arrangements over environmental health activity at local level. For example, the HSC acts as the ‘competent authority’ so far as European Union (EU) law on occupational health and safety is concerned, which requires it to exercise a direct surveillance role. Generally, however, the monitoring role has been less direct and is undertaken through the wide network of contacts

that central government has with the local authority and professional associations. This is expected to change in terms of other aspects of food safety as, with the advent of the FSA, audits of local authority food enforcement work are proposed, overseen by the FSA. All central departments require local authorities to provide specified statistical and other information, and this includes aspects of the environmental health service. This is particularly prevalent so far as the DETR is concerned in respect of its housing function. Quarterly returns in certain aspects of local housing activity are necessary, as is the submission of an annual housing strategy review, which is linked to bids for capital spending authority. Quarterly returns to the DETR are also required under the Environmental Protection Act part I, dealing with the authorization and control of scheduled processes. Quarterly returns will have to be submitted to the FSA in respect of activity under the Food Safety Act 1990, and returns made on fish and shellfish safety. The regional offices of the DETR have a particular role in relation to the annual allocation of spending approvals for the housing function, and there is an annual meeting with each local authority at which its housing policies and spending bids are discussed. An annual return is also made to the HSC in respect of work undertaken by local authorities in the enforcement of health and safety legislation. Over the past decade, the trend has been towards greater central monitoring and control over local authority activity.

Direct service provision There are some areas of environmental health activity where, as an exception to the general approach, direct services are provided at national level, either within a central department or by a quasi-autonomous body. Examples of such activities are: 1. The Drinking Water Inspectorate: this is part of the DETR and is responsible for assisting the Secretary of State in monitoring the activities of the water companies, with particular reference to drinking water quality. Copyright © 1999 Taylor & Francis Group LLC

2. Inspectorate of Pollution: part of the Environment Agency (EA), this inspectorate shares responsibility with local authorities for the enforcement of pollution legislation under part I of the Environmental Protection Act 1990. 3. The Health and Safety Commission is a quasiautonomous body working under the direction of the Secretary of State for the DETR. It has overall responsibility for occupational health and safety through the framework of the Health and Safety at Work, Etc. Act 1974. Within its auspices is the HSE, the commission’s operational arm, which shares the enforcement of legislation with local environmental health departments. 4. The Meat Hygiene Service is now responsible for meat hygiene at red and white meat slaughterhouses throughout England, Scotland and Wales.

LEGISLATIVE ENFORCEMENT ON A SHARED BASIS There are three main areas of environmental health enforcement activity where there is a shared role between a central body and local authorities: air pollution; food safety; and health and safety. There is a specific mechanism in place to bring the inspectorates together in all three cases so as to ensure the proper degree of collaboration and, through that, a consistency of approach to enforcement. While the detail differs to suit the particular circumstance, two of the arrangements are based around the establishment of a collaborative body, the DETR’s Industrial Pollution Local Authority Liaison Committee (IPLA) for air pollution, and the Health and Safety Executive/ Local Authority Enforcement Liaison Committee (HELA) for health and safety, which contains representatives from both enforcement agencies. Within both the DETR and the HSE there is also a small local authority unit, staffed from both inspectorates in each case, where the main technical tasks of collaboration are achieved, i.e. the production of technical guidance notes, codes of practice, etc. The local authority unit within the HSE is headed by an environmental health officer.

In the case of food safety, the collaborative arrangements will be effected through the FSA. There are arguments to support an extension of the use of structures affecting the provision of environmental health services that are based upon a highly specialized core within central government and a fieldwork (operational) arm within local government, on the pattern of present health and safety structures. One obvious candidate is the EA, where there is an opportunity to develop a specialized/co-ordinating centre supported by environmental health department fieldwork through which some activities currently undertaken by central authorities could be devolved to the local authorities. Following a report by Professor Philip James of the Rowett Research Institute, there are proposals to set up an independent Food Standards Agency on the model of the HSC (see pp. 538–45).

LOCAL AUTHORITY ASSOCIATIONS The Local Government Association (LGA), the Convention of Scottish Local Authorities (COSLA) and the Association of Local Authorities in Northern Ireland (ALANI) are the principal local authority associations in the UK. The LGA represents district, county, metropolitan and unitary local authorities in England and Wales. As part of the LGA, the Welsh Local Government Association (WLGA) supports local government in the principality with full autonomy to deal with Welsh affairs. A separate association, the Association of London Government (ALG), exists to represent the interests of local authorities in the capital. The local authority associations provide a national voice for local government. They aim, through lobbying, to be influential on behalf of local authorities and their communities. Their work is funded by subscriptions from their members. These are normally calculated according to the population and size of the local authorities involved. Each of the associations operates on broadly similar lines. They are staffed by full-time officials accountable to a council of elected members nominated by the constituent member local Copyright © 1999 Taylor & Francis Group LLC

authorities. In much the same way that local authorities operate, the councils of the associations remit work to a number of committees. The LGA was created on 1 April 1997 to replace the former Association of District Councils, Association of Metropolitan Authorities and Association of County Councils. Its Public Protection Committee debates environmental health issues, develops environmental health policy and represents the interests of local authority environmental health in discussions with government. As with the other local authority associations, its full-time officers are supported by a broad network of advisers, usually at chief officer level, drawn from throughout local government. These advisers include professional environmental health officers and officers from other professions spanning the work of local authorities. Collectively, they advise the associations and ensure that the concerns and issues of environmental health are considered corporately within an overall local authority association strategy and agenda. The local authority associations act as the focus for debate on environmental health issues by responding to proposals for environmental healthoriented legislation and guidance and other government consultation papers, and by giving evidence at select committees and committees of inquiry, by lobbying key decision-makers and by publicizing environmental health issues. They also act as a conduit of information from local authorities to government and vice versa, often through advice, publications, seminars and conferences. Through various organizational links with the CIEH and the Royal Environmental Health Institute in Scotland (REHIS), environmental health professionals represent the interests of local government on a number of national bodies, committees and standing liaison forums. These include, for example, HELA and the DETR’s IPLA. In addition, it is common for government to seek nominations from the local authority associations to ad hoc committees and working groups that enable local authorities to influence government policy during its period of development. The Local Air Quality Management Working Group, set up to oversee implementation of part IV of the Environment Act 1995, is a classic

example. Similar bodies span the whole spectrum of environmental health work, and the use of these formal and informal networks is a very important aspect of the promotion of environmental health objectives. The strength of the local authority associations is their elected member support, which explicitly underlies their activity. Elected members also play a full part in representing local authority interests at the national level. National bodies on which local authority association nominated elected members currently serve include the HSC, the Advisory Committee on Dangerous Substances, and the Central and Local Government Environment Forum.

LACOTS The Local Authorities Co-ordinating Body on Food and Trading Standards (LACOTS) was established by the local authority associations in 1978. Its original purpose was to co-ordinate trading standards activity throughout the UK and to promote common interpretation of statutes and consistency of enforcement. In 1992, following a review by the local authority associations, its remit was extended to exercise a similar role in respect of environmental health food safety and hygiene. This decision was taken in the context of a number of significant drivers: the Audit Commission’s review of the local authority food law enforcement function, the review of food legislation that led to the Food Safety Act 1990, and moves to create the Single European Market. LACOTS is a company limited by guarantee and is accountable to the LGA, COSLA and ALANI. The organization is controlled by a management committee comprising senior elected members nominated by the local authority associations. It is funded by money that is ‘top sliced’ from the revenue support grant in England and Wales, with the associations in Scotland and Northern Ireland paying an amount that represents a share of the service given. LACOTS has a small full-time secretariat. However, the backbone of the organization is a series of advisory focus groups and task forces made up of chief officers, heads Copyright © 1999 Taylor & Francis Group LLC

of service, senior managers and expert practitioners, who consider issues and give advice. The advisory structure is multidisciplinary, and professional bodies such as the CIEH and the Institute of Trading Standards Administration, government and other organizations, such as the Public Health Laboratory Service, are invited to participate in relevant groupings. LACOTS employs environmental health officers as well as trading standards officers. LACOTS main aims and activities are: • to promote quality regulation, co-ordinate enforcement and disseminate good practice • to provide advice, guidance and codes for food safety and trading standards authorities (a circular is sent to all local authorities on a roughly fortnightly basis; the circulars are also available on subscription to, for example, trade associations) • to advise central government and the EU on relevant legislation • to promote the ‘home authority principle’ as the key method of enforcement co-ordination • to administer statutory arrangements as the UK’s single liaison body for transborder food problems • to develop information and central records databases to assist enforcement practitioners • to liaise with industry, trade and consumer bodies • to collaborate with enforcement agencies overseas, e.g. the European Forum of Food Law Enforcement Practitioners (FLEP). LACOTS’ future activities may change as the government moves towards creating a Food Standards Agency. Professor Philip James’s interim proposal on a Food Standards Agency, prepared for the Labour Party while it was in opposition, recognized the potential impact of a new agency on the role of LACOTS. James clearly saw the agency as having responsibilities for local authority co-ordination, and recognized that it would need a local authority liaison unit to provide advice, guidance and support to local authorities. In addition to recognizing the considerable overlap between LACOTS and the proposed new role of the agency, James also noted that it would be sensible for any new agency to take over the role

that LACOTS fulfils as the single liaison body for the UK within the EU. James nevertheless saw that LACOTS would retain an important role as a channel for local authority communication, and might be considered as an appropriate component of the agency with joint responsibility to both local authorities and the agency’s executive in his proposals. Exactly how the proposed agency will affect LACOTS existing remit is unclear and will not be clarified until the government formally agrees the extent of the agency’s own remit. (For LACOTS’ views on this see [2].)

LOCAL GOVERNMENT OMBUDSMAN Where a person considers that he has been unfairly treated by a local authority, he can ask the local government ombudsman to investigate to see if there has been maladministration. The Commission for Local Administration is independent and impartial, and has the same powers as the High Court to require the production of information and documents for investigation. There are separate commissions for England, Scotland, Wales and Northern Ireland. Maladministration is deemed to have occurred if a council has done something in the wrong way, had done something that it should not have done, or has failed to do something that it should have done. The ombudsman cannot question the decision of a council, but rather the way in which that decision was reached. As a first stage, the ombudsman will advise the local authority that a complaint has been received and ask for it to provide information in respect of the matter complained of, as well as to indicate whether the matter is one that can be resolved between the local authority and the complainant. After consideration, the ombudsman will decide whether further action or more detailed investigation, is needed. The majority of complaints are resolved after an initial investigation. If further investigation is undertaken, it is likely to involve detailed examination of documents, and interviews with officers involved in the matter. If, however, following a full investigation, the ombudsman finds maladministration, he provides a formal report that must be considered by the council, which must Copyright © 1999 Taylor & Francis Group LLC

then inform the ombudsman of the action it intends to take to remedy the grievance. The local ombudsman does not have the power to force a local authority to take action to remedy a grievance. However, if he is not satisfied with the response of the local authority, he may issue a further report. The ombudsman may suggest that compensation be paid to the complainant if loss has been suffered as a result of the maladministration. The majority of cases considered by the ombudsman relate to planning and housing issues; relatively few are concerned with environmental health. However, one example of an ombudsman inquiry into an environmental health matter involved a complaint that a local authority had not taken action to deal with nuisance caused by barking stray dogs kennelled at an RSPCA premises. The environmental health officers concerned were of the view that a statutory nuisance existed, and were in discussion with the RSPCA to achieve improvements in the management and construction of the premises. These discussions did not achieve results within a timescale that was acceptable to the complainant. The ombudsman found the local authority guilty of maladministration in that it did not use the powers available to it to the full extent or as expeditiously as possible. Sometimes the process of investigation and report by the ombudsman provides confirmation that the environmental health systems are satisfactory. For example, when reporting on an investigation relating to the way in which a local authority dealt with complaints alleging a noise nuisance from an occupant of a terraced house in the course of DIY activity, the ombudsman observed that the council acted commendably in its attempts to provide a fair service to all within the resources available and rejected the complaint. In 1997, a digest of cases referred to the ombudsman was published for the first time [3], with the aim of promoting a good local administration and increasing understanding of how and why decisions are reached. This digest includes cases dealing with asbestos contamination, kennel inspections, nuisance, housing notices and improvement grants. The local government

ombudsman also produces an annual report which includes details of complaints dealt with in the year.

THE CHARTERED INSTITUTE OF ENVIRONMENTAL HEALTH Aims and objectives The organization that was, in due course, to become the CIEH was founded in London in 1883. Just over 100 years later, having proved its ability to establish and maintain professional standards, it was granted a Royal Charter in 1984 as the Institution of Environmental Health Officers. In 1994, as a mark of the profession’s quality and worth, Her Majesty the Queen granted the professional body a new title—the Chartered Institute of Environmental Health. The primary objective of the CIEH is the promotion of environmental health and the dissemination of knowledge about environmental health issues for the benefit of the public. It represents the views of its members on environmental and public health issues and is independent of central and local government. The majority of the 8700 members of the CIEH are employed in local government to enforce a wide range of legislation on issues such as food safety, pollution, housing standards, safety at work and infectious disease, and to educate the public on matters of hygiene and safety. A significant number of members work in the private sector either for individual companies or as private environmental health consultants. There are also environmental health personnel working in central government and non-commercial organizations in addition to those teaching environmental health in universities and colleges throughout the country. For organizational purposes the membership is divided into 17 centres; 15 of these are geographical and two are functional (Port Health and Commercial & Industrial). The centres are run by a centre council elected from the membership in the designated area. A centre elects representatives to the general council in proportion to the number of members in the centre; the general council is the governing body of the CIEH. Copyright © 1999 Taylor & Francis Group LLC

There are six categories of membership ranging from student membership for those people pursuing an approved technical or professional course in environmental health through to corporate membership for those who are both qualified in environmental health and have passed an Assessment of Professional Competence after two years of professional practice. Student members are encouraged to use the services provided for members, to take part in educational activities and to attend the meetings of the centre and branch to which they belong.

Activities Prime among the activities of the CIEH are those that achieve the objectives laid down in the charter, which emphasizes the importance of education, training and the maintenance of high standards of professional practice and conduct by all its members. The CIEH undertakes the following activities in pursuit of maintaining professional standards and meeting its obligations under the Royal Charter: 1. The holding of branch and centre meetings for the conduct of business and the discussion and development of good practice. 2. The provision of seminars, study weekends and other opportunities for professional development at both local and national level. 3. The holding of an annual environmental health congress and an annual general meeting. 4. The monitoring and approval of qualifying courses in environmental health, the assessment of professional competence and the promotion of continuing professional development among the membership (see Chapter 6). 5. The convening of technical committees and working parties at national level to develop policy and recommendations for good practice and to respond to consultation documents published by government departments and other organizations with concerns for environmental health. 6. The distribution of a weekly newspaper and a monthly journal, and the publication of texts, practice notes and policy documents on environmental health issues.

7. The provision of advice to members on educational, constitutional and technical issues. 8. Liaison with officials of the UK government, the EU and the World Health Organization (WHO) on developments in environmental health. The CIEH is a European Collaborating Centre for WHO. Further details are available from: CIEH, Chadwick Court, 15 Hatfields, London SE1 8DJ. Telephone: 0171–928 6006. THE AUDIT COMMISSION The Audit Commission for England and Wales is an independent body established under the provisions of the Local Government Finance Act 1982. Its objectives include the appointment of auditors to local authorities, and helping authorities to bring about improvements in efficiency, both directly through the auditing process and indirectly through the ‘value for money’ studies it carries out. The auditors appointed may be from the District Audit Service (a public body) or from private firms of accountants. The commission members include senior people from industry, local government, the accounting professions and the trade unions. Although waste collection, street cleansing and the cleansing of public conveniences were among the first local government activities to be studied

by the commission, it first turned its attention to the core environmental health function in June 1990 with the publication of an information paper, Environmental Health Survey of Food Premises [4]. It reported the results of by a survey of the condition of food premises that had been undertaken jointly by the commission and the CIEH. This initial interest in the food safety activity was followed in December 1990 by the publication by the commission of a broader study: Safer Food: Local Authorities and the Food Safety Act 1990 [5]. This study looked at the likely effect of the impending implementation of the Act and its regulations on environmental health departments. The commission next took an interest in the general management of environmental health, and in July 1991 published Towards a Healthier Environment: Managing Environmental Health Services [6]. This study considered the management and use of necessarily scarce resources in providing an efficient, effective and economic environmental health service, and in particular: • discussed the wide-ranging activities of the environmental health function in local authorities (Figs 3.1 and 3.2) • considered the changes facing the profession, including new legislation • analysed the problems facing the service and the ways they were being tackled

Fig. 3.1 Percentage of time spent on core activities—there are four major areas. (Source: CIPFA, 1989–90, from [6].) Copyright © 1999 Taylor & Francis Group LLC

Fig. 3.2 Environmental health income and expenditure, 1989–90. Less than 20% of gross expenditure is recovered by fees and charges. (Source: CIPFA, 1989–90, grossed up estimates, from [6].) Since 1 April 1995, income from meat inspection charges has gone to the National Meat Hygiene Service and not to local authorities.

The principal findings of this study were as follows. 1. Each authority should develop a corporate policy for the delivery of environmental health services. 2. Each environmental health department should: (a) translate that policy into departmental objectives consistent with available resources (b) assemble information on local environmental health needs and target resources appropriately (c) determine the style of its intervention, for example, a responsive or proactive stance (d) set out clear task allocations to staff. 3. Operational activity must be informed by accurate and detailed information systems, premises registers, risk assessment. 4. Consistency must be sustained through explicit priorities and protocols as well as cultural norms. 5. Service effectiveness must be monitored through staff management information systems and relevant output measures. 6. Authorities should assure the quality of their services through systematic evaluation of their activities including a performance cycle. The conclusions are illustrated in Fig. 3.3. Copyright © 1999 Taylor & Francis Group LLC

The commission also looked at the activities of environmental health officers in the housing field, and in September 1991 published Healthy Housing: the Role of Environmental Health Services [7]. This report identified the health risk related to house condition, the condition of stock and the role of the environmental health department in enforcing the relevant legislation. The study applied the general conclusions of the earlier report on environmental health services generally [6], and again concluded that there was a lack of clear policies and strategies, inadequate information on the scale and location of housing problems in each area and a wide variation in the performance of staff. The commission’s framework for managing the housing function is shown in Fig. 3.4. In April 1993, the CIEH and the Audit Commission published a joint study of the reaction of chief environmental health officers to these reports [8]. Unfortunately, fewer than 40% of authorities responded to this survey, which generally showed that the commission’s reports were appropriately timed and of high quality. This study was more in the nature of a customer survey than an attempt to identify what effect the reports had had on the operation of the environmental health service.

Fig. 3.3 Clear policy, fresh managerial attitudes, greater team integration and more precise targeting of activity are required. (Source: [6].) LA, local authority; EH, environmental health.

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Office, London.) Such systems are also encouraged by the Citizen’s Charter [10] (see p. 78). Each year, the Audit Commission indicates to local authorities, through a Publication of Information Direction, the performance indicators which each authority is required to report on and publicize. Some of these indicators relate to the administrative operation of the council as a whole, and some are service-specific. For 1997/8 the indicators relating to environmental health included the following. 1. (a)

The target time/times set by the authority for responding to environmental health complaints and requests for services, (b) The percentage of responses provided within the target time. 2. Of the food premises inspections that should have been carried out, the percentage that were carried out. 3. The average number of visits per high- and medium-risk premises. 4. Net spending per head of population on environmental health functions. Fig. 3.4 Effective housing work by environmental health officers. Effective housing work must be based on a number of key elements. (Source: [7].)

The latest report by the commission affecting environmental health is It’s a Small World—Local Government’s Role as a Steward of the Environment’ [9]. This report makes recommendations on: • • • •

waste reduction and management waste conservation energy conservation reduction in car commuting.

One of the more recent roles of the commission has been to assist local authorities in the development of performance indicators, which are intended to identify areas of poor performance for remedial action. (See also Better Regulation Unit (September 1998) A Consultation Paper on Performance Mangement for Environmental Health and Trading Standards Work, Cabinet Copyright © 1999 Taylor & Francis Group LLC

These mandatory reporting requirements on councils are normally encompassed by the wider performance management system operated by each of them, which would normally contain many more indicators relating to environmental health, such as: • unsatisfactory houses brought up to standard within 12 months of inspection • time taken to present licence applications for decision • proportion of environmental health complaints successfully resolved at the first attempt. These performance measures are discretionary and vary from council to council. The commission exercises its functions through: • the issue of national reports (such as those discussed above), which publish the results of surveys into particular activities and draw attention to good practice; in effect they provide benchmarks against which to judge the performance of individual local authorities

• detailed audits of individual authorities at which time the national guidelines are taken into account; such audits were undertaken at most environmental health departments following the national study on the management of the environmental health service and of environmental health aspects of housing.

• the way councils engage with and lead their local communities, through a radical programme of democratic renewal • the way councils plan and deliver local services, through best value in service delivery • in the conduct of councillors and local authority employees by the adoption of a new ethical framework.

THE EUROPEAN FRAMEWORK

The paper goes on to propose that local authorities use ‘their unique status and authority’ to:

Most UK legislation on environmental health is now the result of EU requirements, particularly those relating to environmental protection, food safety, and health and safety. More information is given about this in the appropriate chapters. There is also an increasing trend for an administrative involvement of the EU in the work of UK environmental health departments, e.g. reports on activity under the Food Safety Act 1990 have to be submitted by each department through the UK government. The processes involving EU law are dealt with in Chapter 7. THE LOCAL FRAMEWORK With the few exceptions identified in the previous section, the environmental health function is located at district local authority (community) level. There is general recognition in the UK that there are strong advantages in the core environmental health service operating at the community level where it will be in close contact with the population it serves and the environmental problems it faces. This approach is supported by WHO [11]. Local government The provision of environmental health services is a product of the system of local government that is responsible for it. The role of local government generally, and the way in which it organizes its affairs, is being considered by the government, and in a consultative paper published in February 1998 [12] the DETR suggests three areas in which radical change is needed: Copyright © 1999 Taylor & Francis Group LLC

• provide a vision for their locality • provide a focus for partnership • guarantee quality services for all. Among the measures proposed for ensuring a modernized system of working are: • increased public participation in debate and decision taking • a new consultation strategy for contact with those whom the council serves • involving the public. The methods envisaged for involving the public include: • seeking the views of the citizen—these initiatives enable councils to introduce lay experience and views to their decision-making • recognizing communities by increasing their involvement in direct decision-making—local authorities need to recognize both communities of place and communities of interest; the latter can be far more wide-ranging, and more difficult to identify • enabling the electorate to determine or influence policy on a specific issue—handing over a decision or influence to those affected • watchdog or scrutiny role for the citizen— seeking the direct involvement of the citizen to keep the services secured by the authority up to the mark • opening up the authority—changing the role of individual citizens in the existing structures of the authority.

In relation to the traditional committee structure currently used (and, of course, in which environmental health is politically managed), the paper is critical and describes it as ‘inefficient and opaque’, being ‘designed over a century ago or a bygone age’. Among the proposals to deal with this is one to separate the executive and representative roles of elected members. In order to test the options to achieve this, the following ideas are to be piloted in selected authorities:

through which they could have greater responsibility for their affairs • providing quality services through a ‘best-value’ system (see p. 86).

• a formal single party advisory committee, which would make recommendations to the authority as a whole • a single party executive committee, where responsibility for certain decisions and overall strategy for the authority would be given over to an executive committee • a lead member system, in which responsibilities would be delegated directly to individual councillors (e.g. a lead member for housing); the lead members could meet together in a committee but the committee would have no executive responsibilities itself • a cabinet system, which combines executive responsibilities for lead members with others that are performed jointly by the executive committee of which they are members • an executive mayor, who would be given executive responsibilities which he or she could delegate on to either lead members or a cabinet which he or she would appoint; the mayor could be elected either by the councillors or by the electorate, and the powers of the mayor could be either far-reaching or more constrained.

In 1989, Wilfried Kreisel, director of WHO’s Division of Environmental Health wrote:

The community leadership role is seen by the DETR as having a number of elements: • the instigation of a community planning system involving partnership with a wide range of other agencies and organizations • placing a duty on councils to promote the economic, social and environmental well-being of their areas • freeing councils from the present legal constraints by creating a new framework Copyright © 1999 Taylor & Francis Group LLC

Following consultation on these matters, it is the government’s intention to publish a white paper.

THE ENVIRONMENTAL HEALTH CONTROL SYSTEM

Organization has become a crucial issue in environmental management and health, especially so in the last 20 years. In many countries, actions in the environment are not coherent and many environmental health policies and programmes have become fragmented as governments have reshuffled environmental management responsibilities among public agencies and private interests. [13] This comment is certainly applicable to the UK, where the degree of ‘reshuffling’ has been significant, e.g. the privatization of the sewage, sewage disposal and water industry in 1989. Kreisel saw that a key to solving this problem is the concept of moving beyond the boundaries of environmental health units, to organize environmental health as a broader system in which environmental health outcomes depend on what is done by other agencies of government and by private sector enterprises, and on the messages that reach people through the mass media and community groups. In UK terms, this means that the environmental health department (unit) must do much more than simply enforce legislation. It must be at the centre of a total system of environmental health control. Such a concept is now contained within the UK system of environmental health control based on the environmental health departments (units) located at district council level. But this was not the case at the time of the 1974 reorganization, which was mainly an allocation of specific

functions. It has been developed since 1974 by the environmental health profession along the lines promulgated by WHO. Its essence is the creation, in each unitary and district council and each London borough council, of an environmental health department, or separate unit within a larger department, to which all the council’s environmental health functions are allocated and which is also given the specific role of taking the lead to maintain complete environmental health surveillance over the district. This latter role is performed through the establishment of a comprehensive network of liaison arrangements with other departments and organizations, both inside and outside of the council—hence the ‘extended environmental health unit’.

The production of an effective control system is essentially a team task involving all those whose efforts are critical to the environmental health function. The breadth of this extended unit is illustrated in Fig. 3.5. This theme is also taken by the Environmental Health Commission in its report Agendas for Change [14], which is discussed in Chapter 1. The report stresses the direct and indirect effects of the environment (air, water, food, buildings and landscapes) on health, and identifies the need both for integration of the different specialisms and sectors involved, and for production of a dynamic new local strategy for improvement in which individuals and communities are fully engaged.

Fig. 3.5 The environmental health control system through the extended environmental health unit. LA, local authority; PHLS, Public Health Laboratory Service. Copyright © 1999 Taylor & Francis Group LLC

THE ENVIRONMENTAL HEALTH UNIT Tasks Since the environmental health unit is the focal point of a much broader system of control, it follows that the tasks to be performed within the unit will be diverse. The following groupings indicate the range of activities. Surveillance An essential task for the unit is to undertake ongoing and total surveillance of those environmental issues that affect health. To achieve such an objective successfully involves the establishment both of a wide range of direct activities within the unit, and of collaborative/ monitoring arrangements with other organizations involved in environmental monitoring, both statutory and non-statutory. Direct monitoring activities carried out by staff within the unit or under contract to them may include: • the sampling of food and water for both microbiological and chemical assessments • environmental sampling for the detection of heavy metals, asbestos, Legionella, etc. • detection of atmospheric pollutants • assessment of contaminated land • monitoring of radiation levels in air, foodstuffs, land and water • assessment of proposals for new development, e.g. housing, highways, industrial, etc. Among the collaborative arrangements for identifying the additional information necessary to form a total picture of the state of the environmental health in an area will be those with the following: 1. Environment Agency—the pollution of water abstraction sources, rivers, streams, etc., effluent standards and consents. Monitoring of pollution from scheduled processes. 2. Water companies and water assessors within the DETR—drinking water quality, the exchange of analytical information and the identification of potential problems. Copyright © 1999 Taylor & Francis Group LLC

3. Director of public health of the health authority —public health statistics including mortality and morbidity figures and communicable diseases. 4. Health and Safety Executive—enforcement and accident statistics relating to occupational health and safety, and identification of priority enforcement areas. 5. Veterinary service of MAFF—notifications of zoonoses and hazards to public health arising from animal-related issues, the results of testing of feeding stuffs and meat for residues, etc. This is currently facilitated through the establishment of zoonoses groups on a county basis, but will be affected by the formation of the FSA.

Provision of information The Environmental Information Regulations 1992 require a wide range of bodies, including local authorities, to make available to the public environmental information that they hold relating to: 1. the state of any water or air, the state of any flora or fauna, the state of any soil or of any natural site or other land 2. activities or measures (including noise or other nuisance) that adversely affect anything in (1) above 3. any measures (including environmental management programmes) that are designed to protect against these concerns. There are some exceptions to these requirements, e.g. commercial confidentiality and information subject to legal proceedings. There are other statutory requirements relating to environmental information, e.g. for authorizations of processes under part I of the Environmental Protection Act 1990; where such specific requirements are not as onerous as the 1992 regulations the latter will prevail, and where they are more onerous the more liberal regime will apply. Under the Environment and Safety Information Act 1988, registers of information on enforcement notices served under the Health

and Safety at Work, Etc. Act 1974 must be kept available for public inspection. These requirements fall on the whole range of public bodies involved in environmental issues, e.g. the HSE, the EA, etc., but the environmental health department should be seen as the location where all such information is gathered together and made available to the public. Such a service enhances the central role of the department in environmental management.

Enforcement One of the core functions of the unit is the enforcement of legislation, primarily statute law and secondary legislation, but also local legislation including by-laws. The main areas of legislation involved are: • • • • •

food safety and hygiene communicable disease prevention and control health and safety at work and during recreation housing standards environmental protection including statutory, nuisances • licensing • drinking water surveillance. The inspection of premises in order to enforce legislation is one of the main tasks of the environmental health department, and the way in which this is approached is crucial to its effectiveness. The inspection activity must be structured so as to take full account of the risks inherent in any particular premises or type of premises. Thus more attention and a greater frequency of inspection should be given to those premises whose operations and/or past record involve a greater risk to public health. The need for such an approach has been stressed by the Audit Commission [6, 7] and by the UK government through the DoH. Thus risk assessment and an inspection programme based on it are essential ingredients of the enforcement function. Enforcement is discussed in more detail in Chapter 8. While concern is expressed from time to time about a perceived lack of consistency between local Copyright © 1999 Taylor & Francis Group LLC

authority enforcement agencies, including environmental health departments, the report of a review instigated by the President of the Board of Trade in 1994 [15] indicated a general satisfaction with the arrangements and noted that real improvements had been made. In the past decade these regulatory functions have been performed against the background of government policies that have looked for: • deregulation—the removal of statutory requirements that were judged to be unnecessary • self-regulation—by those carrying the legal responsibility for compliance, with minimal intervention by enforcement agencies. One of the consequences of this has been that some local authorities have established partnership arrangements with local businesses through which compliance with environmental health standards has been sought on a collaborative basis. The framework for such an approach is described in Regulation: a Guide to Good Practice in Local Government [16]. With the election of a new government in 1997, it is possible that the balances within such an approach may be the subject of review and change. A Better Regulation Task Force was established in September 1997. See, for example, Better Regulation Task Force, Consumer Affairs, Central Office of Information, London, 1998.

Service provision Local authorities provide a wide range of environmental health services directly to the community, some being statutorily required and others being discretionary. These include: 1. 2. 3. 4. 5.

refuse collection and street cleansing (statutory) pest control dog warden (statutory) food hygiene training health promotion.

These services may be provided either directly by the environmental health unit or by others on a

contract from the unit. The provision of cleansing services is currently subject to the competitive tendering provisions of the Local Government Act 1988 (which are under review), and it is important that the client function in this case is performed within the environmental health unit since this involves the identification and monitoring of standards for this service. Some services may he provided by the environmental health units as the result of an agency agreement with the body carrying the primary responsibility for that service. One example is the arrangement between a district and a county council for the operation of the food standards function. In this case, the primary authority retains control over the standards of the service and resource allocation, while the district council bears responsibility for the operation of the service within those parameters.

Education/publicity An increasing amount of the unit’s attention is being given both to the provision of environmental health information to the community on a full range of issues, e.g. food hazards, heart disease, environmental pollutants, etc., and also to the need to inform the community of the services available and to involve the public in decisions about the content of those services and the ways in which they are made available. The provisions of the Food Safety Act 1990 and the Health and Safety at Work, Etc. Act 1974 provide for training to be given to staff employed in activities covered by the legislation—in effect the whole range of employment. Many employers look to the environmental health department for assistance, and the CIEH validates such courses through those departments.

Investigative Innovative The unit provides a point of reference for community complaints about issues that are of concern, and these require investigation and determination. Many will be investigations within a legal framework, which may lead to the institution of legal proceedings, e.g. statutory nuisances (see Chapter 8), while others will have no statutory remedy and will require persuasion if the problem is to be eliminated. The number of complaints received by environmental health units from one neighbour about the activities of another are high and rising. They involve a wide range of concerns, including noise, bonfires and generally unacceptable behaviour. The investigation of such complaints is often lengthy and very time-consuming, and frequently does not have an entirely acceptable result. Some environmental health units are attempting to deal with this by encouraging the setting up of voluntary conciliation services through which these types of neighbour disputes may have an informal and negotiated solution agreed by both parties. Not only do such agencies relieve the local authority of work that is often abortive, but they may also be more likely to produce more effective solutions in some cases. Copyright © 1999 Taylor & Francis Group LLC

One of the essential tasks of the unit is to try new things, and to experiment with solutions to problems. Historically it has been the efforts of individual or groups of local authorities that have led to major legislative changes on issues such as clean air, food hygiene, dog control and health promotion. A legitimate function of the unit is to stimulate change to the approach and operation of the environmental health service through experimentation. Examples are the creation of ‘community contracts’ for the street cleaning function in York, a scheme for the retrieval of supermarket trollies in Exeter (now embodied in national legislation through the Environmental Protection Act 1990), and arrangements for health promotion in Oxford. Both the CIEH the local authority associations have a vital role to play in promoting such innovation locally, and in pressing for national change based upon the success of local initiatives. There is a developing role for environmental health officers of undertaking sponsored research as an aspect of environmental health as part of studying for a higher degree, and some of this work can lead to new ideas for environmental health policy and practice.

Agency services The past 10 years have seen a growth of agency and advisory services to the general public, both within local authorities and by others. For example, there are numerous housing advice centres provided by both district councils and voluntary agencies. Some environmental health departments operate agency services for the undertaking of work related to renovation grants, and also for ‘stay-put’ schemes to enable elderly or disabled people to live more comfortably in their own homes (see Chapter 23). These agency services include surveys, the identification of defects, the production of specifications, the letting and supervision of contracts and the identification of funding arrangements, including grant aid. Customers for environmental health services Over the past few years, increasing attention has been given to identifying the customers for public services and a need to relate to them closely in terms of service standards and delivery. At government level this identified itself in the form of the Citizen’s Charter [10]. The Charter programme is now being revamped as Service First [25, 26]. It has four main aims 1. Quality A sustained programme for improving the quality of public services. 2. Choice Wherever possible, there should be a choice between competing providers, as this is the best spur to quality improvement. 3. Standards The citizen must be told what the service standards are and be able to act where service is unacceptable. 4. Value The citizen is also a taxpayer; public services must give value for money within a tax bill the nation can afford. Customer relations is now firmly placed as an issue within the environmental health service. One facet of this is the setting of performance indicators (see p. 71); another is the Charter Mark. This is an award for excellence in the provision of services, including public services, and several environmental health units have successfully applied for it. As part of the response to Agenda 21 [17], there is an increasing tendency to establish widely based Copyright © 1999 Taylor & Francis Group LLC

collaborative groups at local level to consider the environmental issues relating to that area. These groups include representatives of statutory and voluntary bodies, and may involve the Chamber of Commerce, Friends of the Earth and local consumer groups. The central, co-ordinating role played by the environmental health unit in these groups is very important. Changes in the public perception of environmental health issues demand a much closer relationship between the environmental health unit and its community. This is now being embraced in the community governance approach to local administration, described in practice in the two case studies that form the appendix to this chapter (see also Chapter 1 and p. 72).

Policy formulation The determination of local policies for the environmental health function is a matter for each council in the light of its own problems, resources and priorities. The process of policy formulation is generally initiated informally by discussion between the chairperson of the Environmental Health Committee and the director/chief environmental health officer, at which time both professional and political objectives relating to the service can be identified and structured. Proposals for new policies or changes to existing policies are then made by the chief officer to the committee, which produces resolutions in the form of recommendations to a meeting of the full council. Throughout this process the effectiveness of the relationship between the chief officer and the chairperson is crucial. Environmental health policies are derived from several sources, including the following. 1. Legislative duties: legislation may prescribe duties to be undertaken by local authorities and, in some cases, may even prescribe the standards to be achieved, e.g. each local authority is under a duty to enforce the Health and Safety at Work, Etc. Act 1974 in premises allocated to it, and many of the standards to be achieved are prescribed by legislation.

2. Legislative discretion: some legislation allows the local authority to decide for itself whether or not to use certain legislative powers, e.g. the adoption of a registration scheme for skin piercing. 3. Professional initiative: policies may be initiated by the director/chief environmental health officer as a result of: (a) personal initiative (b) initiative by the professional staff of the environmental health unit (c) suggestions from the CIEH, other professional organizations, or the local authority association (d) discussion between colleagues at county chief environmental health officer groups or national conferences. 4. Member/political initiatives. 5. Community pressure, e.g. customer surveys etc.

The role of elected members It is the council as a corporate body, i.e. its elected representatives, that is responsible in law for the delivery of services. This includes the environmental health service. The relationship between the council members, both individually and in formal groupings of committees, etc., and environmental officers is crucial to the effective operation of the organization and of the environmental health unit. According to the Widdicombe Report [18], councillors, while retaining overall legal responsibility for the delivery of services, should seek to leave the day-to-day management of those services as far as possible to officers. This relationship was further considered by the Audit Commission in its Management Paper The Competitive Council [19], and four main roles for elected members were identified. 1. Policy formulation: this role was identified earlier in this chapter and is seen as being the most significant role. 2. Representation: each member represents his ward and will bring to the council departments issues affecting the community in those areas. The degree of contact between elected members and environmental health units in this regard is very significant, and ranges from the pursuit Copyright © 1999 Taylor & Francis Group LLC

of complaints on behalf of individual constituents to the submission of petitions that may represent thousands of people. This role should not be confused with the responsibility for the operation of services, which is a chief officer matter. It is a right of access to that operation on behalf of the community. Members also form a vital link between the council and the community, and this is particularly important to the environmental health service since those links with the community are so critical. 3. Performance review: having established policies and allocated resources, members should be organized in such a way as to effectively monitor the implementation of these policies and appraise their performance. In many councils, performance review committees are established to undertake this task. 4. Operational management: elected members have responsibility to ensure that an adequate management organization exists, and that clear responsibilities have been assigned to chief officers. Apart from this, the Audit Commission supports the views of the Widdicombe Committee that elected members should leave detailed operation to officers. The way in which councils manage their affairs, including the role of elected members, is currently the subject of a government review [12] (see also p. 72). Elected members from local authorities also have a significant part to play in the organization of local government at national level, particularly through the local authority associations. These associations also nominate elected members on to other national bodies, e.g. local authority members sit as commissioners on the HSC. They also have formal liaison committees with other public bodies, e.g. joint consultative committees with health authorities and county councils.

Delegation of authority The Local Government Act 1972 allows a council to delegate decision-making to committees, subcommittees and officers. The correct use of this

power is critical to the effective operation of services, and should take full account of the principles of proper member/officer relationships as outlined above. Delegation needs to be undertaken as a formal process by clear definition through resolution of the council. What is not clearly delegated in such a scheme remains a matter for the full council to determine. Because the environmental health service contains a high level of legislative enforcement, delegation to its chief officer is usually greater than to any other chief officer, and will need to indicate each legal process delegated, e.g. service of notices, institution of proceedings, under each piece of legislation.

Organization Location Following the reorganization of local government in 1974, most environmental health units formed separate departments and the director/chief environmental health officer was a chief officer and member of the chief officer group/management team. However, since that time most individual councils have restructured their services on more than one occasion. According to an unpublished survey by the Society of Environmental Health Officers (SEHO) in 1993, of those authorities responding, about: • 37% of units had formed separate departments • 58% were part of a broader directorate • 5% had structures where the environmental health function had been split. It is possible that since 1993 there has been a continued trend towards the environmental health unit being part of a wider directorate, but no further surveys have been carried out. However, the SEHO hopes to undertake a further study during 1999 in collaboration with the CIEH. There is a wide range of service groupings within such directorates, but it is common for the environmental health service to be linked with both the housing service and that for consumer protection (trading standards). Such directorate Copyright © 1999 Taylor & Francis Group LLC

posts are often held by environmental health officers, but where this is not the case, it is essential for arrangements to be made that ensure the direct provision of professional environmental health advice to the chief officer group, the council and its committees and subcommittees.

Structure The way in which the environmental health department or unit is structured will depend upon local perceptions of problems and needs. However, it is usual for the four main functional areas, i.e. food safety, environmental protection, housing standards and health and safety, to be given particular status within the structure, either by the creation of a specialist team to deal with each, or by identifying individual environmental health officers, usually at principal officer or section head level, to undertake specific responsibility for that function across the whole of the council’s area. Code of Practice No. 9 issued under the Food Safety Act 1990 requires that food authorities should appoint at least one environmental health officer with particular responsibility for food hygiene and safety matters. There are often significant differences in organizational approach between rural authorities, which have large geographic areas where problems are diverse and diffused over wide areas and where travel distances for staff are great, and urban areas, where the problems are often more acute and intensified. The approach in rural areas tends to be one of a geographic allocation to environmental health officers, where responsibility is taken for all, or a wide range of, environmental health activity in that one district, with or without further technical support. In the more concentrated urban area, officers tend to specialize in one aspect of environmental health, e.g. food hygiene or health and safety, either individually or as part of a specialist team. It is possible to have an approach that involves a mixture of both in that, while the majority of activities may be dealt with on a district, generalized basis, some activities, e.g. noise control, can be the subject of a more specialized approach. The three approaches are shown in Fig. 3.6 in

Fig. 3.6 Organizational approaches to environmental health. EHO, environmental health officer.

diagrammatic form. The actual structures required to operate such systems are more complex and involve a different number of managerial levels, e.g. there may be a deputy chief environmental health officer, and the use of technical support staff. The requirement to bring all these separate activities together, and to link them to broader policy objectives, e.g. Agenda 21, and to the liaison arrangements with the other agencies to ensure total environmental health surveillance, is achieved through the establishment of a departmental (unit) management grouping. This is often supported by the designation of particular environmental health officers to link with identified agencies. For example, a principal environmental health officer may be asked to lead on the management of the Copyright © 1999 Taylor & Francis Group LLC

authority’s Agenda 21 policies or to provide structured liaison with, for example, the Environment Agency.

Staffing Just as the establishment of an effective environmental health system relies upon a team beyond the unit, the extended environmental health unit, so the operation of the unit itself is essentially a team task. The types of staff found in the unit are listed below. ENVIRONMENTAL HEALTH OFFICERS The proper use of the broad training and skills of the

environmental health officer is critical to the production of an effective control system. Organizationally, structures usually provide for such officers either to be responsible for a wide range of environmental health activity across a defined area of the district (generalized approach), or for concentrating the use of more intensive skills in a particular facet, e.g. environmental protection (specialized approach). In both cases the environmental health officer is normally a team leader of the section dealing with this particular work, and is supported by technical and/or scientific staff. TECHNICIANS AND TECHNICAL OFFICERS These colleagues support and complement the work of the environmental health officer in particular aspects, e.g. food control, health and safety, and housing. This group is diverse and contains staff with a wide range of knowledge and skills. The creation of the correct balance between the professional and technical staff is an important, and often difficult, issue for the unit to achieve. Essentially, this balance is between the broader environmental management skills of the environmental health officer, and the more specialized in-depth skills of the technician. Environmental health technicians qualifying through the National B.Tec. courses are trained in all the main areas of activity, but in more detail in one or more areas, e.g. food hygiene, housing, or health and safety, while technical officers are trained in only one particular area of the unit’s work, e.g. pest control. OTHER PROFESSIONAL STAFF It is increasingly common to find environmental health units employing professional staff other than environmental health officers. Thus microbiologists, food scientists, chemical engineers and other professionals are likely to become part of the team forming the environmental health unit. ADMINISTRATIVE AND CLERICAL STAFF These colleagues provide the necessary administrative support from within the unit to the professional and technical staff. Copyright © 1999 Taylor & Francis Group LLC

The unit also requires a wide range of support from other departments of the council and from other agencies. The main requirements are for: • personnel, accountancy, legal and computer services—usually provided in-house by the council through the mechanism of a service level agreement with the unit specifying the service required, how it is to be provided and the cost • engineering services—advice may be required on the engineering aspects of water supplies, waste disposal, land contamination, etc.; this is either provided in-house by the relevant department, or by the appointment of private consultants on a project basis. MEDICAL Arrangements are made between the chief environmental health officer and the director of public health of the health authority for the provision of medical advice to the unit. In addition, the authority needs to appoint a Consultant in Communicable Disease Control to work with the environmental health department (see Chapter 16). VETERINARY Veterinary advice, e.g. for issues relating to animal welfare, is usually provided by retaining a local practice. ANALYTICAL The nature of environmental health control requires a wide variety of analytical and scientific services to be provided. In the larger units, this may be produced by the establishment of a scientific support team within the unit, and many units perform scientific analysis to some degree, e.g. the processing of noise recording tapes. Most units will, however, require support from outside agencies. Microbiological support is usually provided by the public health laboratory service in relation to the examination of food and water and for the investigation and control of communicable disease. There are some areas of the country, however, that are not provided with such a service, and in these cases the unit will use other hospital facilities or private microbiological services. Those units with responsibilities for the monitoring of the composition etc. of food are required

Fig. 3.7 The environmental health unit. EHO, environmental health officer. to appoint a public analyst who will either be employed by a council, district or county, or be in private practice. Other private analytical practices will be used on an ad hoc basis, e.g. for the identification of asbestos fibres. The principles embodied in the organization of the unit are shown diagrammatically in Fig. 3.7. This cannot be taken as being typical of any particular type of local authority, it simply illustrates the organizational approach to establishing a structure.

Case studies of environmental health units Clearly, there is no one model of service organization for environmental health that is appropriate to all authorities. The problems encountered in different localities, especially the variation in demographic and socioeconomic characteristics, which are perhaps the most significant determinants of local service requirements, demand that each council reviews local priorities and develops structures suited to the local conditions. Copyright © 1999 Taylor & Francis Group LLC

In addition, in recent years, the increasingly tight constraints on local government finance and the rapidly changing conditions in which services operate have resulted in circumstances where it is necessary to challenge preconceived ideas about the roles of environmental health departments and how they should operate. In order to give readers a feel for the range of problems and approaches to the organization of environmental health units, two case studies are included in the appendix to this chapter. Interdepartmental organization There is a need for an effective working relationship to be established between the chief environmental health officer and the unit, and other departments of the authority. Essentially, this is planned at two levels. Management team The chief environmental health officer/director of environmental health should be a member of

the council’s management team (or chief officer group), at which level the corporate planning of the organization takes place and major policy is formulated for presentation to members. As a major council service, the environmental health service must be professionally represented at this group if the significance of the service, and of other services upon it, are to be given full account. Departmental An effective arrangement needs to exist with most of the other departments of the council. Apart from the provision of support services, particular care needs to be taken to establish close links with the following departments. 1. Planning: access to the planning control function, assessment of proposals and recommendations on them by the environmental health department. 2. Building control: access to building regulation approval applications, assessment and comment. 3. Highways: environmental health implications of highway proposals and the implementation of noise insulation schemes. 4. Leisure: implementation of health targets (see Chapter 10) through leisure activities. 5. Housing: the integration of housing policies and programmes to ensure the effective use of resources and comprehensive housing strategies. 6. Waste disposal: waste disposal, recycling and waste regulation. 7. Education: hygiene control of the school meals service and the promotion of environmental health education in schools. 8. Social services: hygiene of the meals on wheels service and planning/implementation of care in the community policies. 9. Consumer protection: enforcement of the Food Safety Act 1990. 10. Fire protection: liaison on fire prevention aspects of health and safety and housing. (The last five activities in non-metropolitan areas are functions of the county council, and should Copyright © 1999 Taylor & Francis Group LLC

therefore be the subject of interauthority arrangements.) Project teams One common feature of the organization of local authorities is the establishment of project teams or groups composed of officers with relevant qualifications, and skills to work together across departmental boundaries to achieve specific objectives identified the council. Environmental health departments play a full role in such groups and indeed they will lead in several areas, e.g. Agenda 21, health improvement, etc. Intersectoral arrangements In addition to the need to establish liaison structures with those agencies that are directly monitoring environmental health issues or providing direct support to the unit, it is also necessary to establish intersectoral links with those other bodies that are either providing significant environmental health services, or services where joint planning with environmental health is desirable and with which it is therefore necessary to reach agreement on approaches, policies and programmes. These include the following. Health authorities Collaboration on health promotion, communicable diseases and the promotion of public health generally is achieved by arrangements between the chief environmental health officer and the director of public health and also, at member level, through the statutory Joint Consultative Committee (local authorities/health authorities). The relationship between the chief environmental health officer and the director of public health is an important one since there are clear, effective arrangements for communicable disease control to be established and operated (see Chapter 16), joint plans to be agreed on health prevention and noncommunicable environmental hazards, and a substantial environmental health input is required into the public health function. The state of public health in a particular area is a fundamental factor

in the setting of environmental health policies and targets there, and information on this needs to be gained through these liaison arrangements. Health authorities and local authorities need to work together to achieve a shared understanding of the health needs of the population. The annual report of the director of public health needs to reflect the major environmental health issues and the steps being taken by environmental health units to deal with them. The two officers will also need to agree a system for the provision of medical advice to the environmental health unit. This relationship was considered in some detail in the Acheson Report on the public health function [20], and advice on the relevant arrangements is contained in NHS Management Executive Health Service Guideline HSG (93)56 issued in November 1993. The need for partnership working and for stronger links between local authorities and health authorities is stressed in the health white paper The New NHS published in 1997 [21], and subsequently, in more detail, in the consultative paper on new policies for public health Our Healthier Nation [22]. The government’s intentions on public health are for there to be a stronger role for local authorities in achieving better health (although local leadership will be by health authorities) through health improvement programmes that will set out what each locality will do to help in the ‘national contracts for health’ (see Chapter 10). The public health role of the NHS will also be strengthened to ensure that all parts of the health service become more focused on preventing ill-health. The paper also comments that expertise in public health needs to be strengthened in all sectors, including, presumably, local authorities. With the aim of ensuring that the public health function can play a full part in achieving better health, the Chief Medical Officer is leading a project at local, regional and national level. See Department of Health, Interim Report of the CMO’s Project to Strengthen the Public Health Function, DoH, London, February 1998.

County councils The existence of a two-tiered system in some nonmetropolitan areas brings a need for a further set Copyright © 1999 Taylor & Francis Group LLC

of relationships. Effective and close co-operation is required at both elected member and officer levels to secure the integration of policies and programmes in such a way that environmental health objectives and standards will be enhanced, or at the very least not detrimentally affected, through county council services. These arrangements should be both formal, i.e. joint consultative committees of elected members, and informal, i.e. a good relationship and regular discussion between the chief environmental health officer or his or her representative, and chief/senior officers in the various county council departments. It is the difficulty of ensuring effective arrangements between the two tiers that has, among other things, led to the recent review of the system and the proposal for more single-tier government.

Interauthority arrangements One of the difficulties inherent in a locally-based environmental health system is that of achieving the necessary level of collaboration between the various environmental health units in order to produce the required degree of consistency in the enforcement of national legislation. Collaboration is also required to combine the effort needed to react to legislative proposals, identify common problems and solutions, and generally to produce a national level picture of the environmental health function, bearing in mind the lack of a single focal point within the central government structure. This collaboration is sought through two streams, the CIEH and the Local Government Association (LGA), although there are ‘bridges’ between the two mainly by way of some environmental health officers operating in both streams. An outline of these arrangements is shown in Fig. 3.8. Central to these arrangements are the county-based specialist groups, e.g. food safety, health and safety, housing and environmental protection, under the guidance of the Chief Environmental Health Officers’ Group [23]. The most recent improvement to the system is the establishment of LACOTS (see p. 65), and the implementation of the proposal for a new Food Standards Agency will be a further step in this direction.

Fig. 3.8 Interauthority collaboration on environmental health. CEHO, chief environmental health officer; EHO, environmental health officer; LAU, local authority unit.

BEST VALUE The principle of the compulsory exposure of local authority services to competition by tender was first put into practice by the Local Government, Planning and Land Act 1980 as a first step by the newly elected Conservative Government to improve the efficiency and effectiveness of local government. The 1980 Act requires competition with the private sector for the construction and maintenance work carried out by local authorities, e.g. highways, housing and sewerage, and also requires the establishment of separate direct labour organization (DLO) accounts together with a need to earn a rate of return prescribed by the Secretary of State. This was followed by the Local Government Act 1988, which was based upon the Copyright © 1999 Taylor & Francis Group LLC

government’s perception of creating further opportunity for substantial savings and increased efficiency by exposing a much wider range of functions to competition. The Act defines the activities required to be subjected to a process of competition as laid down in the Act and regulations made under it, and these include: 1. refuse collection 2. cleaning of buildings including public conve niences 3. other cleaning including street cleaning 4. school and welfare catering 5. other catering 6. grounds’ maintenance 7. repair and maintenance of vehicles 8. management of sport and leisure facilities 9. housing management

10. legal, financial, personnel and computer services 11. construction-related services, e.g. architecture and engineering The process of competition is tightly controlled by the Act and regulations, with particular emphasis being placed on the elimination of unfair competition, i.e. authorities unfairly favouring their in-house tenders. Separate accounts need to be established for each defined activity where the in-house direct service organizations (DSOs) are successful, and there are rate of return provisions. The Secretary of State is also given extensive powers to enquire into an authority’s performance under the Act, and to limit or end its operation in the event of a failure to fulfil the Act’s requirements. The incoming Labour Government of 1997 indicated its intention to replace the compulsory competitive tendering (CCT) regime with a duty on local authorities to achieve best value but this will require primary legislation. The Local Government (Best Value and Capping) Bill containing these provisions was published in December 1998 and awaits parliamentary approval. It is likely that the framework of the present system will operate for some time to come, although there may be detailed changes in the regulations and administrative advice. In the meantime, various pilot schemes began operating in April 1998 with the intention of building to a new Best Value (BV) regime by 2000. In these pilot areas, the local authorities will be exempted from current CCT regulations in certain sectors so as to enable the scheme to operate. The government has indicated that local authorities are likely to be expected to review 25% of their services each year and to establish targets for improvement against BV objectives to be specified by, say, the Audit Commission. In contrast to the CCT regime, BV is unlikely to designate the specific services to be covered. Instead the approach will apply to all services including those that are regulatory in nature. The environmental health service is therefore likely to be more significantly affected than previously [27], and some interesting possible new approaches to the service Copyright © 1999 Taylor & Francis Group LLC

will emerge from the consideration of the principles of the new regime. These are likely to include: • best value • innovative approaches to service delivery • improving effectiveness and quality of local services • partnerships • fair and open competition.

POSSIBLE CHANGES TO THE ORGANIZATION OF THE ENVIRONMENTAL HEALTH SERVICE While structural change within local authorities, including the environmental health function, is a constant and ongoing process, it is still the case that there has been no fundamental review of what the service is trying to achieve or of its structure since 1974. Such a review is likely within the next few years as a result of two initiatives: • the new focus on public health by the government [21] • the report of the Commission on Environmental Health [14]. Although most environmental health departments have reacted structurally to the major environmental and health issues of the 1990s, including Agenda 21 and Health of the Nation [24], it is nevertheless true that the core structure is devised to implement and enforce specific regulations and requirements. The new emphasis on public health, especially the recognition that poverty and deprivation, poor housing, unemployment and a polluted environment have a major impact on the health of the community, may well require structures that are geared much more to dealing with these broader issues than to enforcing particular rules. Certainly the public health role that is located in the health authorities, and the environmental health role within the local authorities, need to be brought much closer together than can be achieved by the rather loose collaborative arrangements that exist at present. It is also likely that the BV approach

to all local government services will ask questions of and create opportunities for innovation in the way in which the environmental health service is delivered.

APPENDIX 3A: CASE STUDY 1—THE ENVIRONMENTAL HEALTH SERVICE IN BRISTOL Robert Lambourne Introduction to the city of Bristol Bristol is situated in the south-west of England and is considered by many to be the regional capital. It has good motorway links to the Midlands, Wales and London. Above all else, Bristol is a maritime city; it has been a port for 1000 years and its wealth is founded on international trade by sea, including, it must be acknowledged, the shameful triangular slave trade in which human beings were reduced to a commodity. John Cabot’s voyage from Bristol to Newfoundland in 1497 remains a defining moment in the city’s history and is one reason for Bristol’s strong transatlantic link. The docks, in the heart of Bristol, are a constant reminder of the city’s origins and play a crucial role in its current and future success. The commercial Port of Bristol at Avonmouth is maintaining and developing Bristol’s traditional status as a great port city. Few cities have been so heavily influenced by engineers, especially ones as brilliant as William Jessop and Isambard Kingdom Brunel: the Floating Harbour, the Clifton Suspension Bridge, the SS Great Britain and Temple Meads Railway Station are all well known Bristol landmarks. Bristol remains the most industrialized city in the region, with large investments in the chemical industry and aerospace sectors, which are fundamental to the economy. Steeped in history and heritage, the city has an unusual diversity of architecture, which complements a dramatic natural topography and served as an inspiration for the celebrated nineteenth century Bristol School of painters. The relationship between Clifton’s Georgian terraces, the Avon Gorge, the Suspension Bridge and the historic port creates some of the most Copyright © 1999 Taylor & Francis Group LLC

extraordinary vistas to be seen in any European city. Another defining characteristic of the city is its reputation for culture and fun. The city of Bristol is the centre for hot air balloons and kites, community festivals and carnivals, theatres and museums, artists and animators, music and film. While Bristol has a unique and defining character, along with most large cities it also has its own social, economic and environmental problems. In line with national and regional trends, Bristol experienced a major change in industrial and employment structure in the 1980s. Local manufacturing industries such as paper and packaging, food, drink and tobacco suffered major job losses. Services generally, but private services in particular, expanded. The city centre has become synonymous with the provision of financial and business services and only a few manufacturing businesses remain in the inner area. The growing popularity of Bristol as a commercial centre has brought into sharp relief the twin problems of land availability and traffic congestion. Approximately 150000 commuters travel into the centre each day, most in private cars. Bristol’s resident population peaked in the immediate post1945 period and steadily declined after 1954. This trend has changed in the past 5 years, with a midyear resident population estimate approaching 400000. Bristol is a major marketing and service centre for the south-west of England, with approximately 5500 retail and service units. During the late 1980s and early 1990s government policy to promote out-of-town shopping complexes presented a real threat to the ongoing sustainability of the city centre area, which affords 60% of employment to the community of Bristol and surrounding regions. The city council, in partnership with the business community, embarked upon a visionary and strategic approach to restoring confidence in the regeneration of the city centre and inner city areas. This is now reaping commercial success and renewing life and energy at the heart of the city. As with most major cities, the recession in the late 1980s resulted in unemployment, especially among older age groups and black and other minority ethnic populations. The overall incidence of social and economic inequality still remains unacceptably high in Bristol. Tackling material

deprivation, enhancing access to primary health care and harnessing support from communities in determining local health and environmental priorities through the local Agenda 21 process are cornerstones in developing the delivery of environmental health services in Bristol. As part of an integrated strategy of promoting community development and a framework for sustainable development, Bristol Health and Environmental Services (BHES) has established a centre for community recycling, environmental action, training and education: the CREATE Centre. CREATE is located in a bonded warehouse in the city centre and operates in partnership with a wide range of community, voluntary, public and private organizations to promote sustainable practice.

Organizational philosophy The organizational structure and management style appropriate for the delivery of the best environmental health provision clearly varies from authority to authority. It needs to take account of local circumstances, financial restrictions, political priorities and changing legislative requirements, as well as national and global agendas for change. It cannot be a finite process, but one that continues to evolve. It must meet new challenges and address the sophisticated demands and expectations of modern society. This case study considers the development of environmental health provision in Bristol since 1974, but its primary focus considers the city’s return to its former city and county borough status as a new unitary authority on 1 April 1996. The development of local government over the past two decades, but most importantly during the 1990s, represents a dramatic change in organizational culture and a revolution in management. Local authorities have moved from being producer- to consumer-driven, and have adopted business-like methods that demonstrate performance and value for money. Services have moved away from small bureaucratic, compartmentalized departments to large integrated directorates with a focus on strategic planning and corporate working on clear agendas and themes This has enabled environmental health Copyright © 1999 Taylor & Francis Group LLC

provision to have a much broader impact, both in responding to local community needs, and for national and global issues of concern. During 1974, Bristol’s environmental health provision was restructured. It changed from a generalized district approach to organization and service delivery, to one of three specialist divisions headed by a chief environmental health officer covering the main functional areas of food, environmental protection and housing. The division had a classic hierarchical structure with teams of specialist environmental health officers and technical support personnel delivering its core statutory services. This general structural approach to specialist service delivery was retained, subject to minor amendments resulting from changes in legislation and service demand, until 1990. The council had commissioned a review of its management and procedures by the Institute of Local Government Studies (INLOGOV) of the University of Birmingham. The result, Into the 90s, proposals for a new political management system, was a diagnostic report that outlined the consultant’s evaluation of the main problems associated with the extant management structure and planning and decision-making process. The report also contained a series of proposals for change. The report suggested that the existing local authority departmental structures, which were profession-based (e.g. planning, engineering, accountancy), may not be the best way of organizing the deployment of the knowledge and skills concerned to the benefit of the authority as a whole. It also challenged the traditional structure of chief officers heading hierarchically-organized departments (and taking ultimate responsibility for everything that happens within the department) as not the best means to deliver efficient and effective service. The consultants emphasized the important strategic planning, co-ordination, monitoring and performance management role of future directors, and suggested that specific responsibility for service delivery should be delegated to unit managers. These managers should have set tasks to perform, agreed performance targets, a budgetary allocation and considerable devolved powers of virement in the use of financial and personnel resources to facilitate their ability to carry out the task.

The review concluded that the authority should move away from its organization along professional lines to the coherent grouping of related and complementary services. It recommended four new front-line programme area service directorates (housing, leisure, health and environmental services, and planning and development services) and four central service directorates, and the bringing together of various elements of the council’s direct labour operations as a contract services division.

These structural arrangements were complemented by streamlining the decision-making process for councillors, rationalizing committee arrangements, reducing the frequency of council and committee meetings, and reviewing the nature of delegation systems and the form, content and purpose of committee reports to ensure that councillors’ valuable time was targeted at policy and strategic service delivery decisions. Subsequently, a new committee structure to mirror the restructuring of the council was adopted (Fig. 3A.1)

Fig. 3A.1 Bristol local authority structure in 1991.

Fig. 3.A2 Formation of the new Health and Environmental Services Directorate of Bristol City Council in 1991. IT, information technology; IS, information service. Copyright © 1999 Taylor & Francis Group LLC

and implemented in 1991. As a result, the environmental health and engineering departments were combined to form one directorate, which also took in licensing from legal services and the responsibility for cemeteries and crematoria. In order to embody a comprehensive approach to meeting housing needs in the city, the department’s inspectorial and regulatory role for unfit, substandard and multi-occupied housing was transferred to the new Directorate of Housing Services. The advantages of grouping environmental health and engineering together were: the integration of teams that have an impact upon the quality and character of the local environment; and the formation of a unit with the political weight and budget to match the council’s other large directorates. The structure of the newly designated Health and Environmental Services Directorate is shown in Fig. 3A.2.

Organizational culture and performance management Organizational case studies traditionally tend to focus primarily on structural arrangements where form follows function or vice versa. Organizational culture is often overlooked. However, an understanding of it is fundamental to the successful development of any service, as it determines management style and the development of service priorities to meet the core values of any organization. Strategic and operational planning, together with performance management, operates at three levels within the council. The city council’s elected members publish annually a core strategy statement, which establishes a clear direction for the council as a democratic organization and summarizes key values and objectives for corporate action. This strategic statement of intent informs the Corporate Management Team and heads of service in producing an Annual Service Action Plan (business plan) for each directorate. This comprises three elements: a clear and well publicized mission statement, which identifies the directorate’s purpose and key roles; a detailed policy and strategic framework plan; and team operational plans. Copyright © 1999 Taylor & Francis Group LLC

Mission statement The purpose of the Directorate of Health and Environmental Services is to provide first class responsive and accessible services that sustain, enhance and renew the environment. KEY ROLES The key functions of the directorate are: • to protect the public from harmful activities and risks • to promote the safety and enhance the quality of the environmental elements of air, land and water • to maintain and improve the infrastructure of Bristol to the benefit of the public, the economy and the environment • to promote the conservation of environmental resources • to be responsive to the needs of those the directorate serves • to ensure equality in employment, service accessibility and provision • to demonstrate a management style that encourages participation and empowerment and that recognizes training and employee development as an investment • to work in partnership both within and outside the directorate to maximize efficiency and effectiveness. Policy and strategic framework plan The mission statement is supported by a detailed policy and strategic framework plan with clearly established policy objectives, actions and targets for all sectors of the directorate’s service. The directorate’s Annual Service Action Plan (business plan) is not merely limited to meeting the requirements of published statutory performance indicators, but includes key initiatives and projects that are reported quarterly to council committees as part of performance monitoring protocols. Team operational plans The directorate is a wide and diverse service, and while an Annual Service Action Plan embodying

clear policy objectives and a strategic framework sets a clear sense of purpose and direction for the organization, detailed work programmes, priorities and initiatives for each sector of the directorate are produced annually in team operational plans. This permits effective performance management at political, senior management and operational levels within the organization.

The changing service culture A service revolution has taken place in local government during the past decade, producing changes that have transformed thinking about the relationship between local authorities and their communities. Indeed, reference to the service users as customers rather than as clients, tenants or residents, as they were termed before, denotes a significant change in culture. This rejects the traditional model of being producer-driven, where recipients of services have only a marginal influence in determining service priorities, and replaces it with an ethos that actively encourages individuals and communities to be involved in deciding which local services should be delivered, when, how and by whom. Improving access to services and community empowerment, which in modern jargon is termed community governance, has been an integral theme in developing the service during the 1990s and was a primary objective in restructuring the directorate as part of local government reorganization to deliver a new focus on area management on vesting day, 1 April 1996.

Local government reorganization On 1 April 1996 the city of Bristol again became a unitary authority following the demise of the former Avon County Council. The major local government services of education and social services, together with a raft of other functions, were restructured within the authority. This transformed Bristol from a district council with a civic budget of £56 million per annum into the largest employer and council within the region, with an operating civic budget in excess of £300 million. Prior to local government Copyright © 1999 Taylor & Francis Group LLC

reorganization, both the Avon County Council and Bristol Council had been subject, like most authorities, to significant financial restrictions. Local government reorganization did not reverse this trend: indeed it resulted in a further 10% cut on the civic budget, arising from integration of the two authorities’ services. Both education and social services, which are the principal budget fundholders, were already under significant public and political pressure to maintain standards, so a significant burden of the budgetary savings fell on other central and front-line services. This represented a significant constraint, which had to be planned for and dealt with as part of the restructuring process. While there was a regrouping of central support directorates, the Health and Environmental Services Directorate retained its identity but assimilated the following former county council functions: • • • • • • •

waste disposal operations structural design and highway services scientific services trading standards service county green initiative teams road safety services county gypsy and travellers functions

Local government reorganization on this scale posed many challenges and the opportunity to produce more accessible and accountable services for the community. The magnitude of the change within a tight timeframe, in a climate of uncertainty over budgets, appointments to new posts and a need to ensure a seamless transition of services, necessitated a major commitment by the directorate’s Senior Management Team in terms of industrial relations, trade union consultations, a review of accommodation needs and negotiation of joint arrangements for certain services with the other new unitary authorities. The directorate entered into joint arrangements with the three other unitary authorities in the former county in relation to scientific services, waste disposal operations and metrology. A new organizational structure was adopted (Fig. 3A.3), which was designed to take account of the following important principles: • a flattened management structure of a maximum of four tiers

Fig. 3A.3 Restructuring of health and environmental services in Bristol. WDO, waste disposal organization; WDA, waste disposal authority.

• supporting and developing the core values of the new council • like and related services drawn together to enhance coherence and communications • each team achieving a clear policy, budget and service focus • consistency in the scope and size of teams and job responsibilities to support team working • the allocation and definition of team and job responsibilities encouraging multidisciplinary and corporate working • facilitating local working and effective area management • making provision to meet the requirement to expose increasing numbers of services to competition Copyright © 1999 Taylor & Francis Group LLC

• establishing distinct and generic management roles at the strategic and operational levels to secure the benefits of devolution. While taking account of these principles, the primary thrust of the restructuring was a move towards an area service delivery mechanism within the council’s four geographic divisions of north, south, east and central. In addition, the opportunity was taken to develop an integrated consumer protection group and to enhance the status of the city’s CREATE initiative, which was taking a corporate and regional lead in developing policy and practice on sustainable development. The area service delivery mechanism was achieved through a matrix management approach with designated senior managers having both a functional and an

area responsibility. While service delivery was still retained with specialist teams, personnel were organized within geographical areas in order to internalize a commitment as stakeholders in those communities. The directorate has always worked closely with the community and has an extensive network of contacts and relationships with a wide range of community organizations, the voluntary sector, business, industry and commerce. By establishing new area management teams, both at the corporate level and within the directorate, mechanisms were established for developing area service delivery with the objective of being responsive to community needs. While the foundation stones for successful area management have been laid, development continues with further political consideration being given to decentralization, developing customer centres/one-stop shops, extension of the community services approach, and development of new community forums and customer and jury panels. The Health and Environmental Services Directorate had been moving towards area service delivery since 1994 when four community action teams were established, which brought together officers from a number of functional areas (cleansing client, highways, lighting, food and safety, pollution control and pest control). This provided a framework to internalize attitudes and produce a positive focus for developing area management as a precursor to the restructuring described above.

Towards the millennium The traditional environmental health approach has made a significant contribution to enhancing public health and improving environmental quality through multi-agency working and by directing core services to intervene and control adverse circumstances and, where possible, to educate and promote prevention. Despite these endeavours, social deprivation—most graphically exhibited by homelessness on our streets, a re-emergence of diseases such as tuberculosis, and a deterioration of air quality in our major cities—emphasizes that this traditional ‘piecemeal’ approach requires a Copyright © 1999 Taylor & Francis Group LLC

radical review to meet the challenges of the next century. Securing real improvements in public health will require managers to see the ‘big picture’, to recognize that social, economic and environmental issues are inextricably linked to the well-being of the communities they serve. Making a difference can only be achieved by flexibility, teamwork and, most importantly, by developing real partnerships and co-operation with all those interested in the public health agenda. Developing such an integrated approach has been an important aspect in the evolution of service delivery in Bristol in the 1990s. This is highlighted by a corporate agenda that gives explicit priority to cross-directorate issues relating to vulnerable client groups such as children, young and older people, adoption of integrated urban regeneration strategies, developing partnerships addressing the issue of antipoverty, a third economy and community development. The city council has made a major commitment to developing its health agenda, green initiatives and community safety; the Health and Environmental Services Directorate takes the corporate lead in the latter two. One of the greatest challenges for future environmental health provision will be meeting escalating public demands and expectations. With resource constraints this can only be achieved by an ongoing critical review of service priorities, ensuring that they are relevant to local health and environmental needs and that the council works in real partnership with other like-minded organizations and service providers to secure real improvements in public health and sustainable practice for future generations.

APPENDIX 3B: CASE STUDY 2— ENVIRONMENTAL HEALTH IN KING’S LYNN AND WEST NORFOLK Robert D.Foster Introduction King’s Lynn is the largest town in the West Norfolk region and also the principal centre for parts of Cambridgeshire and Lincolnshire.

As a port and trading centre, King’s Lynn has an active history that dates back to the times of the Norman Conquest. By the thirteenth century, King’s Lynn was the third largest port in Britain, after London and Southampton. The borough is fortunate in having one of the most exceptional and unspoilt historic townscapes in Europe, as well as the wildlife sanctuaries and lovely shorelines of the Wash and the north-west Norfolk coast, and the rare charm of the Fens. The rural areas comprise 99 parishes covering about 550 square miles with some of the most attractive and agriculturally productive of countryside in the UK. Apart from King’s Lynn, the other main towns are historic Downham Market and the seaside resort of Hunstanton, which attracts a million day visitors a year. Tourists attracted by the unspoilt seaside and countryside, wildlife and historic buildings, and such features as the Royal Estate of Sandringham, form an important part of the local economy, which also features a wide crosssection of major manufacturing, service and agriculture-related industries including Campbell soups, Foster Refrigeration, Sandford UK (Berol) and Dow Chemicals. The population base is 132000, but the catchment population for shopping is around 180000. In recognition of the long-term decline of its agricultural base and rural deprivation, the whole of the southern part of the borough has won European Objective 5b status. However, major recent investment includes extension of the port facilities, a new gas-fired power station, expansion of most of the major established companies and town centre redevelopment.

Organizational philosophy The Environmental Health Department is a standalone department carrying out the full range of environmental health activities. Recently it has added the lead role for such issues as recycling and waste management and the holistic strategies concerning the environment, health improvement and local Agenda 21. The environmental health agenda is moving fast. Global concerns for the environment are being Copyright © 1999 Taylor & Francis Group LLC

translated into local action through the engagement of communities, and the principle of sustainable development is being enunciated through the process of local Agenda 21 originating from the Rio Earth Summit in 1992. The Local Government Management Board has widened local Agenda 21 to include social and economic dimensions as well as environmental ones. The EU continues to move forward on many environmental fronts and is beginning to address health issues and their relationship with the environment. The UK government has fully supported the Earth Summit and has produced reports on sustainable development in the UK, targets for the national health, and a National Environmental Health Action Plan. In the meantime, there has been a continuous flow of new duties and initiatives placed on environmental health departments by central government affecting work priorities. These major initiatives have come at a time of rising demand and expectations from the public for services and when severe budget restraints have been placed on local government. Environmental health departments in these circumstances have had to reconsider their traditional role and adapt to take on the new challenges. The following issues relate to these changes and have been a major factor in the development of services in King’s Lynn and West Norfolk.

Organizational culture External change has forced the department to rethink patterns of service delivery, take on new responsibilities and skills and prioritize the use of resources. The emphasis has been on identifying those services that are relevant and creating systems to ensure confidence in their delivery. As a result, the orientation of the department has changed from being a professionally-derived base to being a customer-focused base. This is important attitudinally and is key to major change in how staff view their work. These achievements are recognized in the award of Investors in People and Charter Mark to the department over the past 5 years.

Business excellence

Community governance

Apart from the previously mentioned awards, the department has also been pursuing the British Quality Foundation Business Excellence model. The model embraces all aspects of an organization’s performance, including those covered by Investors in People and Charter Mark. An annual assessment is carried out, improvements that are needed are identified and action plans are drawn up. The model is much more ambitious than those implemented so far, and the borough council has decided that this is the means to achieve the government’s requirements for best value. The department is now in the process of undertaking its second year of the Business Excellence model.

Community governance recognizes the influence that local authorities exert over a wide range of bodies, both voluntary and governmental, that provide services in their area. There has been the development of outreach activities to harness the potential for the engagement of wide sectors of the community in mutually acceptable activities aimed at promoting environmental and health issues. Fundamental to this is raising awareness of the relevance of their activities and helping to direct their efforts along common paths. The department has facilitated this process by setting up an Environmental Forum and a separate Health Forum, on which a wide range of bodies working in the community are represented, and by participating in generic projects such as Healthy Norfolk 2000, which was set up to achieve the Health of the Nation targets.

Strategic planning More clarity is needed in the provision of services and this is achieved through the development of service and corporate strategies. They define priorities that are supported by the borough council, customers and partners, and have enabled the department to develop a Service Plan clarifying the priorities for the current year and providing clear direction for the use of the department’s resources. Corporate impact Over the past 10 years the department has moved from being a mainly technically specialized service to including the exercise of strategic corporate issues affecting the whole of the council services and general community. The lead role for health, environment and local Agenda 21 strategies is undertaken, affecting all the council’s committees, the services it provides and the form of a wide range of community initiatives. Although partnership working is now regarded as a normal work function, these strategies do require intensive intersectional co-operation. Initiatives such as these have led to the development of the concept of community governance. Members of the department are, in many instances, heavily involved and play a lead role in the internal and external groups that exist to take strategic development forward. Copyright © 1999 Taylor & Francis Group LLC

Specialization New functions are being continually devolved upon local authorities by central government. They often originate from the EU, which has a more prescriptive and numerative approach and imposes greater enforcement burdens than previously, e.g. food premises inspections. In addition, reflecting society generally, the nature of the work has become more technical and sophisticated. These changes have resulted in the formation of teams within the department to provide the indepth specialist services needed to meet the new duties and provide continuity when change occurs. Increased specialization by environmental health officers (EHOs) has been necessary, as has the employment of specialist technical support staff.

Technical support staff Although the department’s numbers have increased over the past 10 years to reflect the workloads, the number of EHOs has remained the same, with technical support staff being brought in to carry out the more routine tasks, e.g. dog warden, and

to provide additional specialist skills, e.g. microbiologist. This has enabled better deployment of the more flexible skills of EHO staff, thus making the most cost-effective use of resources. The increase in the number of technicians and their skill level has brought about the need to look at career progression for technicians and the supervisory role that EHOs have for them.

Staff development A critical part of the management of environmental health departments today is the efficient management of highly skilled staff. It is essential that their skills are kept ‘honed’ so that they can deliver the technical and quality outcomes required. The progress of each member of staff is reviewed at least twice a year, and training needs are identified and implemented as part of the council’s appraisal process. As part of its commitment to Investors in People, the council has increased its training budget to the equivalent of 15% of the payroll, and full advantage of this is taken by the department. Increased specialization can bring to the fore the potential problem of narrow vision and lack of appreciation of the wider context of staff actions. To counter this, efforts are made to have regular team meetings, which also act as quality groups, departmental and council newsletters are produced, staff are members of corporate groups and task groups that cut across sections, and appropriate training, including management training, is provided. To avoid the problem of a lack of continuity when staff are absent or leave, specialized areas of work are dealt with by the team approach. The council’s delegation scheme is structured so that the chief officer can delegate responsibility to carry out duties commensurate with the individual staff member’s stage of development and capability. The aim is to delegate down through the organization as much responsibility as possible, including service of statutory notices, with the aim of improving both job satisfaction and service to the public. The department carries a full complement of students—3 EHOs and one modern training apprentice—and facilitates attendance at postgraduate day release courses in a wide range Copyright © 1999 Taylor & Francis Group LLC

of additional qualifications considered essential for modern environmental health services. The department can provide virtually the full range of practical training for EHO students and runs a number of relevant courses available nationally. Organization of the department The department was originally based on geographical districts with specialist support, but this was changed into four specialist division areas in 1988, and subsequently into three specialist areas in 1996. The main reason for the latter move was to change the structure from being professionally determined to having a customer focus. The current department therefore comprises commercial and domestic divisions with a supporting administrative division. Within the two technical divisions there are teams providing particular expertise in specialist areas. Fig. 3B.1 shows how the current organization has evolved over the past 2 years. The major recent changes are the setting up of a specialist Health and Safety and Licensing Team within the Commercial Division and the appointment of additional staff in the Housing, Environmental Protection and Health and Safety Teams. Vision statement and key objectives The vision statement of the department is: ‘The department will continually strive both to protect and improve the safety and health of the public and to protect and improve the environment in which they live, work and play’. This statement is strengthened by the following service key objectives: • to protect the private sector housing stock from deterioration • to protect and promote the health, safety and welfare of people while at work, at home or in pursuit of leisure • to provide help, support and information to the public in event of natural, man-made and civil emergencies • to monitor the environment and to control, prevent or eliminate pollution and nuisances

Fig. 3B.1 Structure of the Environmental Health Department in King’s Lynn and West Norfolk borough council, p/t, part-time; KWNT, Keep West Norfolk Tidy Group; MIS, management information systems.

• to promote the protection of the environment and its natural resources • to keep the borough clean and clear of refuse and litter • to safeguard the public by ensuring that all food and drink produced, imported or sold within the borough is, in all respects, fit and suitable for human consumption • to control and prevent the spread of notifiable diseases and food poisoning • to control the presence of vermin or other pests • to protect the health, safety and welfare of animals where the council has an enforcement responsibility.

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Vision statements and key objectives need to be translated into strategies and action programmes to make them valid and relevant, and this is the stage at which partners and users of the department’s services need to be involved,

Strategy development The department produced its first environmental and health strategies in 1990 followed by the local Agenda 21 strategy in 1994. Extensive consultation exercises with the local community were undertaken before their final adoption by the council. It also became a founder member in 1990 of Healthy

Norfolk 2000, a ‘healthy alliance’ partnership organization that was the natural vehicle to meet the government’s Health of the Nation targets. Subsequently, various community-based forums have been created, including an Environment Forum, a Health Forum and a Food Producers’ Forum. This activity forms an essential element in the ‘community governance’ approach to strategy development and is used extensively by the department for community input. Other partnership, approaches that have been developed or are underway include such topics as noise and anti-social neighbours, contaminated land, private sector housing, litter cleanup campaigns and energy efficiency.

Service standards In determining the most effective use of resources and to meet customer needs the department has set service standards for its main functions (Fig. 3B.2). Compliance with service standards is monitored on a regular basis by section managers. Targets are set for percentage compliance, e.g. 90% for the response time to service requests of two working days being met. These service standards and targets are reviewed at regular intervals and reflect the practicalities of providing a doorstep service in a large rural area, the nature and urgency of the request, and the resources available. It is not sufficient to determine such standards from just a professional point of view and the principles of Charter Mark and Business Excellence require customer views to be incorporated into the review process. This is achieved at King’s Lynn through the vehicle of the various forums mentioned and through surveys of individuals and local organisations such as the 101 Parish and Town Councils in the area.

Service plan A service plan is produced, usually annually, which incorporates the vision statement, key objectives, organizational and service strategies, the service standards and the service priorities determined by council policy and legislative and government Copyright © 1999 Taylor & Francis Group LLC

requirements. From this summary of key inputs and determinants, priorities are identified for action during the year. Targets are then set for the department and consequently for managers and their teams and individual members of staff, which are reflected in staff performance targets as part of the council’s performance management system.

Challenges facing the department The past 5 years in particular have seen major growth in the functions carried out by the department. They have originated not only from government action but through increased public expectation of service delivery, both in standard and scope, and the corporate initiatives resulting from the movement of the link between environment and health to central stage in the council’s priorities. The department has been well supported by an increase in staff numbers to meet these demands (3 in 1997), but this is very unlikely to continue due to increasingly severe financial restrictions. Staff rationalization to reduce the number of divisions and senior management staff was carried out in 1996 and 1997, and staff numbers increased at the ‘sharp end’ through the savings achieved. While the opportunity to make adjustments will always be taken when changes in staff occur, it is likely that the main opportunities have already been taken. In future, the capacity to meet increased work demands will continue to concentrate on priority setting and on the linked ability to achieve extra income. A current example of the latter includes a ‘Houses in Multiple Occupation’ registration scheme, for which the staffing resource will be met by the registration fee charged for each bed space. It is hoped that the implementation of the new food safety requirements following the Pennington Report on the outbreak of E.coli O157 in Scotland in 1997 will require licensing of high risk food premises, for which a fee will be charged, thus financing the additional staffing levels needed to carry out the increased levels of enforcement. New and often highly desirable legislation continues to flow from central government. For

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Fig. 3B2 King’s Lynn and West Norfolk’s Customer Charter.

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example, the department is faced with implementing local air quality management and contaminated land strategies in the near future. New policies are being developed to adapt housing investment programmes and housing strategies to accommodate empty property, thermal insulation and community safety initiatives as well as moving investment of resources in the private sector to preventative maintenance. In taking the lead role in the local Agenda 21 strategy, the department is, in common with many other local authorities after adoption of the strategy, faced with implementation and ensuring that the principles of sustainable development are reflected in every activity of the council and that they are also disseminated into the wider community. This will probably be the major challenge over the next few years as it needs everyone to have an understanding of and a change in attitudes towards the way in which society goes about its functions. The importance of the community governance role cannot be overestimated, especially for environmental health departments. It describes to a large extent the way in which environmental health already carries out many of its promotional and community-based functions, especially those involving other agencies in the NHS, community/ neighbourhood groups and businesses. Networking and the building of alliances and partnerships is the key to integrating community needs, and without it there cannot be acknowledgement of the links between environment and health and sustainable development. An integrated approach would also appear to be essential for successful bids to obtain resource allocation from government. Working together in this fashion has proved to be very productive in King’s Lynn and West Norfolk and will undoubtedly continue to be so, but it is time-consuming. It will remain a priority, however, as successive governments have indicated that this is the preferred approach. The department is well versed in the so-called ‘quality approach’ to the provision of services. The current challenges are to reapply for the Citizen’s Charter Mark and to meet the government’s ‘Best Value’ initiative by the councilwide implementation of the British Quality Copyright © 1999 Taylor & Francis Group LLC

Foundation Business Excellence model. This is on top of the current council-wide Investors in People award. The Charter Mark in particular is regarded as essential to the delivery of quality services, ensuring at the same time that they are relevant and costeffective. The department is committed to its principles and will continue to take them and the wider needs of the British Quality Foundation approach into account. With the increasing diversity, sophistication and volume of work, management will need to keep staff training and support needs under continual review. While the basic environmental health degree is being kept as up-to-date as is practicable, it cannot possibly equip graduates with all the necessary skills. Postgraduate training will therefore continue to be essential for new and existing staff, and is assessed as part of the performance management system. Work pressures require flexibility in staff deployment, and the structure of the department will be kept under review to ensure that staff are organized as efficiently as possible with the right mix of relevant skills and support staff. Along with the increased use of skilled technicians to support EHOs will come the need to develop career progression to reflect their role. The environmental health department has faced and met massive changes in all aspects of its work over the past decade. This will continue and management, structure and skills need to be flexible and adaptable to deliver services. Best value, however it is interpreted, will be a major future influence and will guide many aspects, both attitudinal and the way services are delivered. For the first time environmental health departments will not be exempt from market testing through competitive tendering as this is a component of best value, and sufficient companies now exist that can provide basic environmental health services. The challenge will be to demonstrate that best value is being obtained without the need for competitive tendering. In King’s Lynn and West Norfolk it is hoped to do this by virtue of the quality systems already in place and through the adoption of the British Quality Foundation Business Excellence model.

REFERENCES 1. DETR (1998) White Paper: A Mayor and Assembly for London: the Government’s Proposals for Modernizing the Governance of London, Cmnd 3897, Stationery Office, London. 2. LACOTS (1998) LAC 5 98, 6 March 1998, LACOTS, London. 3. Local Government Ombudsman (June 1997) Local Government Ombudsman—Report of Cases 1996, 21 Queen Anne’s Gate, London, SW1H 9BU. 4.Audit Commission (June 1990) Environmental Health Survey of Food Premises, Bookpoint, Abingdon. 5. Audit Commission (December 1990) Safer Food: Local Authorities and the Food Safety Act 1990, Bookpoint, Abingdon. 6. Audit Commission (July 1991) Towards a Healthier Environment: Managing Environmental Health Services, Bookpoint, Abingdon. 7. Audit Commission (September 1991) Healthy Housing: the Role of Environmental Health Services, Bookpoint, Abingdon. 8. IEHO and Audit Commission (April 1993) The Audit Commission Study of Environmental Health: an Assessment by Chief EHOs, CIEH, London. 9. Audit Commission (1997) It’s a Small World —Local Government’s Role as a Steward of the Environment, Bookpoint, Abingdon. 10. The Citizen’s Charter—Raising the Standard (July 1991), Stationery Office, London. 11. WHO (1978) Role, Functions and Training Requirements of Environmental Health Officers (Sanitarians) in Europe, WHO Regional Office for Europe, Copenhagen. 12. DETR (February 1998) Modernizing Local Government: Local Democracy and Community Leadership, DETR, London. 13. Kreisel, W. (1989) Affecting change— environmental health in the 1990s. Address to the NEHA AEC. 14. CIEH (1997) Agendas for Change—Report of the Environmental Health Commission, CIEH, London. Copyright © 1999 Taylor & Francis Group LLC

15. DTI (1994) Report of the Interdepartmental Review Team, Department of Trade and Industry, London. 16. LGMB (1996) Regulation: a Guide to Good Practice in Local Government, Local Government Management Board, Arndale House, Arndale Centre, Luton, LU1 2TS. 17. UN (1992) Earth Summit. Agenda 21. The United Nations Programme of Action from Rio, UN Department of Information, New York. 18. Report of the Committee of Enquiry (1986) The Conduct of Local Authority Business, Cmnd 9797, Stationery Office, London. 19. Audit Commission (1988) The Competitive Council, Management Paper No. 1, Stationery Office, London. 20. The Report of the Committee of Enquiry into the Future Development of the Public Health Function (1988) Public Health in England, Cmnd 289, Stationery Office, London. 21. DoH (1997) White Paper: The New NHS, Department of Health, Stationery_Office, London. 22. DoH (February 1998) Our Healthier Nation: A Contract For Health, Department of Health, Cmnd 3852, Stationery Office, London. 23. Bassett, W.H. (1992) Setting sail for new joint efforts. Municipal Journal, 22, 29 May-4 June. 24. DoH (1992) The Health of the Nation: A Strategy for Health in England, Department of Health, HMSO, London. 25. Cabinet Office (1998) Service First: The New Charter Programme, Cabinet Office, London. 26. En-Charter (1999) How to Improve Environmental Health Services—A Good Practice Guide, 2nd edn, Service First Publications, London. 17. Buckland, W. and Coupland, S. (September 1998). Best Value: A Framework for Consistency, E.H.Journal, pp. 267–70.

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The organization of environmental health in Scotland Michael Halls

There are several differences between the system of environmental health that operates in Scotland, and that in other parts of the UK. These differences embrace both the structure of the local authorities and the functions that are undertaken by environmental health departments. In this chapter, if there is no reference to a Scottish way of working it can be assumed that the arrangements are similar to those for England and Wales.

however, the necessary relationships were soon forged and the liaison arrangements between the two agencies and local government are now very good. One of the first acts of the new government after coming to power in May 1997 was to set up a scheme for devolution of certain powers from Westminster to a Scottish parliament to be established in Edinburgh. At the time of writing, it is not clear how this will impinge on local government in Scotland.

LOCAL GOVERNMENT SYSTEM The system of local government in Scotland went through another reorganization on 1 April 1996, when, in place of the 65 regional, district and island councils, 32 unitary authorities were established. The change meant the disappearance of 9 regional councils and 53 district councils, but the three island councils remained more or less the same. Of equal significance, and on the same date, certain powers were removed from the local authorities as a result of the creation of the Scottish Environment Protection Agency (see p. 105). One year earlier, on 1 April 1995, the powers of local authorities in relation to meat hygiene were vested in the Meat Hygiene Service (see p. 664). Because both these organizations comprise non-elected members, their setting up was resisted by local government. Once they became established, Copyright © 1999 Taylor & Francis Group LLC

CENTRAL GOVERNMENT FRAMEWORK In October 1995, new arrangements came into force for the organization of the Scottish Office, the arm of central government that deals with purely Scottish affairs. Under the previous arrangements, environmental health had had dealings with three departments of the Scottish Office, but after the reorganization the interests of environmental health were centralized under two departments: the Scottish Office Agriculture, Environment and Fisheries Department (SOAEFD); and the Scottish Office Department of Health (SODH). The structure of the departments is such that environmental health interests are looked after in SOAEFD by either the Agriculture Group (e.g.

food safety, standards, etc.) or the Environmental Affairs Group (e.g. pollution control) and in SODH by the Chief Medical Officer’ section. The SOAEFD has many functions other than those related to environmental health, but the major liaison between the department and local councils’ environmental health departments is with the sections dealing with food safety, water supplies and the environment, notably with regard to sustainable development. The SODH’s interests are mainly related to the National Health Service (NHS), but because local authorities and the departments of public health in the Health Boards are essential partners with environmental health in the task of maintaining and improving the health of the people of Scotland, there are regular lines of communication between the two. The Scottish Office enjoys a considerable degree of autonomy, and as a result some local government functions are discharged somewhat differently in Scotland than in England and Wales. Examples of the differences can be seen in food law enforcement, the law relating to milk and dairies, and in waste disposal.

THE CONVENTION OF SCOTTISH LOCAL AUTHORITIES (COSLA) COSLA is the representative voice of Scottish local government. It also acts on behalf of its member councils as their employers’ association, negotiating salaries, wages and conditions of service for local government employees with the relevant trade unions. COSLA is funded by a levy paid by each of its 32 member councils, calculated on the basis of population. COSLA’s annual budget for 1997/8 was approximately £2 million. The organization has four stated key objectives: 1. to provide national leadership for local government in Scotland in order to help councils strengthen local democracy and community support for local government 2. to increase the role and influence of local government in all matters affecting the communities they serve Copyright © 1999 Taylor & Francis Group LLC

3. to increase the control that local government has over its own affairs 4. to establish effective relationships with government, European institutions and partner organizations. It also accepts responsibility, in partnership with its member councils, for developing, encouraging and promoting best practice. One of the ways in which it tries to achieve this is by offering consultancy services to its members. It also works closely with the Scottish Office, especially with regard to local government finance. COSLA’s headquarters are at Rosebery House, 9 Haymarket Terrace, Edinburgh EH12 5XZ. It also maintains an office in Brussels.

THE MEAT HYGIENE SERVICE (MHS) The MHS was set up in 1995 as an agency of the Ministry of Agriculture, Fisheries and Food and its remit, unlike its parent ministry, covers Scotland as well as England and Wales.

THE SCOTTISH ENVIRONMENT PROTECTION AGENCY The Scottish Environment Protection Agency (SEPA) became fully operational in 1996 and took over the responsibility for protecting the environment of Scotland from: • the 7 river purification boards and the river purification functions of the 3 island councils • the 53 district councils and the 3 islands councils with regard to their powers relating to waste regulation and some functions relating to local air pollution • Her Majesty’s Industrial Pollution Inspectorate • the Hazardous Waste Inspectorate of the Scottish Office (some functions) SEPA has around 650 staff, including many environmental health officers, and has a presence in 22 locations throughout the country. Its

headquarters are at Erskine House, The Castle Business Park, Stirling FK9 4TR. The agency’s mission statement is ‘to provide an efficient and integrated environmental protection system for Scotland which will both improve the environment and contribute to the government’s goal of sustainable development’.

THE ROYAL ENVIRONMENTAL HEALTH INSTITUTE OF SCOTLAND (REHIS) REHIS is the professional body that represents the interests of the environmental health profession in Scotland. Its membership includes representatives of all officers engaged in the various aspects of environmental health work. Environmental health officers account for the largest proportion of its membership, but other officers may also be given full membership provided they are suitably qualified. Membership includes a number of consultants in public health medicine, veterinarians, meat inspectors, and people involved in various aspects of environmental health education. Representatives of each of these groupings may be elected to the executive council of REHIS. Elected members of local authorities and health boards, and people engaged in commercial activities associated with environmental health, are eligible for associate membership. In addition to representing the professional interests of environmental health officers, REHIS’s main aims are to promote environmental health throughout Scotland and to secure the proper organization of the recruitment, training and qualifications of environmental health officers and red and white meat inspectors. This is achieved by overseeing the professional training of, and by examining, environmental health officers and meat inspectors, by organizing regular training courses, and by holding an annual national conference and exhibition. A magazine that covers a wide range of topics of interest to the membership is published regularly. An annual report on environmental health in Scotland and a compendium of conference papers are also published each year. Copyright © 1999 Taylor & Francis Group LLC

REHIS now stipulates that all members who are qualified environmental health officers (EHOs) must comply with its scheme of Continuing Professional Development (CPD). The purpose of this scheme is to maintain, improve and broaden the knowledge, skills and expertise of EHOs and to develop the personal qualities necessary to undertake professional tasks and duties. The scheme also assists in the development of the managerial skills necessary to supplement professional knowledge, and activities are undertaken regularly so as to ensure that the learning process is continuous throughout the officer’s working life. Arrangements are in hand to introduce a similar scheme for other qualified officers who are members of REHIS. REHIS is also responsible for the organization of courses in meat and poultry inspection. The syllabus for these courses is approved by the Scottish Office. Courses and examinations, which lead to the relevant certificate being awarded, are organized by REHIS. REHIS is consulted by government departments and COSLA on proposed legislation and environmental health issues, and advises its members and individual local authorities on a wide variety of topics. The office that deals with the business and administrative affairs of REHIS is in Edinburgh at the following address: The Royal Environmental Health Institute of Scotland 3 Manor Place Edinburgh EH3 7DH Tel: 0131–225 6999 Fax: 0131–225 3993.

TRAINING AND QUALIFICATION OF ENVIRONMENTAL HEALTH OFFICERS In Scotland, the route leading to full professional qualification in environmental health entails obtaining a BSc in environmental health, and undertaking a period of practical training and assessment leading to the Diploma in

Environmental Health of the Royal Environmental Health Institute of Scotland. Four-year honours degree courses following syllabuses approved by REHIS are established at the University of Edinburgh and the University of Strathclyde. The off-campus element requires students to complete 48 weeks of practical training with a local authority following a programme prescribed by REHIS. This can be undertaken either in separate blocks during university vacations, or ‘end-on’ as one period after graduating. The final stage is a twoday assessment of competence involving interviews and practical tests. If this is completed satisfactorily, the Diploma in Environmental Health is granted. NATIONAL CO-ORDINATING GROUPS FOR ENVIRONMENTAL HEALTH Because Scotland is a small country (with a population of just over 5 million), it has been possible to establish national co-ordinating bodies to provide a forum at which major environmental health issues can be discussed. Examples of these are described below. The Scottish Centre for Infection and Environmental Health (SCIEH) The SCIEH was established in 1993 by the amalgamation of the Communicable Diseases (Scotland) Unit and the Environmental Health (Scotland) Unit. It is based at Clifton House, Clifton Place, Glasgow G3 7LN. SCIEH is a multidisciplinary organization comprising expertise in environmental health, clinical infectious diseases, information sciences, public health medicine, nursing, social sciences and veterinary public health. The SCIEH is responsible for the surveillance, on a national basis, of environmental health hazards and the provision of advice, expertise and support to local authorities and Health Boards throughout Scotland. Its mission statement is ‘to improve the health of the Scottish population by providing the best possible information and expert support to practitioners, policy-makers and others on infectious and environmental hazards’. Copyright © 1999 Taylor & Francis Group LLC

SCIEH is mainly funded by central government but also earns income by providing advice on a consultancy basis to interested organizations. It also has a role in education and training and carries out extensive research. The Scottish Environmental Health Group This group was set up in 1977 by the former Scottish Office Home and Health Department to discuss important environmental health and communicable diseases issues. It comprises representatives from the relevant Scottish Office departments, the Health and Safety Executive (HSE), the Health Boards, the SCIEH and a proportion of the officers in charge of the environmental health function carried out by the 32 unitary authorities. The Scottish Food Co-ordinating Committee The Scottish Food Co-ordinating Committee (SFCC) was set up in 1982/3 with a remit to ensure uniformity of standards of enforcement in relation to food legislation. It was also expected to provide expert advice to enforcement authorities and, more recently, has had its role expanded to include the co-ordination of the food surveillance and food hygiene work undertaken by Scottish councils. The SFCC maintains links with a number of liaison groups working at a more local level. The membership of SFCC and the local groups comprises environmental health officers, public analysts, microbiologists, trading standards officers and representatives of the Scottish Office. SFCC operates with 2 subcommittees, one dealing with food standards and the other with food safety, and there are well-established links with LACOTS (see p. 65), involving SFCC members in the latter’s Food Safety Panel and its Quality Standards Panel.

The Scottish Food Safety Officer’s Registration Board (SFSORB) This body was set up by REHIS to provide a means whereby food officers other than EHOs could

obtain qualifications to enable them to carry out inspections of food premises or food standards. The SFSORB is approved by the Scottish Office and is authorized by the Food Safety Act’s Code of Practice to award the appropriate certificates. The SFSORB consists of representatives of REHIS, the Scottish Office, the Association of Meat Inspectors, the Institute of Food Science and Technology and the Scottish Food Safety Officers Association. It has developed syllabuses for the Ordinary and Higher Certificates in Food Premises Inspection and the Higher Certificate in Food Standards Inspection. Applicants have to satisfy the board that their educational qualifications are acceptable or they have to sit a written food examination set by the board. In addition, all candidates have to submit a case study or series of reports and are subsequently interviewed to assess their competence in carrying out food inspections.

ENVIRONMENTAL HEALTH IN LOCAL GOVERNMENT The reorganization of local government that took place in 1996 led to one of the largest and most comprehensive changes to affect environmental health in the second half of the twentieth century. Whereas the authorities in existence until then had, more or less, adopted similar systems for delivering an environmental health service based on a discrete department headed by a director of environmental health, the new councils have adopted almost as many systems for delivering the service as there are councils! Very few councils have a stand-alone environmental health department, and the most common location for the service is in a large department with other enforcement services, such as consumer protection or trading standards. Other authorities have adopted even greater amalgamations, and the titles of the departments charged with the environmental health function give a clue to the groupings established. Examples include: Environmental and Consumer Protection Services; Community Services; Environment; Protective Services; Technical and Leisure Services; Copyright © 1999 Taylor & Francis Group LLC

Planning, Roads and Environment; and Environmental and Protective Services. The committee structures set up to deal with environmental health issues mirror the departmental structures quoted above. Having been redrawn, the local government map of Scotland still shows in graphic detail the differences of scale that have always existed with regard to both the size and population of local government areas. The council with the highest population is the city of Glasgow, with 624000 people and that with the lowest is Orkney with 20000. Discounting the island authorities, the council with the lowest population is Clackmannan with 49000. When areas are examined, huge differences become apparent, reflecting the sparsity of the more rural areas. Highland Council administers an area that, at 2.6 million hectares, is one-third the size of the whole of Scotland, and at the other end of the spectrum is the city of Dundee, which occupies only 5500 hectares. The number of elected councillors currently stands at 1331, but moves are afoot to reduce this number by the year 2000, and in due course the new Scottish parliament will undoubtedly look carefully at this issue. The functions carried out by the departments responsible for providing the environmental health service in Scotland are very similar to those in other parts of the UK, although there are some differences due to the fact that some aspects of the law in Scotland are not the same as that in England and Wales. In general, however, the basic environmental services of food safety, occupational health and safety, aspects of pollution control, housing standards, communicable disease control, and waste management fall on the department charged with providing the environmental health service. Environmental health officers act as both advisers and enforcers and, probably because their training is essentially practical and based on a holistic approach, they tend also to be given responsibility for a range of other local government functions, such as pest control, control of dogs, animal welfare provisions, and, increasingly, matters relating to sustainable development.

LEGISLATION APPLYING TO SCOTLAND A proportion of the legislation used on a daily basis by environmental health officers in Scotland applies to the whole of the UK. Examples include enactments relating to the environment and its protection, occupational health and safety, and food safety. Other laws apply only to Scotland, although they generally resemble similar powers available in the rest of the UK. Peculiarly, Scottish legislation includes the Civic Government (Scotland) Act 1982, which gives powers to councils to deal with, inter alia, repairs to buildings, licensing of street traders, late catering licences, control of dogs and the making of by-laws—all of which are used by environmental health departments in the discharge of their duties. A second example is the Licensing (Scotland) Act 1976. Although primarily concerned with the conditions attached to the issue of liquor licences, it also contains provisions that relate to food hygiene standards in licensed premises, and can also enable the licensing authority to impose noise control standards where music or entertainment is provided in licensed premises. With regard to housing standards, there is a difference between Scotland, where the ‘tolerable standard’ has existed since the 1970s, and England and Wales, where a standard based on ‘fitness’ is used. The tolerable standard is currently under

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review, and in the future the two standards might be made more similar. A description of the judicial system in Scotland is given in Chapter 7.

FINANCIAL ACCOUNTABILITY The Commission for Local Authority Accounts in Scotland (the Accounts Commission) has responsibility for ensuring that all local authority accounts are externally audited. The Accounts Commission, through the office of Controller of Audit, exercises this function either directly using its own staff, or by the use of private firms of approved auditors. The accounts of environmental health departments are subject to this process, which requires the auditor to ensure that all statutory requirements have been met and proper practices have been observed in the preparation of the accounts. The Accounts Commission is also empowered under the Local Government Act 1988 to undertake value-for-money studies in areas that include environmental health functions. These studies can lead to the making of recommendations aimed at improving economy, efficiency and effectiveness, and at highlighting areas where management can be improved.

5

The organization of environmental health in Northern Ireland Michael Joyce

The present system of local government in Northern Ireland was established in 1973. There are 26 singletier local authorities, 2 city councils, 13 borough councils and 11 district councils. (There are no county councils.) The population of the councils varies considerably, from Belfast with a population of 297300, to Moyle with 14900.

Table 5.1 Responsibility for services in Northern Ireland

LOCAL AUTHORITY FUNCTIONS The powers of local authorities in Northern Ireland are limited compared with local government elsewhere in the UK. Councils are not responsible for health services, social services, education, housing, water supply, sewerage or planning. These services are provided by government departments, agencies or nominated statutory boards as shown in Table 5.1. There is a statutory requirement for councils to be consulted by the planning service of the Department of the Environment on planning proposals.

ENVIRONMENTAL HEALTH FUNCTIONS With the exception of the environmental functions listed in Table 5.1, councils have responsibility for waste collection and disposal, street cleaning and a Copyright © 1999 Taylor & Francis Group LLC

wide range of environmental health functions including food safety, food composition and labelling, food complaint investigation, health and safety at work, safety of consumer goods, and air and noise pollution control. They also have responsibility for licensing and by-law controls in important areas of trade and business. Not all these functions are allocated to the environmental health department of the councils for enforcement, but the majority are. Generally, where any of these functions are the concern of other departments, environmental health officers have a significant input in terms of the provision of information and support.

Belfast city council has a director of health and environmental services and other councils have a director of environmental health or a chief environmental health officer. In nearly all the authorities, environmental health is organized in separate departments and the head of department is a member of the authority’s management team.

THE GROUP ENVIRONMENTAL HEALTH SYSTEM An unusual and sometimes controversial aspect of the environmental health service is the group system, whereby the 25 councils outside Belfast city council are statutorily joined together in groups for specific purposes while remaining independent enforcement authorities. A group system was first established in 1948 based on county council and county borough boundaries. When local government was reorganized in 1973, county councils were abolished and new groups were established with boundaries that were coterminous with those of the Health and Social Services Board areas. These arrangements were made under powers contained in the Local Government Act (Northern Ireland) 1972 by the Local Government (Employment of Environmental Health Officers) (N.I.) Order 1973. The purpose of the initial group system was to make available the services of specialist officers to even the smallest district council and to government bodies, and to ensure effective coordination and uniformity of the service in district councils by having all environmental health officers working in the districts employed by the group and working under the general direction of the committee’s chief environmental health officer. As a result of objections from a number of district councils over the years, the system was subjected to scrutiny and to a ‘Value for Money Study’, which resulted in the introduction of a Local Government (Employment of Group Environmental Health Staff) Order (N.I.) 1994. This radically changed the way the groups operated by returning employment of environmental health officers to each district council and by removing Copyright © 1999 Taylor & Francis Group LLC

the general direction powers of the group’s chief environmental health officer. The group committee still has its own staff of specialist officers who, with the committee’s chief officer, the officer responsible for environmental health, provide specialist services to the constituent district councils, co-ordinate the environmental health service within and between groups, assist district councils to draw up annual environmental health plans and monitor district councils’ provision of environmental health services. The group committees also employ a number of environmental health officers and water quality inspectors for control of water pollution, who are made available to the Environment and Heritage Service (see below). The group committees are still responsible for student and professional training and provide a pest control service to meet district council needs. The merits of the group system are still the subject of debate within the profession and the local government service, some district councils arguing for total independence and group supporters maintaining that the objectives of the UK environmental health action plan and uniformity of enforcement cannot be attained without group led co-ordination and support.

ENVIRONMENTAL HEALTH AT GOVERNMENT LEVEL In 1996, the restructuring of the former Environment Service led to the establishment within the Department of the Environment for Northern Ireland of the Environment and Heritage Service (EHS), a next steps agency that has the overall responsibility for the protection of the environment from pollution of air, water and land. These changes led to a review of the role of the environmental health unit within the department, and as a result on 1 October 1996 there was a transfer of the government focus for environmental health and public health issues in Northern Ireland to the Department of Health and Social Services where the posts of chief and deputy chief environmental health officers were established. The other environmental health officers remaining from the environmental health unit were

charged with the responsibility for establishing an air and environmental quality unit and a waste and contaminated land unit within the Environment and Heritage Service. The air and environmental quality unit will major on the technical and policy advice aspects of ambient and air quality and noise control. The waste and contaminated land unit will exercise the enforcement role in these fields, previously exercised by district councils. The chief environmental health officer is responsible for maintaining a body of environmental health expertise within the Northern Ireland civil service and for providing policy advice on the full range of environmental health issues to the Northern Ireland ministers and departments. Additionally, he maintains an oversight of the environmental health service provided by the 26 district councils for promoting good practice and advising on professional matters. LIAISON ARRANGEMENTS Liaison in environmental health matters is principally effected through regular meetings of the chief environmental health officers group which consists of the chief environmental health officer, Department of Health and Social Services (N.I.), the director of health and environmental services, Belfast, the group chief environmental health officers and a number of district directors of environmental health nominated by their colleagues in each of the group areas. There are also a number of committees consisting of specialist environmental health officers that meet regularly to discuss food control, pollution control, radiation monitoring, health and safety at work, consumer protection, student and in-service training, housing and general environmental health. Each committee has a planned programme of work that includes liaison with appropriate government departments and agencies, commenting on new legislation, organization of joint inspection, sampling and promotion programmes, and the development of appropriate standard procedures to ensure uniformity of enforcement. Close liaison is maintained between the specialist committees and the Northern Ireland Centre of Copyright © 1999 Taylor & Francis Group LLC

the Chartered Institute of Environmental Health particularly in relation to new legislation, training and promotion. Liaison is also maintained with enforcement bodies in Great Britain through attendance by specialist representatives at the Local Authorities Co-ordinating Body on Trading Standards (LACOTS) panel meetings (see p. 65) dealing with food safety, food labelling and composition, and consumer safety. LEGISLATION Legislation on environmental health matters in Northern Ireland closely follows the legislation for England and Wales, but there is often a considerable time delay before legislation in Northern Ireland is brought into line with that in Great Britain. Guidance on this aspect of environmental health law is outlined briefly below. Public health Nuisances, drainage, sanitary conveniences, offensive trades and burial grounds are dealt with under the Public Health (Ireland) Acts 1878 to 1907. These Acts were amended regularly, and the provisions corresponded fairly closely to British legislation until the introduction of the Environmental Protection Act 1990.

Food The principal food legislation is contained in the Food Safety (Northern Ireland) Order 1991, which closely follows the Food Safety Act 1990 (see Chapter 34). Food hygiene regulations and food composition and labelling regulations follow British legislation. The enforcement of food composition and labelling law is the responsibility of district councils, and is carried out by environmental health officers. A few exceptions to this are specified in the Food Safety (Enforcement) Order (Northern Ireland) 1997, e.g. dairy farms, liquid milk plants and certain meat plants. There is a well developed system of co-ordination and liaison through the Northern Ireland food specialist group, which is made up of group food

specialist officers and a representative of the chief environmental health officers. This group has formal links with the specialist panels of LACOTS that deal with food safety and food labelling and composition, and participates fully in co-ordinated national sampling and enforcement programmes. A significant role of the food specialists group is close liaison with the Department of Agriculture for Northern Ireland and the Department of Health and Social Services Northern Ireland on enforcement of a range of regulations arising from vertical directives on hygiene and inspection controls on meat products, minced meat, meat preparations, wild game and farm game meat, eggs and egg products, milk and milk products. This liaison has led to the establishment of a Joint Supervisory Group, a multidisciplinary team that monitors the effectiveness of enforcement at district council level on a regular basis. Consumer protection In Northern Ireland, the law regarding the safety of consumer goods is, with one or two exceptions, enforced by the environmental health departments of district councils. The significant legislation is the Consumer Protection (N.I.) Order 1987 and the General Product Safety Regulations 1994, although there are also a considerable number of regulations covering the safety aspects of particular products or groups of products. The legislation in Northern Ireland is similar to that in England and Wales. District councils are also responsible for enforcement of the Construction Products Regulations 1991, which are made under the European Communities Act 1972. Occupational health and safety General provisions for the control of occupational health and safety are contained in the Health and Safety at Work (N.I.) Order 1978. There are other relevant provisions in the Factories Act (N.I.) 1978, the Office and Shop Premises Act (N.I.) 1966 and a considerable number of more specific regulations which, because they are based on European Union (EU) legislation, are very similar to the regulations for the rest of the UK (see Chapters 25 – 30). Copyright © 1999 Taylor & Francis Group LLC

The Health and Safety at Work (Enforcing Authority) Regulations (N.I.) 1993 allocates enforcement responsibility by using main activity criteria, as in the legislation for England and Wales. The regulations identify work activities, some of which are allocated to district councils while others are allocated to the Health and Safety Division of the Department of Economic Development whose role is similar to that of the Health and Safety Executive. Health and safety enforcement in relation to agriculture was allocated to the Department of Agriculture. An amendment of the regulations in 1997, however, amalgamated the Health and Safety Inspectorates of the Department of Economic Development and the Department of Agriculture. No provision has been made in the regulations for the transfer of enforcement responsibility by agreement between enforcement bodies because Section 18(2)(b) of the Health and Safety at Work, Etc. Act 1974, and therefore the Related Regulations of the Health and Safety (Enforcing Authority) Regulations 1998 have been omitted from the equivalent Northern Ireland legislation. An important role is also played by the Health and Safety Agency for Northern Ireland, which was established by the Health and Safety at Work (N.I.) Order 1978 to promote health, safety and welfare at work, to approve codes of practice, to issue guidance, to review enforcement strategies, to appraise proposed and existing legislation, to carry out and encourage research, to encourage training and to provide information and advice. A consultation paper has been issued proposing the creation of a non-departmental public body to be known as the Health and Safety Executive for Northern Ireland (note at proof: the Agency was thus renamed in the Health and Safety at Work (Amendment) (N.I.) Order 1998), which will encompass the Health and Safety Agency for Northern Ireland and the central unified inspectorates. It is anticipated that this will provide an opportunity for introducing procedures for transfer of duties between enforcement bodies. Liaison on health and safety matters is effected regionally in two ways. The local authority committee of the Health and Safety Agency meets quarterly to review progress in relation to district

council enforcement. The committee consists of officers of the agency, elected district council representatives, who are members of the agency, and environmental health officers from district councils and the group committees. It has made a considerable impact, particularly in the field of promotion of health and safety at work and in the development of new legislation. The Northern Ireland health and safety liaison group, which is formed of environmental health officers from the district councils, the group committees and a health and safety inspector from the Department of Economic Development, also meets regularly to agree responsibility for enforcement, to develop standard procedures and uniformity of enforcement, and to organize training programmes for officers and joint enforcement initiatives to be carried out in Northern Ireland.

of the Waste and Contaminated Land (Northern Ireland) Order 1997.

Noise control Controls over noise nuisance, noise on construction sites, loudspeakers in the street, and powers to issue and approve codes of practice for minimizing noise are contained in the Pollution Control and Local Government (Northern Ireland) Order 1978. The legislative controls are similar to those contained in the Control of Pollution Act 1974 (see Chapter 41) and are enforced by district councils in Northern Ireland. (The part dealing with noise abatement zones has not been implemented.)

Atmospheric pollution Waste management Waste collection and disposal is the duty of district councils, which are also responsible for street cleaning, litter and abandoned motor vehicles. Allocation of responsibility for these functions varies within councils, but even where environmental health officers do not have complete control they have considerable input. When implemented, the Waste and Contaminated Land (Northern Ireland) Order 1997 will make significant changes in relation to waste disposal, site licensing, contaminated land and storage of certain chemicals, but the necessary commencement order has not yet been made. The current legislation is found in the Pollution Control and Local Government (Northern Ireland) Order 1978, the Pollution Control (Licensing of Waste Disposal) Regulations (Northern Ireland) 1980, the Trans-Frontier Shipment of Hazardous Waste Regulations (Northern Ireland) 1989 and the Collection and Disposal of Waste (Northern Ireland) Regulations 1991. Responsibility for the licensing of waste disposal sites, the issuing of consignment notes for hazardous and special waste, and the control of certain contaminated land will be transferred to the Environment and Heritage Service when new regulations are made following the commencement Copyright © 1999 Taylor & Francis Group LLC

The principal legislation enforced by district councils at present is contained in the Clean Air (Northern Ireland) Order 1981, the Pollution Control and Local Government (Northern Ireland) Order 1978 and the nuisance provisions of the Public Health (Ireland) Act 1878. This legislation is broadly similar to that contained in the Clean Air Act of 1993 (see Chapter 42). Non-scheduled processes and domestic air pollution are controlled by environmental health officers of district councils. Provisions similar to those in Section 5 of the Health and Safety at Work, Etc. Act 1974 are not contained in the Health and Safety at Work (Northern Ireland) Order 1978. Emissions to the Atmosphere Regulations have not been made. The Alkali Etc. Works (Northern Ireland) Order 1991 as amended by the Alkali Amendment Order 1994 lists both the noxious or offensive gases and the registrable (scheduled) processes or works. The Industrial Pollution and Radiochemical Inspectorate of the Environment and Heritage Services of the Department of the Environment (Northern Ireland) enforces the Alkali Etc. Works Regulations Act 1906 as amended by the Orders of 1991 and 1994. New controls similar to those in Part I of the Environmental Protection Act 1996 will be gradually introduced by the Pollution Control (Northern

Ireland) Order 1998. Each year, so many processes will have the appropriate new controls introduced. Prior to their introduction the existing legislation that applies to them will remain in force. While the controls are broadly similar in the Northern Ireland order and the legislation for England and Wales, enforcement responsibility for certain processes, which falls to district councils in England and Wales, is in Northern Ireland allocated to the Pollution Control and Radio Chemical Inspectorate of the Environment and Heritage Service. The processes are divided into three groups. Those in Part C are allocated to district councils for enforcement. The Air Quality Standards Regulations (Northern Ireland) 1990 implement the EU directive requirements in relation to sulphur dioxide, suspended particulates, lead in the air and nitrogen dioxide. The Radioactive Substances Act 1993 extends to Northern Ireland.

Water pollution Under the Water Act (Northern Ireland) 1972, the EHS, an agency within the Department of the Environment for Northern Ireland (DOENI), has a duty to promote the conservation of the water resources of Northern Ireland and the cleanliness of water in waterways and underground strata. In performing this duty, the EHS is required to have regard to the needs of industry and agriculture, the protection of fisheries, the protection of public health, the preservation of amenity and the conservation of flora and fauna. The EHS protects the aquatic environment by preparing water quality management plans, controlling effluent discharges, taking action to combat or minimize the effects of pollution, and by monitoring water quality. The provisions of the Water Act (N.I.) 1972 are broadly similar to those formerly contained in the Control of Pollution Act 1974 in that a ‘consent’ is required to make a discharge of trade or sewage effluent or of any polluting matter to a waterway or underground stratum. The provisions of the Food and Environment Protection Act 1985 cover discharges and dumping into the sea. Environmental health officers (water pollution) employed by Belfast city council and the group Copyright © 1999 Taylor & Francis Group LLC

committees carry out the work in connection with ‘consents’ and the investigation of pollution incidents on behalf of the EHS, reporting directly to the officers of that service. Housing The Northern Ireland Housing Executive, not the district councils, is the enforcing authority for the parts of housing orders that deal with housing conditions, individual unfit houses and houses in multiple occupation. The main legislation is contained in the Housing (Northern Ireland) Order 1981, amended in 1983, and the Rent (Northern Ireland) Order 1978. The Housing (Northern Ireland) Order introduced in 1991 brought many of the provisions of these housing orders into line with corresponding parts of the legislation for England and Wales contained in the Housing Act 1988 and the Local Government and Housing Act 1989 (see Chapter 23). A considerable amount of survey and inspection work is carried out on behalf of the Northern Ireland Housing Executive by the environmental health officers of district councils. District councils have important duties under the Rent (Northern Ireland) Order 1978 where in the Regulated Tenancy Sector they ensure compliance by landlords with their repairing obligations through service of Certificates of Disrepair and follow-up enforcement action to ensure that repair work specified in the certificates is completed. District councils also have responsibility for issuing regulated rent certificates for the change from restricted tenancies, in which rents are tied to pre-1978 levels, to regulated tenancies. The Housing (Northern Ireland) Order 1992 effected changes to the Rent (Northern Ireland) Order 1978, which gave district councils specific authority to investigate and prosecute offences of illegal eviction or tenant harassment. Communicable disease The legislation for controlling communicable disease is contained in the Public Health Act (Northern Ireland) 1967 and the Health and Personal Social Services (Northern Ireland) Order

1972. Health and Social Services Boards through their Directors of Public Health and their Consultants in Communicable Disease Control enforce the legislation, which includes provision for notification of specified diseases and for prohibition from work of carriers, contacts, etc. There are four health boards, each of which is coterminous with a local environmental health group. Belfast, with the eastern group environmental health committee, forms the eastern health and social services board area. A considerable amount of fieldwork on behalf of the health and social services boards is carried out by environmental health officers, some of whom are authorized under the above legislation. They are involved in the investigation of food poisoning outbreaks and in the sampling of food and water. Bacteriological examination of a wide range of samples is carried out by the laboratory at Belfast City Hospital, which acts as a regional laboratory for routine programmes of microbiological sampling and in investigations of food, water and environmental specimens in food poisoning inquiries. The directors of public health in the health and social services boards liaise closely with the district directors of environmental health and the group chief environmental health officers. As a result written protocols and standard procedures exist to cover the various functions in which the boards and environmental health departments have a joint interest.

Port health In relation to port health, district councils act as agents of the health and social services boards, which are the enforcing authorities under the relevant legislation: the Public Health (Aircraft) Regulations (Northern Ireland) 1971, and the Public Health (Ships) Regulations (Northern Ireland) 1971. The environmental health officers at the ports carry out the full range of port health duties associated with hygiene and infectious disease. District councils enforce the general provisions of the Imported Food (Northern Ireland) Regulations 1991, which were recently updated Copyright © 1999 Taylor & Francis Group LLC

with regard to third country imports by the Imported Food Regulations (N.I.) 1997. District councils act jointly with the Department of Agriculture in enforcement of the Products of Animal Origin (Import and Export) Regulations (N.I.) 1993.

Drinking water The provision of a wholesome sufficient supply of water to houses is required by the Water Supplies and Sewerage Act (Northern Ireland) 1945. Enforcement of the provisions of the Act is the responsibility of district councils. The public water supplies in Northern Ireland have not been privatized as elsewhere in the UK, but an executive agency within the Department of the Environment (Northern Ireland)—the Water Service—has responsibility for the supply and distribution of water. The EHS has responsibility for monitoring water quality, and for this purpose it has established a Drinking Water Inspectorate. Both these agencies have separate directorates. The drinking water inspector administers the provisions of the Water Quality Regulations (Northern Ireland) 1994, which applies to the mains supplies provided by the Water Service, and the provisions of the Private Water Supplies Regulations (Northern Ireland) 1994 in respect of private supplies that serve more than one dwelling. Both these regulations transpose into Northern Ireland law the provisions of the EU drinking water directive, the Quality of Water for Human Consumption (EC/778/EEC). For public water supplies the remit of the Drinking Water Inspectorate is to check by audit that the water services sampling, analytical reporting, water treatment and distribution procedures are in accordance with the requirements of the water supplies regulations. In the case of private water supplies, the Department of Agriculture (Northern Ireland), the Department of Health and Social Services (Northern Ireland) and district councils have a statutory role to play, and the Drinking Water Inspectorate regularly reviews existing control and monitoring arrangements with a view to having them supplemented if necessary.

Through their environmental health departments, district councils, on behalf of the Health and Social Services Boards, carry out planned programmes of sampling of all water supplies. The environmental health officers have responsibility under food control and health and safety at work legislation for monitoring the supply of drinking water to businesses to which the relevant orders apply. Dogs and other animals The Dogs (Northern Ireland) Order 1983 provides a range of dog control measures that are enforced by district councils. Requirements include an annual licensing fee of £5, with a discount for owners aged over 65 years living alone and exemptions for guide dogs for the blind and hearing dogs for the deaf. The order provides penalties for the offences of allowing dogs to stray and for attacks on livestock or persons. Provision is made within the order for the issue of fixed penalty notices for the offences of keeping a dog without a licence, allowing a dog to stray, failing to display identification and allowing the fouling of footpaths contrary to by-laws. The Dangerous Dogs (Northern Ireland) Order 1991 is enforced by district councils and introduced to Northern Ireland similar powers for the control of dogs as exist in this legislation in England and Wales (see Chapter 13). The Welfare of Animals Act (Northern Ireland) 1972, which requires licensing of pet shops, animal boarding, riding and zoological establishments, is enforced by the Department of Agriculture. Pest control The Prevention of Damage by Pests Act 1949 (see Chapter 12) does not apply in Northern Ireland, where the relevant legislation is the Rats and Mice Destruction Act 1919.

Caravans and camping The relevant legislation is the Caravans Act (N.I.) 1963, the provisions of which are similar to those Copyright © 1999 Taylor & Francis Group LLC

in the Caravan Sites (Control of Development) Act 1960. Swimming, boating, etc. Controls on swimming and boating are exercised under public health and health and safety at work legislation supplemented by local by-laws. Entertainment licensing District councils are responsible for the licensing of places of entertainment under the Local Government (Miscellaneous Provisions) (Northern Ireland) Order 1985, the provisions of which closely follow those in the Local Government (Miscellaneous Provisions) Act 1982. Acupuncture, tattooing, ear piercing and electrolysis Acupuncture, tattooing, ear piercing and electrolysis are subject to registration by the district council where the council has applied the Local Government (Miscellaneous Provisions) (Northern Ireland) Order 1985, which also contains the power to make by-laws. Similar provisions for England and Wales are contained in the Local Government (Miscellaneous Provisions) Act 1982. Hairdressing Registration of premises by district councils is required under the Hairdressers Act (N.I.) 1939 and SR&O No. 86 of 1939. Provisions similar to those in the Public Health Act 1961 for the making of by-laws are contained in the legislation.

THE FUTURE The United Kingdom Environmental Health Action Plan, [1], Agendas for Change [2] and Agenda 21 issues [3] require environmental health departments to formulate a studied, planned approach involving the development of targets and

appropriate programmes of work to achieve them, and the allocation of available resources. The annual environmental health action plan for district councils and the requirements for coordination and monitoring set down in the Local Government (Employment of Group Environmental Health Staff) (Northern Ireland) Order 1994 could, if appropriate partnerships are created, provide the framework for developing structured short- and long-term programmes for achieving the objectives of these key environmental health documents. The trend towards the development of planned programmes of work based on appropriate risk assessment in the core functions of environmental health can only support this approach. Without considerable political change, e.g. the establishment of a local assembly and further local government reorganization, it seems unlikely that there will be further structural change in the environmental health system. If a period of stability can be established it could be argued that Northern Ireland has an appropriate framework and an ideal size of region to develop a ‘blueprint’ that could benefit environmental health throughout the UK.

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REFERENCES 1. DoE/DoH (1996) The United Kingdom Environmental Health Action Plan, the Department of the Environment and the Department of Health, HMSO, London. 2. CIEH (1997) Agendas for Change, Report of the Environmental Health Commission, CIEH, London. 3. UN (1992) Earth Summit. Agenda 21: The United Nations Programme of Action from Rio, United Nations Department of Information, New York.

FURTHER READING Dickson, B. (1994) The Legal System of Northern Ireland—The Law in Action, SLS Publications, Belfast. DoENI (1996) A Corporate Framework for the Department of Environment for Northern Ireland, Department of Environment (Northern Ireland), Belfast. DoENI (1996) Your Guide to the Department of Environment for Northern Ireland and its Agencies, Department of Environment (Northern Ireland), Belfast.

6

Training and professional standards Paul Robinson

TRAINING OF ENVIRONMENTAL HEALTH OFFICERS The routes to qualification as an environmental health officer (EHO) are many and varied, but all involve the following common elements: • complete a BSc (Hons) degree or MSc in Environmental Health which must be accredited by the Chartered Institute of Environmental Health (CIEH) • undertake a period of practical training that is deemed to be satisfactory through the assessment of a completed practical training logbook and portfolio of evidence • pass the CIEH professional examinations. Completion of all three of these elements leads to the graduate being registered by the Environmental Health Officers Registration Board (EHORB) and the issuing of a Certificate of Registration, which is the formal qualification recognized for practice as an EHO within the UK. Accredited environmental health courses all cover the same basic syllabus although the emphasis may vary from course to course. Science, technology, statistics, social science, public administration and law are studied at a general level. Auditing, investigation, risk assessment and problem solving techniques are considered generically before being applied in the areas of Copyright © 1999 Taylor & Francis Group LLC

public health, food safety, occupational health and safety, environmental protection and housing, which are each covered in depth. Laboratory work, case studies, visits, group work and tutorials make the courses varied and interesting. Group work is encouraged in all aspects of the course, and students are also expected to do a lot of work independently. This is good preparation for a career that can involve working both alone and as part of a team. The majority of accredited courses offer a parttime route that enables people already working in environmental health to obtain the professional qualification while still remaining in employment. However, practical training remains an important element of the course, and a balance has to be struck between receiving practical training as an EHO and carrying out day to day technical duties. Most students pursue an integrated course of study where practical training occurs in the third year of a 4-year degree course or throughout the part-time course. However, for those students who are not able to find a 1-year practical training placement during their course, the majority of accredited courses offer a non-integrated route, which allows the academic BSc or MSc to be completed prior to undertaking the necessary practical training. Competition for practical training places is fierce and candidates need to be both keen and persistent to secure an integrated practical training place.

At least 24 weeks of the practical training requirement has to be spent in a UK local authority, working and learning alongside qualified EHOs. This gives the student the opportunity to experience all aspects of the work. The remaining months can be spent in the same or a different authority, or with environmental health practitioners in the private sector or outside the UK. There are accredited courses throughout England, Wales, Scotland and Northern Ireland, allowing ready access to a course without the need for excessive travel. A list of accredited courses is provided in the appendix at the end of this chapter. A student practical training logbook provides guidance on the practical training to be obtained. Each student must complete this which, with an accompanying portfolio of evidence produced by the student while undertaking practical training, must be assessed by the CIEH as satisfactory. The professional examinations, which can only be taken once the first two elements have been obtained, consist of three parts: • five written papers • a risk audit • an interview. Each of these is based on scenarios that may be encountered by EHOs during their professional practice, and assesses the ability of the graduate to integrate theory and practice in addressing practical environmental health issues.

TRAINING OF ENVIRONMENTAL HEALTH TECHNICIANS Environmental health technical support staff are drawn from a variety of backgrounds and provide essential support to environmental health departments and private sector companies. Some technicians have a construction background, others come from nursing or the food industry, and yet others have experience in applied sciences. There is no specific prescription for or definition of the work of a technician, and it depends upon the needs of each employer. Many technicians pursue the BTec National Diploma or Higher Diploma in Copyright © 1999 Taylor & Francis Group LLC

Environmental Health Studies, and these courses can, in turn, be a stepping stone on to the professional qualification route. Technicians are eligible for associate membership of the CIEH (see Chapter 3), and those pursuing the BTec are eligible for student membership. A list of BTec courses is provided in the appendix at the end of this chapter. Technical support staff working in the inspection and auditing of food premises must possess a Higher or Ordinary Certificate in Food Premises Inspection, depending on the level of risk associated with the premises being inspected. These certificates are issued by EHORB, the Institute of Food Science and Technology (IFST), and the Royal Environmental Health Institute of Scotland (REHIS). There are different routes to obtaining these certificates, and it is advisable to contact the relevant body for details. Generally, it involves the completion of an appropriate course of study, a period of practical training and some form of examination or assessment. With the issuing of Section 18 guidance in 1996 under the Health and Safety at Work, Etc. Act 1974 specifying the abilities of health and safety enforcement officers, it is likely that technical support staff working in the occupational health and safety field will, in future, need a recognized qualification. It is hoped that by 1999 EHORB will offer a Certificate in Health and Safety similar to that for Food Premises Inspection.

ASSESSMENT OF PROFESSIONAL COMPETENCE After qualifying to practise, EHOs are eligible for graduate membership of the CIEH. After at least two years of professional practice, graduate members can apply to take an Assessment of Professional Competence (APC) and become full corporate members of the CIEH. The assessment requires candidates to submit a work experience log, which summarizes the work they have undertaken during their minimum two years of practice. A case study must also be prepared and submitted, documenting how the EHO has resolved a particular problem that has come up over the previous two years. Candidates must also attend a professional interview.

Via the case study submitted and the interview, EHOs need to demonstrate to the assessor that they have developed their professional skills to a level that is acceptable for corporate membership. The skills assessed are: 1. 2. 3. 4. 5. 6. 7.

investigative analytical interpretive communicative educative organizational attitudinal.

routes— contact the course leader for details of options available Bristol University of the West of England Faculty of Applied Sciences Coldharbour Lane Frenchay, Bristol BS16 1QY Tel: 0117–965 6261 Ms Melanie Grey Cardiff

CONTINUING PROFESSIONAL DEVELOPMENT The CIEH’s scheme of continuing professional development (CPD) was introduced in July 1992 on a voluntary basis and made mandatory in 1996. All members of the CIEH have a personal responsibility to maintain their professional competence throughout their professional practice. The scheme requires graduate and corporate members to undertake and record at least 20 hours of relevant CPD activity every year. Activities such as training courses, seminars, branch and centre meetings, research and the writing/presentation of papers are all considered to be relevant, as is preparing for and taking the APC. The address of the CIEH headquarters is: The Chartered Institute of Environmental Health (CIEH) Chadwick Court 15 Hatfields London SE1 8DJ Tel: 0171–928 6006. APPENDIX: CENTRES OFFERING COURSES IN ENVIRONMENTAL HEALTH BSc (Hons) degree in Environmental Health/ Science Four year integrated courses, the majority of which offer part-time and non-integrated Copyright © 1999 Taylor & Francis Group LLC

University of Wales Institute Cardiff School of Environmental Sciences Western Avenue Cardiff, CF5 2YB Tel: 01222–551111 Mr Andrew Curnin Edinburgh University of Edinburgh Medical School Department of Public Health Sciences Teviot Place Edinburgh, EH8 9AJ Tel: 0131–650 1000 Dr Iain Beverland Leeds Leeds Metropolitan University Calverley Street Leeds, LS1 3HE Tel: 0113–283 2600 Ms Catherine Gairn London King’s College London School of Life Basic Medical and Health Sciences Campden Hill Road London, W8 7AH Tel: 0171–836 5454 Mr Norman Parkinson

Middlesex University School of Applied Sciences Bounds Green Road London, N11 2NQ Tel: 0181–368 1299 Mr Alan Page University of Greenwich School of Land & Construction Management Dartford Campus Oakfield Lane Dartford, DA1 2SZ Tel: 0181–331 8000 Mr Stuart Allan

Ulster

Manchester

Birmingham

Manchester Metropolitan University Department of Food and Consumer Technology The Hollings Faculty Old Hall Lane Manchester, M14 6HR Tel: 0161–247 2000 Mr Graham Kilner

University of Birmingham School of Biological Studies Edgbaston Birmingham, B15 2TT Tel: 0121–414 7180 Mrs Janet Higgitt

University of Ulster Shore Road, Newtonabbey Co. Antrim N.Ireland, BT37 0QB Tel: 01232–365131 Mr Vance Kyle MSc in Environmental Health For graduates with appropriate science degrees

Bristol Norwich Norwich City College of Further and Higher Education Ipswich Road Norwich NR2 2LJ Tel: 01603–660011 Dr Michael Howard Nottingham Nottingham Trent University Burton Street Nottingham, NG1 4BU Tel: 0115–941 8418 Mrs Ann McCarthy

University of the West of England Faculty of Applied Sciences Coldharbour Lane Frenchay, Bristol BS16 1QY Tel: 0117–965 6261 Ms Melanie Grey Courses that are being considered for accreditation BSc Environmental Health at Strathclyde University (Glasgow) MSc Environmental Health at Liverpool University

Salford University of Salford Dept of Environmental Management Salford, M5 4WT Tel: 0161–745 5000 Mrs Norma Ford Copyright © 1999 Taylor & Francis Group LLC

Please contact the Education Unit at the CIEH before contacting either of these universities to check progress on accreditation

Centres approved to offer BTec qualifications in Environmental Health National Certificate Basford Hall College, Nottingham Tel: 0115–916 2001 Blackpool & the Fylde College, Blackpool Tel: 01253–352352 College of North East London, London Tel: 0181–802 3111

National Diploma College of North East London, London Tel: 0181–802 3111 Defence Medical Services, Aldershot Tel: 01252–340203 Leeds College of Building, Leeds Tel: 0113–243 0765 University College Suffolk, Ipswich Tel: 01473–255885

East Durham Community College, Peterlee Tel: 0191–518 2000

Higher National Certificate

Leeds College of Building, Leeds Tel: 0113–243 0765

College of North East London, London Tel: 0181–802 3111

Matthew Boulton College, Birmingham Tel: 0121–446 4545

Leeds College of Building, Leeds Tel: 0113–2430 765

Norfolk College of Arts & Technology, King’s Lynn Tel: 01553–761144

North East Surrey College of Technology, Surrey Tel: 0181–394 1731

North East Surrey College of Technology, Ewell Tel: 0181–394 1731

University of Salford Tel: 0161–736 6541

University College Suffolk, Ipswich Tel: 01473–255885

Weston College, Weston-super-Mare Tel: 01934–411411

Higher National Diploma University of Salford, Salford 0161–295 5000 Weston College, Weston-super-Mare Tel: 01934–411411 Copyright © 1999 Taylor & Francis Group LLC

University of Salford Tel: 0161–295 5000

Part Two Environmental Health Law and Administration

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7

Environmental health law Frank B.Wright

This chapter is concerned with the law of the UK. The UK comprises Great Britain and Northern Ireland, with Great Britain being made up of England, Wales and Scotland. The Channel Islands and the Isle of Man are Crown dependencies and are not part of the UK. The UK constitution is not contained in any single document but has evolved over the course of time. It was formed originally by customary law and later by the common law, then by statute and convention. The UK is a constitutional monarchy. It is governed by the Sovereign, who is both the Head of State and Head of Government. The organs of government are the legislature (Parliament), the executive and the judiciary. Although the powers of the monarchy are now very limited, being restricted primarily to advisory and ceremonial functions, some important duties that are reserved for the Sovereign remain. These include the summoning, the proroguing and the dissolving of Parliament, the appointment of ministers, including the Prime Minister, and the appointment of judges and certain senior officials. International treaties, entered into on behalf of the UK, are concluded by ministers acting under the royal prerogative. Ministers are responsible to Parliament. International treaties must be incorporated into UK law by an Act of Parliament.

intends to fulfil its international obligations. However, where the words of an Act of Parliament are clear and unambiguous, they must be given effect even if the decision results in a breach of international law. The primary sources of European Union (EU) law consist of the three founding treaties (European Coal and Steel Community, European Atomic Energy Community and European Economic Community) with their annexes and protocols, which supplement the treaties; the Convention on Certain Institutions Common to the European Communities (1957); the Merger Treaty (1965); certain treaties on budgetary matters; treaties on accession and their annexes; the Act of Council concerning direct elections for the European Parliament (1976); the Single European Act (1986); the Treaty on European Union (1991); and the Treaty of Amsterdam (1997). The Treaties of the European Communities and European Community law were incorporated into UK law by the European Communities Act 1972 and the European Communities (Amendment) Act 1993. The courts of the UK have not demonstrated any reticence in applying EU law and construe UK legislation so far as possible in conformity with the purpose of EU legislation. Where it appears to the courts that there is inadvertently conflicting UK legislation, they will endeavour to give effect to EU law.

The international and European dimension

Common law

There is a presumption of interpretation that in incorporating an international treaty the UK

The earliest laws of which there is documentary evidence date from the Anglo-Saxon period of

SOURCES

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history before the Norman Conquest. These laws related to particular areas such as Kent, Wessex and Mercia. As a centralized system of law developed, customary law gave way to national law. The national law came to be known as common law. Common law was developed by the King’s judges and is derived entirely from case law. In addition to settling principles of law, which were to be observed nationally, the courts began to establish formal rules of procedure for those who wished to bring cases before them. Court rules established that actions had to be commenced by royal writ and set out in an accepted form. Difficulties emerged in relation to the use of writs and forms of action. Litigants who were unable to get satisfaction petitioned the monarch, who in turn handed the petitions to the Lord Chancellor. The Lord Chancellor set up the Court of Chancery, which was guided by principles of fairness or equity in coming to a decision. The law of equity became established in the fifteenth century. Both common law and equity came to operate as parallel systems, each bound by its own judicial precedents. The Supreme Court of Judicature Acts 1873–75 reorganized the existing court structures and brought together the common law courts and the Courts of Chancery. This legislation has now been consolidated. Where common law and equity conflict, the law of equity prevails. All courts administer the principles of common law and equity, and grant the remedies of both as the case demands.

Statute law including the parliamentary process An Act of Parliament that has been given royal assent and placed on the parliamentary roll is the law and must be given effect by the courts (see British Railways Board v. Pickin [1974] A.C. 765). Parliament is made up of three elements: the Sovereign, the House of Lords and the House of Commons. In order for a legislative measure to become an Act of Parliament and be recognized as such by the courts it has to undergo one of several procedures. The measure is drafted, usually by parliamentary counsel to the Treasury, and presented to the House of Commons or House of Lords, more usually the House of Commons, as a Copyright © 1999 Taylor & Francis Group LLC

Bill. Before a Public Bill becomes an Act of Parliament it must undergo five stages in each house: first reading; second reading; committee stage; report stage; and third reading. The first reading is a formality. There is no debate at this point. Nowadays this stage constitutes an order to print the Bill. At the second reading there is a debate on the principles of the Bill, while the committee stage sees the Bill examined in detail, clause by clause. In most cases the committee stage takes place in a standing committee, or the whole house may act as a committee. At the report stage there is a detailed review of the Bill as amended in the committee stage. On the third reading the Bill is finally debated. These stages can be taken quickly, although the process normally takes a number of months. Much depends on the Bill’s political importance. A Bill may be considered first in either house but it has to pass through both houses to become law. Both houses must agree the same text of a Bill, so that the amendments made by the second house are then considered in the originating house, and if not agreed, sent back or themselves amended, until agreement is reached. Under the Parliament Acts 1911 and 1949, if the House of Lords rejects any Public Bill (except one to prolong the life of a Parliament) that has been passed by the Commons in two successive sessions, then the Bill will become law without the consent of the Lords, unless the Commons directs to the contrary. The royal assent is signified by letters patent to such Bills and measures as have passed both Houses of Parliament (or Bills that have been passed under the Parliament Acts 1911 and 1949). The Sovereign has not given royal assent in person since 1854. The power to withhold assent resides with the Sovereign but has not been exercised in the UK since 1707, in the reign of Queen Anne. Public Bills promoted by a Member of Parliament who is not a member of the Government are known as Private Members’ Bills.

Delegated legislation This is law made by subordinate authorities acting under law-making powers delegated by Parliament or the Sovereign. Many statutes empower ministers

to make delegated legislation. Such legislation includes the following.

Orders in Council The Sovereign in Council, or Privy Council, was the chief source of executive power until cabinet government developed in the eighteenth century. Membership of the Privy Council is automatic upon appointment to certain government and judicial positions in the UK. Membership is also accorded by the Queen to eminent people in the UK and independent countries of the Common-wealth of which Her Majesty is Queen, on the recommendation of the British Prime Minister. The Privy Council Office is headed by the Lord President of the Council, who is a cabinet minister. Orders in Council are approved by the Queen in the presence of three Privy Councillors (enough to constitute a quorum) after which it is announced that the Queen held a Privy Council. The matters considered, however, will have previously been recommended by the responsible departments of government. Orders in Council may be made by ministers acting under the royal prerogative. See, for example, Section 84 of the Health and Safety at Work, Etc. Act 1974, which provides that Her Majesty may by Order in Council extend the provisions of the Act outside Great Britain.

Statutory Instruments Many thousands of Statutory Instruments are issued annually by Ministers of the Crown acting under delegated powers provided by Acts of Parliament. Statutory Instruments are of considerable importance as a source of environmental health law because of the detailed technical nature of the law enforcement role. Each one published is allocated a number for the year, see for example the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (SI 1995 No. 3163). Statutory Instruments fall into four broad categories: Affirmative Instruments, which are subject to the approval of both Houses of Parliament before they can come into or remain in force; Negative Instruments, which are subject to annulment by resolution of either House; General Copyright © 1999 Taylor & Francis Group LLC

Instruments, which include those not required to be laid before Parliament and those that are required to be so laid but are not subject to approval or annulment; and Special Procedure Orders, against which parties outside may lodge petitions.

By-laws Local authorities (i.e. district and London borough councils) have long had power, delegated by Parliament and subject to confirmation by ministers, to make by-laws, see for example by-laws made for the good rule and government of local authority areas and by-laws for the prevention and suppression of nuisances made under the Local Government Act 1972, Section 235. By-laws must be consistent with the common law and statute and must not be made if provision for that purpose has already been made, or is or may be made by any other enactment.

European Union secondary legislation The EU has policies on environmental conservation and protection, health, agriculture, fisheries and food, social policy including employment protection and health and safety at work, consumer protection, transport, energy and industry, amongst others. Many of these policies affect the work of the environmental health officer. The law-making powers of the EU institutions are to be found in Article 249 of the EEC Treaty. It is there provided that: In order to carry out their task the Council and the Commission shall, in accordance with the provisions of this Treaty, make regulations, issue directives, take decisions, make recommendations or deliver opinions. These measures, described as ‘acts’ are defined as follows. • A regulation shall have general application. It shall be binding in its entirety and directly applicable in all member states. • A directive shall be binding in its entirety, as to the result to be achieved, upon each member

state to which it is addressed, but shall leave to the national authorities the choice of form and methods. • A decision shall be binding in its entirety upon those to whom it is addressed. • Recommendations and opinions shall have no binding force. Regulations must be recognized as legal instruments and do not need national implementation —indeed it is impermissible to do so (Commission v. Haly Case 39/72 [1971] E.C.R. 1039). Most of the EU legislation affecting the work of the environmental health officer takes the form of directives. Examples of such directives are listed below. 1. 89/391/EEC Council Directive on the introduction of measures to encourage improvements in the safety and health of workers at work, 12 June 1989. 2. 89/397/EEC Council Directive on the official control of foodstuffs, 14 June 1989. 3. 89/437/EEC Council Directive on hygiene and health problems affecting the production and the placing on the market of egg products, 20 June 1989. 4. 89/428/EEC Council Directive on procedures for harmonizing the programmes for the reduction and eventual elimination of pollution caused by waste from the titanium dioxide industry, 21 June 1989. The Court of Justice has held that in certain circumstances at least, directives and decisions might contain directly effective provisions (Grad v. Finanzamt Traunstein Case 9/70 [1970] E.C.R. 825). For this to occur two conditions must be fulfilled. First, there must be a clear and precise obligation, and second it must not require the intervention of any act on the part of institutions of the EU or the member states. Individuals may invoke before their national courts, as against the state, such provisions despite the fact that they are contained in directives or decisions rather than regulations. Governments of member states to which directives have been addressed are obliged to implement them within the period of time specified. Failure to do so could lead to an action Copyright © 1999 Taylor & Francis Group LLC

in the European Court of Justice by another member state or, more likely, by the Commission. (See Articles 226 and 227 EC Treaty.) Actions are also possible in the domestic courts of the member state. In two cases (joined), Francovich v. Italian State and Bonifaci v. Italian State [1992] I.R.L.R. 84, it was held that where a member state fails to enact the legislation required in order to achieve the objective prescribed by a directive it may be possible for an aggrieved individual to take remedial action directly against his member state government. One possible route might lie in the context of the principles established by the European Court of Justice in Francovich. Francovich implied that where damage is suffered through the acts or omissions of a private party which are incompatible with directly applicable provisions of a directive which has not been implemented by appropriate legislation, an action in damages will lie against the state. However, it would appear that three conditions must be fulfilled before such liability can be created. In the first place, the objective sought by the directive must include the creation of rights for individuals. The second is that the content of those rights must be ascertainable from the provisions of the directive itself. The third condition is the existence of a causal link between violation by the state of its duty to implement the directive and the loss sustained by the individual. Where these three conditions are met, EU law directly confers on individuals the right to obtain compensation against the state. Recommendations and opinions have no binding force but may be indicative of important policy orientations, and member states may take such measures into account when enacting national legislation or when making administrative directions.

THE COURTS AND TRIBUNALS European Court of Justice The European Court of Justice is composed of 13 judges and 6 advocates-general appointed for renewable 6-year terms by the governments of the

member states. The Court exists to safeguard the law in the interpretation and application of the Community Treaties, to decide on the legality of decisions made by the Council of Ministers or the Commission, and to determine violations of the treaties. Cases may be brought before it by member states, EU institutions, firms or individuals. Its decisions are directly binding in all member states. A Court of First Instance consisting of 15 judges appointed by common accord by the governments of the member states hears staff cases, cases involving EU competition law and certain applications under the European Coal and Steel Community Treaty. There is a right of appeal from this court, on matters of law, to the European Court of Justice.

The jurisdictions of the UK There is one legislature for the UK but three separate legal jurisdictions: England and Wales; Scotland; and Northern Ireland. These jurisdictions have separate law, judicial procedure and court structure, although there is a common distinction between civil and criminal law.

The judicature of England and Wales The supreme judicial authority for England and Wales is the House of Lords. It is staffed by the Lord Chancellor and 12 Lords of Appeal in Ordinary (Law Lords) who are members of the Upper House of the legislature. Cases are normally heard by a panel of 5 Law Lords. Each Law Lord expresses his own opinion in the form of a speech. In recent years a number of environmental health cases have been heard in this court. (See for example Alphacell v. Woodward [1972] A.C. 824, Salford City Council v. McNally [1976] A.C. 379, and Austin Rover Group Limited v. Her Majesty’s Inspector of Factories [1990] A.C. 619.) The Supreme Court of Judicature comprises the Court of Appeal, the High Court of Justice and the Crown Court. The Court of Appeal has two divisions: a Criminal Division and a Civil Division. The jurisdiction of the Court of Appeal includes Copyright © 1999 Taylor & Francis Group LLC

civil and criminal appeals from the three divisions of the High Court, including divisional courts, from the county courts, from the Employment Appeal Tribunal, from the Lands Tribunal and the Transport Tribunal. For civil cases the Master of the Rolls is the most senior judge. The President of the Family Division and the Vice Chancellor sit occasionally. The Criminal Division is presided over by the Lord Chief Justice. There are 34 Lords Justices to carry out the work of the two divisions. They are assisted on occasion by High Court judges. Three Appeal Court judges will normally hear a case and a majority is sufficient for a decision. The High Court of Justice is the superior civil court. Its work is carried on by 93 High Court judges in three divisions: Queen’s Bench Division; the Chancery Division; and the Family Division. The Queen’s Bench Division deals with commercial and maritime law and with civil cases not assigned to other courts. Within the Queen’s Bench Division is the Divisional Court, which reviews decisions of governmental and other public bodies and hears appeals from lower courts (see for example R. v. Health and Safety Commission ex parte Spelthorne Borough Council (1983), The Times, 18 July 1983). The Chancery Division is concerned mainly with equity, bankruptcy and contentious probate business, and the Family Division deals with matters relating to family law. Sittings are held at the Royal Courts of Justice in London or at Crown Court centres throughout England and Wales. High Court judges sit alone to hear cases at first instance. Appeals from lower courts are heard by two or three judges, or by a single judge of the appropriate division. Under the provisions of Section 81 of the Environmental Protection Act 1990, for example, a local authority may take action in the High Court for the purpose of securing the abatement, prohibition or restriction of any statutory nuisance where they are of the opinion that proceedings for an offence of contravening an abatement notice would not provide a sufficient remedy. (See for example Hammersmith London Borough Council v. Magnum Automated Forecourts Ltd. [1978] 1 W.L.R. 50.) Most minor civil cases, including most cases under the Housing Acts, are dealt with by the 270 county courts throughout England and Wales.

These courts are staffed by county court judges (who also sit as circuit judges in criminal cases), and district judges for smaller claims. Magistrates’ courts can hear certain classes of civil cases, including family matters and debt collection, while committees of magistrates license public houses and restaurants, clubs and betting shops. The Crown Court, brought into being by the Courts Act 1971, has an exclusively criminal jurisdiction. It sits in some 90 centres, divided into six circuits, and is presided over by High Court judges, full-time circuit judges, and part-time recorders and assistant recorders, sitting with a jury of 12 lay persons in all trials that are contested. It deals with a wide range of serious criminal offences, including those relating to environmental pollution, health and safety at work, food hygiene, the sentencing of offenders committed for sentence by magistrates’ courts and appeals from lower courts. Magistrates usually sit with a circuit judge or recorder to deal with appeals and committals for sentence. Minor criminal offences (summary offences) are dealt with by some 30000 justices sitting in 620 magistrates’ courts, which usually consist of three lay magistrates, sitting without a jury. The magistrates are advised on law and procedure by a fully qualified clerk to the justices. In the busier courts, a full-time, salaried and legally qualified stipendiary magistrate presides alone. There are currently around 88 stipendiary magistrates in England and Wales.

The Scottish judicature Scotland has a legal system that differs substantially from that of England and Wales. Scotland is divided into six sheriffdoms, each with a full-time Sheriff Principal. The sheriffdoms are further divided into sheriff court districts, each of which has a legally qualified, resident sheriff or sheriffs, who are the judges of the court. The sheriff court has a wide civil jurisdiction. Appeals against decisions of the sheriff may be made to the Sheriff Principal and thence to the Court of Session or directly to the Court of Session, which sits only in Edinburgh, and from there to the House of Lords in London. There will normally Copyright © 1999 Taylor & Francis Group LLC

be at least two Scottish judges hearing appeals from the Scottish courts in the House of Lords. In criminal cases sheriffs principal and sheriffs have similar powers; sitting with a jury of 15 members they may try more serious cases on indictment, or sitting alone they may try lesser cases under summary procedure. Judges in the Sheriff Court may not impose a sentence of more than 3 years’ imprisonment. Cases will be committed to the High Court of Justiciary if the sheriff forms the view on reading the papers that on conviction a court may wish to impose a more severe sentence. The High Court of Justiciary consists of the same judges who sit in the Court of Session. It has jurisdiction over all of Scotland in respect of crimes committed unless a statute provides otherwise. It is both a trial and an appeal court. As a court of first instance it comprises a single judge sitting with a jury of 15. As a court of appeal it sits only in Edinburgh and then comprises at least three judges. In recent years a number of environmental health cases have been heard in this court. (See for example Strathclyde Regional Council v. Tudhope (1982) SCCR 286, Docherty v. Stakis Hotels Ltd. (1991) SCCR 7, Kvaerner Govan Ltd. v. Her Majesty’s Advocate (1992) SCCR 10 and Lockhart v. Kevin Oliphant Ltd. (1993) SLT 179.) There is no appeal to the House of Lords in criminal cases. Minor summary offences are dealt with in district courts, which are administered by the district and the islands local authorities and presided over by lay justices of the peace (of whom there are about 4000) and, in Glasgow only, by stipendiary magistrates. (See also Chapter 4.)

The Northern Ireland judicature In Northern Ireland the legal system and the courts structure closely resemble those of England and Wales; there are, however, differences in enacted law. (See also Chapter 5.)

Industrial tribunals Members of industrial tribunals in England and Wales, Scotland and Northern Ireland, amongst

their other duties, hear appeals against the service of improvement and prohibition notices issued by inspectors acting under powers granted under the Health and Safety at Work, Etc. Act 1974. Industrial tribunal chairmen are legally qualified and are appointed by the Lord Chancellor. Lay members serving on tribunals in Great Britain are appointed by the Secretary of State for Trade and Industry following their nomination by specified employer and employee groups. Lay members serving on tribunals in Northern Ireland are appointed by the Department of Economic Development, Northern Ireland. Appeals may be made from a tribunal on a point of law only. The appeal is to the High Court (or the Court of Session in Scotland) and must be made within 42 days of the date of the entry of the decision in the register.

THE LAW RELATING TO STATUTORY NUISANCES Since Edwin Chadwick, one of the founding leaders of the public health movement, sent poor law medical investigators into the London slums in 1838 and issued in 1842 his Report on an Enquiry into the Sanitary Condition of the Labouring Population of Great Britain (see Chapter 2), which led to the nineteenth century Public Health Acts, the suppression and abatement of nuisances has been an important local authority responsibility. It is true that remedies to deal with nuisances were available at the time of the Chadwick Report, but resort to the law in the nineteenth century was the prerogative of the rich. In addition, strong social pressures were at work in militating against such court actions and the procedures were both unwieldy and time consuming. Consequently, local authorities had, and continue today to have, an important role to play in this area of environmental protection, both because of the clear public interest in maintaining public health standards and a pollution-free environment, and because for an individual bringing a nuisance action can be prohibitively expensive.

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Public and private nuisances The law of nuisance can be divided into public and private nuisance. Public nuisances are crimes, although they can be tortious in some circumstances. An act or omission that materially affects the reasonable comfort and convenience of a class of Her Majesty’s subjects is a public nuisance and a criminal act. It is possible to obtain an injunction to restrain a public nuisance through the Attorney General on a relator action. Under the Local Government Act 1972, Section 222, local authorities are entitled to take injunction proceedings in the High Court in order to prevent harm to inhabitants of their area. Aside from these two avenues, the right to take action is only available if special damage has been suffered. Private nuisances are always tortious and the principal remedies are damages and an injunction. A private nuisance is ‘the unlawful interference with a person’s use and enjoyment of land, or of some right over or in connection with it’. It is thus a property right. The basis for a claim in private nuisance is founded on a balancing exercise centred around the question of reasonableness, and in assessing this balance the court will take into account the locality of the nuisance, the duration of the nuisance and any hypersensitivity on the part of the plaintiff. The law of statutory nuisance was consolidated in the Public Health Act 1936 after previous Acts in 1848, 1855, 1860 and 1875. The law was updated in a piecemeal fashion and again consolidated in Part III of the Environmental Protection Act 1990.

The control of statutory nuisances It is the duty of every local authority to inspect its area to detect statutory nuisances and investigate complaints. If, having done so, it is satisfied that a statutory nuisance exists and is likely to recur, it should serve an abatement notice. A statutory nuisance is a nuisance at common law. This is a private nuisance of public health significance, that is one created by unlawful interference with a person’s use or enjoyment of land. This can take the form not only of physical damage to land but

also of causing discomfort to the owner or the occupier. An element of repetition is required because a one-off incident will rarely constitute a nuisance. It is also necessary to put the alleged nuisance in the context of the locality, as something that may be nuisance in a residential area may not be in a purely industrial location. Statutory nuisances with which the legislation is concerned are those created by any premises in a state deemed prejudicial to health generally or which, owing to the emission of smoke, fumes, gas or noise or, in the case of industrial, trade or business premises, dust, steam and smells, are prejudicial to health or a nuisance. Section 79 of the Environmental Protection Act 1990 places a duty on every local authority to cause its area to be inspected from time to time to detect whether a nuisance is likely to occur or recur. Thus if an individual within an area makes a complaint, the local authority is obliged to investigate it; if there is a failure to do so the remedy of judicial review is available to an aggrieved applicant (see R. v. Crown Court at Liverpool and another, ex parte Cooke [1996] All ER 589). Section 80 provides that where a local authority is satisfied that a nuisance exists, or is likely to occur or recur, it must serve an abatement notice on the person by whose act, default or sufferance the nuisance is attributable, or if that person cannot be found or the nuisance has not yet occurred, on the owner or occupier of the premises from which the nuisance arises or continues. The following categories of statutory nuisance are listed in the Environmental Protection Act 1990 Section 79. (a)

(b)

Any premises in such a state as to be prejudicial to health or a nuisance. Note: ‘Premises’ includes land and, subject to subsection (12) and Section 81A(9), any vessel. A vessel powered by steam reciprocating machinery is not a vessel to which this part of this Act applies. Smoke emitted from premises so as to be prejudicial to health or a nuisance. Note: This provision does not apply to smoke emitted from a chimney of a private dwelling within a smoke control area, dark smoke emitted from a chimney of a building or a chimney serving the furnace of a boiler or industrial

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plant attached to a building or for the time being fixed to or installed on any land, smoke emitted from a railway locomotive steam engine, or dark smoke emitted otherwise than as mentioned above from industrial or trade premises. This provision also does not apply to premises occupied on behalf of the Crown for naval, military or air force purposes or for the purposes of the department of the Secretary of State having responsibility for defence, or occupied by or for the purposes of a visiting force. (c) Fumes or gases emitted from premises, which are private dwellings, so as to be prejudicial to health or a nuisance. (d) Any dust, steam, smell or other effluvia arising on industrial, trade or business premises and being prejudicial to health or a nuisance. Note: This provision does not apply to steam emitted from a railway locomotive engine. (e) Any accumulation or deposit which is prejudicial to health or a nuisance. (f) Any animal kept in such a place or manner as to be prejudicial to health or a nuisance. (g) Noise, including vibration, emitted from premises so as to be prejudicial to health or a nuisance. Note: This provision does not apply to noise caused by aircraft other than model aircraft and not to premises occupied on behalf of the Crown for naval, military or air force purposes or for the purposes of the department of the Secretary of State having responsibility for defence, or occupied by or for the purposes of a visiting force. (ga) Noise, including vibration, that is prejudicial to health or a nuisance and is emitted from or caused by a vehicle, machinery or equipment in a street. Note: This provision does not apply to noise made by traffic, by any naval, military or air force of the Crown or by a visiting force, or by a political demonstration or a demonstration supporting or opposing a cause or campaign (see also the provision of the Noise Act 1996, p. 41). (h) Any other matter declared by any enactment to be a statutory nuisance.

Other matters declared by other enactments to be a statutory nuisance are: Public Health Act 1936, Section 141 Any well, tank, cistern, or water-butt used for the supply of water for domestic purposes which is so placed, constructed or kept as to render the water therein liable to contamination prejudicial to health. Public Health Act 1936, Section 259 1. Any pond, pool, ditch, gutter or watercourse which is so foul or in such a state as to be prejudicial to health or a nuisance. 2. Any part of a watercourse, not being a part ordinarily navigated by vessels employed in the carriage of goods by water, which is so choked or silted up as to obstruct or impede the proper flow of water and thereby to cause a nuisance, or give rise to conditions prejudicial to health. Public Health Act 1936, Section 268 A tent, van, shed or similar structure used for human habitation: (a) which is in such a state, or so overcrowded, as to be prejudicial to the health of the inmates; or (b) the use of which, by reason of the absence of proper sanitary accommodation or otherwise, gives rise, whether on the site or on other land, to a nuisance or to conditions prejudicial to health.

2. A quarry which is not provided with an efficient and properly maintained barrier so designed and constructed as to prevent persons from accidentally falling into it and which by reason of its accessibility from a highway, or a place of public resort, constitutes a danger to members of the public. Though not a statutory nuisance under the Environmental Protection Act 1990, Section 59(1), the Building Act 1984 provides that if a local authority considers that certain features of a building, e.g. a cesspool, private sewer, drain, soilpipe or rainwater pipe, is in such a condition as to be prejudicial to health or a nuisance, then it must serve a notice on the owner or occupier of the building requiring such work as may be necessary to be done. Remedies for statutory nuisances The procedures for the remedy of statutory nuisances are set out in Part III of the Environmental Protection Act 1990. An expedited procedure is set out in Section 76 of the Building Act 1984 where the need for a remedy is perceived to be urgent. (See below.) It is the duty of every local authority to cause its area to be inspected from time to time to detect any statutory nuisances and, where a complaint of a statutory nuisance is made to it by a person living within its area, to take such steps as are reasonably practicable to investigate the complaint. Abatement notice procedure

Mines and Quarries Act 1954, Section 151 A shaft or outlet of certain abandoned and disused mines where: 1. (a) it is not provided with a properly maintained device designed and constructed as to prevent persons from accidentally falling down the shaft or accidentally entering the outlet, or (b) by reason of its accessibility from a highway, or a place of public resort, it constitutes a danger to members of the public. Copyright © 1999 Taylor & Francis Group LLC

Section 80(1) of the Environmental Protection Act 1990 provides that where a local authority is satisfied that a statutory nuisance exists, or is likely to occur or recur, in the area of the authority, the local authority shall serve a notice (‘an abatement notice’) imposing all or any of the following requirements: 1. Requiring the abatement of the nuisance or prohibiting or restricting its occurrence or recurrence. 2. Requiring the execution of such works, and the taking of such other steps, as may be necessary for any of those purposes.

The abatement notice must specify the time or times within which the requirements of the notice are to be complied with. The abatement notice must be served on the person responsible for the nuisance except where: 1. the nuisance arises from any defect of a structural character, when it must be served on the owner of the premises, or 2. where the person responsible for the nuisance cannot be found or the nuisance has not yet occurred, when it must be served on the owner or occupier of the premises. The person served with the notice may appeal against the notice to a magistrates’ court within a period of 21 days beginning with the date on which he was served with the notice. If a person on whom an abatement notice is served, without reasonable excuse, contravenes or fails to comply with any requirement or prohibition imposed by the notice, he will be guilty of an offence. The notice may also require the execution of works, and the taking of any such steps as may be necessary for the purpose of the notice or as may be specified in the notice. The notice must specify the time or times within which the requirements of the notice are to be complied with. Appeals procedure A person served with an abatement notice has 21 days from the service of the notice in which to appeal against the notice to a magistrates’ court. The grounds of appeal are set out in regulations made under Schedule 3, Environmental Protection Act, the Statutory Nuisance (Appeals) Regulations 1990 (SI 1990 No. 2276) and the Statutory Nuisance (Appeals) (Amendment) Regulations 1990 (SI 1990 No. 2483). These include: (a) that the abatement notice is not justified in terms of Section 80; (b) that there has been a substantive or procedural error in the service of the notice; (c) that the authority has unreasonably refused to accept compliance with alternative requirements or that their requirements are unreasonable or unnecessary; Copyright © 1999 Taylor & Francis Group LLC

(d) that the period for compliance is unreasonable; (e) that the best practicable means were used to counteract the effect of nuisance from trade or business premises. The regulations further provide for the suspension of an abatement notice pending the court’s decision, unless the local authority overrides the suspension in the abatement notice with a statement to the effect that the notice is to have effect regardless, and that: (a) the nuisance is prejudicial to health; (b) suspension would render the notice of no practical effect; or (c) any expenditure incurred before an appeal would be disproportionate to the public benefit. If a person on whom a notice is served without reasonable excuse contravenes any requirements of the notice he will be guilty of an offence under Part III of the Environmental Protection Act 1990.

Sentencing powers for contravention of an abatement notice A person who commits an offence on industrial, trade or business premises is liable on summary conviction to a fine not exceeding £20000. Other persons are liable to a fine not exceeding level 5 on the standard scale (currently £5000), with a further fine of one-tenth of that level for each day on which the offence continues after conviction. Furthermore, if the person served fails to execute all or any of the works in accordance with the abatement notice, the local authority may execute those works and may recover from the person in default their costs incurred in so doing except such of the costs as that person shows were unnecessary in the circumstances. In proceedings brought by the local authority to recover such costs, the person in default cannot raise any question which he could have raised on appeal against the notice.

Expedited action for defective premises (Building Act 1984, Section 76) Where it appears to a local authority that any premises are in such a state as to be prejudicial to health or a nuisance, and that unreasonable delay in remedying the defective state would be occasioned by following the somewhat lengthy procedure set out in Part III of the Environmental Protection Act 1990, the local authority may serve on the person on whom it would have been appropriate to serve an abatement notice under the Environmental Protection Act 1990, a notice stating that the local authority intends to remedy the defective state and specifying the defects that it intends to remedy. The local authority may then, after the expiration of 9 days after service of such a notice, execute the necessary works to remedy the premises’ defective state, and recover reasonable expenses from the person on whom the notice was served. However, if, within 7 days after the service of the notice, the recipient of the notice serves a counter-notice that he intends to remedy the defects specified in the first-mentioned notice, the local authority must take no action unless the person who served the counter-notice fails within what seems to the local authority to be a reasonable period of time to begin to execute works to remedy the defects, or having begun to execute such works fails to make reasonable progress towards their completion. In proceedings to recover expenses for work carried out in default and initiated by the local authority, the court must inquire whether the local authority was justified in concluding that the premises were in a defective state, or that unreasonable delay in remedying the defective state would have been occasioned by following the procedure prescribed, and if the defendant proves that he served a counter-notice shall inquire whether the defendant failed to begin the works to remedy the defects within a reasonable time, or failed to make reasonable progress towards their completion, and if the court determines that the local authority was not justified in using this provision the local authority shall not recover the expenses or any part of them. A local authority must not serve a notice under this provision or proceed with the execution of Copyright © 1999 Taylor & Francis Group LLC

works in accordance with a notice so served if the execution of the works would, to its knowledge, be in contravention of a building preservation order under Section 29 of the Town and Country Planning Act 1947. Proceedings in the High Court Where a local authority considers that proceedings for an offence under Section 80 would afford an inadequate remedy in the case of any statutory nuisance, it may take proceedings in the High Court to secure the abatement, prohibition or restriction of the nuisance (usually by way of injunction.) See further Hammersmith London Borough Council v. Magnum Automated Forecourts Ltd [1978] 1 W.L.R. 50. In such proceedings it will be a defence to prove that noise was authorized by a construction site consent under Section 61 of the Control of Pollution Act 1974. Individual action by persons aggrieved by statutory nuisances Nowadays environmental health departments of local authorities are often understaffed and may be unable to deal fully with every statutory nuisance in their district. This provision enables any person, after giving 21 days’ notice to the defendant (3 days in case of noise) to make a complaint to a magistrates’ court on the ground that he is aggrieved by the existence of a statutory nuisance. This is a more expeditious and economic form than an action for private nuisance in the county court. If the magistrates’ court is satisfied that the alleged nuisance exists, or that although abated it is likely to recur on the same premises or, in the case of a noise nuisance, is caused by noise emitted from or caused by an unattended vehicle or un-attended machinery or equipment and is in the same street as before, the court must make an order for either or both of the following purposes: (a) requiring the defendant to abate the nuisance, within a time specified in the order, and to execute works necessary for that purpose; (b) prohibiting a recurrence of the nuisance, and requiring the defendant, within a time specified

in the order, to execute any works necessary to prevent the recurrence. The court may also impose on the defendant a fine not exceeding level 5 on the standard scale (currently £5000) together with a further fine of an amount equal to one-tenth of that level for each day on which the offence continues after the conviction. If the magistrates’ court is satisfied that the alleged nuisance exists and is such as, in the opinion of the court, to render premises unfit for human habitation, an order may be made to prohibit the use of the premises for human habitation until the premises are, to the satisfaction of the court, rendered fit for that purpose. Before instituting proceedings for such an order against any person, the person aggrieved by the nuisance shall give to that person such notice in writing of his intention to bring such proceedings and the notice must specify the matter complained of. If a person is convicted of an offence, a magistrates’ court may, after giving the local authority in whose area the nuisance has occurred an opportunity of being heard, direct the authority to do anything which the person convicted was required to do by the order to which the conviction relates. It is most important for individual complainants to note that if they wish to make complaint to the local authority or to a magistrates’ court, sufficient and proper evidence (dates, times, severity and length of the nuisance if it has occurred and the number of people affected), is gathered or there is strong evidence to show that the statutory nuisance is about to occur.

Power of entry By schedule 3, para. 2 of the Environmental Protection Act 1990, any person authorized by a local authority may, on production, if so required, of his authority, enter any premises at any reasonable time for the purpose of ascertaining whether or not a statutory nuisance exists; or for the purpose of taking any action, or executing any work, authorized or required by Part III of the Environmental Protection Act 1990. It should Copyright © 1999 Taylor & Francis Group LLC

be noted, however, that admission to any premises used wholly or mainly for residential purposes shall not, except in an emergency, be demanded as of right unless 24 hours’ notice of the intended entry has been given to the occupier. If it is shown to the satisfaction of a justice of the peace on sworn information in writing that admission to any premises has been refused, or that refusal is apprehended, or that the premises are unoccupied or the occupier is temporarily absent, or that the case is one of emergency, or that an application for admission would defeat the object of the entry, and that there is reasonable ground for entry into the premises for the purpose for which entry is required, the justice may by warrant authorize the local authority, by any authorized person, to enter the premises, if need be by force. The warrant will continue in force until the purpose for which the entry is required has been satisfied. An authorized person entering any premises has wide powers. He may take with him such other persons and such equipment as may be necessary; carry out such inspections, measurements and tests as he considers necessary for the discharge of any of the local authority’s functions under Part III; and take away such samples or articles as he considers necessary for that purpose. The authorized person must secure any unoccupied premises on leaving. For the purpose of taking any action, or executing any work, authorized by or required under Part III in relation to a statutory nuisance within Section 79(1)(ga) of the Environmental Protection Act 1990 caused by noise emitted from or caused by the vehicle, machinery or equipment, any person authorized by a local authority may after notifying the police and on production (if so required) of his authority enter or open a vehicle, machinery or equipment, if necessary by force, or remove a vehicle, machinery or equipment from a street to a secure place. If entry has been gained to any unattended vehicle, machinery or equipment the authorized person shall leave it secured against interference or theft in such manner and as effectually as he found it. If the unattended vehicle, machinery or equipment cannot be left secured the authorized person must immobilize it by such means as he considers expedient, or remove it from the street

to a secure place taking care not to cause more damage than is necessary. The local authority must then notify the police of its removal and current location.

the consent of the person having the right to disclose the information, be liable, on summary conviction, to a fine not exceeding level 5 on the standard scale.

Recovery of expenses

FURTHER READING

A local authority may recover its reasonable expenses in executing the powers set out above.

Bassett, W.H. (1998) Environmental Health Procedures, 5th edn, E. & F.N.Spon, London. Burnett-Hall, R. (1995) Environmental Law, Sweet & Maxwell, London. Hutter, B.M. (1988) The Reasonable Arm of the Law, Clarendon Press, Oxford. Kramer, L. (1997) E.C.Treaty and Environmental Law, Sweet & Maxwell, London. Neal, A.C. and Wright, F.B. (1992) The European Communities’ Health and Safety Legislation, Chapman & Hall, London. Wright, F.B. (1997) Law of Health and Safety at Work, Sweet & Maxwell, London.

Offences relating to entry A person who wilfully obstructs any person acting in the exercise of any powers set out above will be liable, on summary conviction, to a fine not exceeding level 3 on the standard scale. If a person discloses any information relating to any trade secret obtained in the exercise of any powers set out above he shall, unless the disclosure was made in the performance of his duty or with

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8

Enforcement of environmental health law Terence Moran

WHAT IS ENFORCEMENT? First and foremost, enforcement should never simply be taken to mean prosecution. It was Hawkins [1] who recognized that law may be enforced by compulsion and coercion, or by conciliation and compromise, and, in the words of Hutter [2] the term ‘enforcement’ should be used to accommodate a ‘much wider concept, defining enforcement as the whole process of compelling observance with some broadly perceived objectives of the law’. It is this definition that is accepted for the purposes of this chapter and it is this process of compulsion, and the mechanisms to be employed to achieve this end, that will be explored. Adopting Hutter’s definition, we may then define enforcement activity as ‘the decisions environmental health officers make about how to dispose of individual cases and how, as members of a department, they interpret the law in terms of policies and strategy. Thus enforcement constitutes the bridge between the government’s decision to intervene and protect the environment, and the impact of this intervention upon both the environment and the regulated’ [2]. Historically, the enforcement of environmental legislation has been characterized by a relatively low number of prosecutions [3]. This has been attributed to an informal regulatory style, which, in the words of Vogel, is typified by: an absence of statutory standards; minimal use of prosecution; a Copyright © 1999 Taylor & Francis Group LLC

flexible enforcement strategy; considerable administrative discretion; decentralized implementation; close co-operation between regulators and the regulated; and restrictions on the ability of non-industry constituents to participate in the regulatory process [4]. It is a style that has not always been seen as entirely satisfactory. Those involved in the enforcement of environmental health law often find themselves uncertain of their role; are they to be police officers or friendly advisers? This ambivalence of attitude resulted in the development of what may be termed a dual-track approach, often using informal cooperation in preference to coercion. Hutter identified that many regulatory agencies (not just environmental health officers), had adopted this co-operative approach, which relied on negotiation, bargaining, education and advice to secure compliance [2]. Carson found: …[factory] inspectors do not see themselves as members of an industrial police force primarily concerned with the apprehension and subsequent punishment of offenders. Rather they perceive their function to be that of securing compliance with the standards of safety, health and welfare required and thereby achieving the ends at which the legislation is directed. [5] This attraction to informal techniques was similarly found to be displayed by water authorities. Quoting one officer, Hawkins records:

…the objective of the job is not to maximize the income of the exchequer by getting fines. The job is to make the best use we can of the water for the country…we get more co-operation if we use prosecution as a last resort. [1] As Hutter [2] points out, the law in books is rarely implemented in a clear-cut fashion. It is in this area that environmental health officers (EHOs) have to determine matters before them: what the law means; whether matters before them are covered by the legislation; and what the most appropriate method of resolution is. It is not enough simply to claim that it is the technical complexity of environmental health law that causes the difficulty in enforcement. The situation is altogether more complex, involving considerations of history, policy and jurisprudence. A number of interacting factors have been identified, including: • the range of penalties available and the perceived low level of penalties actually imposed • the exercise of discretion in decision-making regarding enforcement • the accountability of EHOs • limited resources • EHOs’ perception of themselves as educators and advisers rather than police officers • the uncertainty of the criminality of the prohibited conduct in this area.

ENFORCEMENT POLICY Uncertainties remain, not least in the area of enforcement policy. An Audit Commission report in 1991 [6] suggested that only a minority of local authorities had fully developed enforcement policies, and that even fewer had been published. For example, the Audit Commission found that only 43% of local authorities had a departmental policy for food hygiene and safety law enforcement. Furthermore, those authorities that did have policies appeared to do little to publicize them. Thus over 90% of respondents to a Department of Trade and Industry (DTI) business survey in Copyright © 1999 Taylor & Francis Group LLC

1994 did not know whether their local authority had an enforcement policy [7]. The lack of visibility of such policies inevitably raises questions of transparency, accountability and effectiveness. Yet it is relatively easy to formulate policies that incorporate the means to measure effectiveness. Rowan-Robinson and Ross [8] have developed a framework that allows some measurement of effectiveness. They have suggested a 9-point approach as an aid to the measurement of the effectiveness of enforcement: 1. 2. 3. 4. 5. 6. 7. 8. 9.

the clarity of the objectives of the legislation the measurement of unlawful conduct the character of the enforcement agency the resources devoted to enforcement the objectives of enforcement the character of the deviant population the organization of the enforcement agency external dependency relationships sanctions for a breach of control. [8]

Rowan-Robinson and Ross suggested that the most important institutional pressure that structures the way that enforcement agencies seek to obtain legislative goals is the agency’s own policy on enforcement [8]. They identify that ‘the development of a formal “top-down” policy compels an agency to address the way in which enforcement practice may accommodate whatever constraints are imposed and still contribute in the most effective way to policy implementation’ [8]. In the absence of a ‘topdown’ approach, enforcement policy will emerge from the ‘bottom up’ as the sum of day to day practice by officers. Policy is then formulated, rather than mediated, by officers on a case by case basis. This is the least desirable scenario, creating as it does a policy that is opaque, untargeted, and unlikely to be commensurate or, in the words of the Health and Safety Executive Local Authority Unit, ‘proportionate to risk’ [9]. A policy that is not commensurate must inevitably lack credibility. Taking a lead from the Crown Prosecution Service, a prosecution policy can be a public declaration of the principles upon which EHOs will exercise their functions. The purpose of the

policy is the promotion of efficient and consistent decision-making so as to develop, and thereafter maintain, public confidence in EHOs’ performance of their duties. Such a policy can acknowledge the range of options available and how, depending on circumstances, EHOs may use those options to ensure protection of the public. These options extend from education and advice via warning letters and statutory notices to prosecutions. Perhaps the key to understanding the operation of such a policy is first to accept the value of the use of discretion. EHOs are given considerable discretion when applying the law. Hawkins saw this discretion as ‘operationally efficient’, as it is only the enforcing officer who really knows the target groups, their problems and their negotiating styles’ [1]. However, Richardson, Ogus and Burrows [10] noted that the exercising of discretion must be correctly guided and managed. The misuse of discretionary powers can carry severe consequences, not only for those suspected of criminal activity but also for the public at large and, importantly, for the reputation of the system of justice. For all enforcing authorities it is not, nor has it ever been, simply a matter of whether or not to prosecute. Even the imposition of strict liability should not to be taken to require an automatic prosecution. In Smedleys Ltd v. Breed [1974], a case relating to contaminated food, Viscount Dilhorne asked: In [the] circumstances, what useful purpose was served by the prosecution of the appellants… It may have been the view that in every case where an offence was known or suspected, it was the duty of a food and drugs authority to institute a prosecution, that if evidence sufficed a prosecution should automatically be started …I do not find anything in the Act imposing on [an authority] a duty to prosecute automatically whenever an offence was known or suspected and I cannot believe that they should not consider whether the general interests of consumers were likely to be affected when deciding whether or not to institute proceedings …No duty is imposed on them to prosecute in every single case and although this Act imposes Copyright © 1999 Taylor & Francis Group LLC

on the food and drugs authorities the duty of prosecuting for offences…it does not say— and I would find it surprising if it had—that they must prosecute in every case without regard to whether the public interest will be served by a prosecution. A prosecution where no useful purpose was served was, and therefore remains, unnecessary. The Health and Safety Executive/Local Authority Liaison Committee (HELA) recognized this in their guidance to local authorities [9] and suggested that local authorities should generally reserve prosecutions in the area of health and safety at work for the more serious offences that either did result or could have resulted in serious injury or ill-health, or that represented a blatant disregard by employers, employees, or others of their responsibilities under health and safety legislation. There is, in fact, little evidence to suggest that local authorities routinely embark on unnecessary prosecutions. The DTI Interdepartmental Review Team report [7] found that fewer than 10% of those who responded showed a marked preference for formal action, the preferred approach being altogether more flexible. If legal proceedings are to be instituted, it is important that such action is undertaken only after reference to appropriate policy guidance. Proceedings should then be instigated on a fair and consistent basis, a basis derived from a mature enforcement policy. Codes of Practice made under the Food Safety Act 1990 offer one model for the form such guidance may take. The codes have long recommended that, before deciding whether a prosecution should be made, food authorities should consider a number of factors, which may include: • the seriousness of the alleged offence • the previous history of the party concerned • the likelihood of the defendant being able to establish a due diligence defence • the ability of any important witnesses and their willingness to co-operate • the willingness of the party to prevent a recurrence of the problem

• the probable public benefit of a prosecution and the importance of the case • whether other action, such as issuing a formal caution, would be more appropriate or effective • any explanation offered by the affected company. This is not, however, the only guidance that EHOs can draw on. Both HELA and the Environment Agency have published guidance on these matters. In the area of health and safety at work, the Health and Safety Commission (HSC), in their 1992 annual report, described the Health and Safety Executive’s (HSE’s) approach to enforcement. From this it was evident that prosecution was viewed as only one element in a strategy that was primarily preventative. The HSE will use prosecution as a tool to draw attention to the need for compliance and the maintenance of good standards. Inspectors investigating breaches of the law are to consider their potential to cause harm as well as any harm actually caused. The HSC has developed this approach into an enforcement policy [11], which has embraced the principles of proportionality, consistency, transparency and targeting. The HSC defines proportionality as meaning that enforcement action taken by an enforcing authority is to be proportionate to the seriousness of the breach and the risks to health and safety. Consistency here relates to the enforcement practice, i.e. adopting a similar approach to the options of enforcement rather than ensuring uniformity. Transparency of the arrangements is the extent to which those subject to regulation and the wider public are clear about what is expected of them and what they can, in turn, expect of the enforcing agency. Targeting means enforcement action should be properly targeted at those who are responsible for the risk and at those whose activities give rise to the risks that are the most serious or least well controlled. The approach identified by the HSE is echoed by that adopted by the Environment Agency, which has published the principles that it will adopt for its enforcement activities in its Enforcement Policy Statement. In January 1999 the EA published a new enforcement and Copyright © 1999 Taylor & Francis Group LLC

prosecution policy available by telephoning 0645 333 111 or on the EA’s website w w w. e n v i ro n m e n t - a g e n c y. g o v. u k . W h e n undertaking such activities it will take into account the principal aim of the agency under Section 4(1) of the Environment Act 1995, the government’s Code of Practice for enforcement agencies and the requirements of schedule 1 of the Deregulation and Contracting Out Act 1994, which advocates codes of practice for regulatory agencies. The code sets out four basic principles that should inform the enforcement of environmental protection law. These are: proportionality, consistency, targeting of action and transparency. By proportionality, the Environment Agency means relating enforcement action to the risks and costs. However, the code states that there are some risks that are so serious that they may not be permitted irrespective of economic and other consequences, while at the other end of the scale some risks may be so inconsequential as to be not worth further expenditure. For the Environment Agency, consistency of approach does not mean merely ‘uniformity’, but instead means adopting a similar approach in similar circumstances. However, because of the number of variables officers may face, the Environment Agency recognizes that consistency may not be easy. Among the variables identified are: • the degree of pollution • the attitude and actions of management • the history of the pollution incidents. Nevertheless, it is recognized that decisions on enforcement action should be a matter of sound professional judgement, and that the Environment Agency, through its officers, should exercise discretion. In operating transparently, officers of the Environment Agency are expected to explain why they intend to take enforcement action and to distinguish compulsory requirements from those that are a matter of guidance and therefore merely desirable. Targeting for the Environment Agency is a matter of ensuring that inspection and other action

is primarily directed towards those whose activities give rise to the most serious environmental damage. So far as prosecution policy is concerned, the Environment Agency will use discretion in deciding whether to initiate proceedings. Consistent with published studies, it is mindful that other approaches to enforcement may prove more effective than prosecution. However, it does recognize instances where prosecution without prior warning may be appropriate. Prosecution remains relatively rare. Whatever enforcement option officers may ultimately elect to take, their decision should be informed by a full appreciation of all the relevant facts. This is vital as not only will the officers then be in a position to make a proportionate enforcement decision, but they also will be able to meet certain statutory requirements, such as those relating to disclosure. Officers considering any form of enforcement action must therefore be competent to undertake an appropriate level of investigation. This means that they must be aware of all of the statutory powers, options and obligations they are given as an aid to both investigation and enforcement.

policies and procedures (which contribute to best value), and will provide information to show that they are observing them.

Principles of good enforcement—policy STANDARDS In consultation with business and other relevant interested parties, including technical experts where appropriate, local authorities must draw up clear standards setting out the level of service and performance the public and business people can expect to receive. They must publish these standards and their annual performance against them. The standards will be made available to businesses and others who are regulated. OPENNESS Local authorities must provide information and advice in plain language on the rules that they apply and must disseminate this as widely as possible. They must be open about how they set about their work, including any charges that they set, consulting business, voluntary organizations, charities, consumers and workforce representatives. They must discuss general issues, specific compliance failures or problems with anyone experiencing difficulties.

Enforcement Concordat In 1997 the Secretary of State for the Environment, Transport and the Regions signed, with the chairman of the Local Government Association (LGA), a framework document for partnership. The framework commits central and local government to working together to stengthen and sustain locally elected government in England and sets out arrangements for the conduct of central/ local government relations. Within this framework, in March 1998 the LGA and the government launched an Enforcement Concordat for adoption by local authorities that is relevant to all environmental health law enforcement. In the concordat, the term ‘enforcement’ is deemed to include advisory visits and assisting with compliance as well as licensing and formal enforcement action. Adopting the concordat means that a local authority is committed to the following Copyright © 1999 Taylor & Francis Group LLC

HELPFULNESS Local authorities should believe that prevention is better than cure and that their role therefore involves actively working with business, especially small and medium-sized businesses, to advise on and assist with compliance. They should provide a courteous and efficient service, and their staff should identify themselves by name. They should provide a contact point and telephone number for further dealings with them and encourage business to seek advice/information. Applications for approval of establishments, licenses, registrations, etc. should be dealt with efficiently and promptly. They should ensure that, wherever practicable, enforcement services are effectively co-ordinated to minimize unnecessary overlaps and time delays. COMPLAINTS ABOUT SERVICE Local authorities should provide well publicized, effective and timely complaints procedures that are easily

accessible to business, the public, employees and consumer groups. In cases where disputes cannot be resolved, any right of complaint or appeal must be explained, with details of the process and the likely timescales involved. PROPORTIONALITY Local authorities should minimize the costs of compliance for business by ensuring that any action required is proportionate to the risks. As far as the law allows, they should take account of the circumstances and attitude of the operator when considering action. They should take particular care to work with small businesses, and voluntary and community organizations so that they can meet their legal obligations without unnecessary expense. CONSISTENCY Local authorities should carry out duties in a fair, equitable and consistent manner. While inspectors are expected to exercise judgement in individual cases, arrangements should be in place to promote consistency, including effective arrangements for liaison with other authorities and enforcement bodies through schemes such as those operated by the Local Authorities Coordinating Body on Food and Trading Standards (LACOTS) and the Local Authority National Type Approval Confederation (LANTAC). Principles of good enforcement—procedures Advice from an officer should be put clearly and simply and be confirmed in writing, on request, explaining why any remedial work is necessary and over what time-scale, and making sure that legal requirements are clearly distinguished from best practice advice. Before formal enforcement action is taken, officers should provide an opportunity to discuss the circumstances of the case and, if possible, resolve points of difference, unless immediate action is required (for example, in the interests of health and safety or to prevent evidence being destroyed). Where immediate action is considered necessary, an explanation of why such action was required should be given at the time and confirmed in writing in most cases within 5 working days, and in all cases within 10 working days. Copyright © 1999 Taylor & Francis Group LLC

Where there are rights of appeal against formal action, advice on the appeal mechanism should be clearly set out in writing at the time the action is taken (whenever possible this advice should be issued with the enforcement notice).

INSPECTION Programming of inspections The ‘trigger’ event for enforcement activity may take many forms. There may be a major food poisoning outbreak or a major pollution incident, there may be a workplace accident or a member of the public may make a formal complaint. In the sense that these events are unpredictable they are therefore beyond the control of EHOs. However, not all such ‘triggers’ are unanticipated or unplanned. There is, for example, the preplanned inspection. Enforcement officers find themselves, now more than ever, involved in ‘risk based approaches’ to enforcement. Whether that be in the area of health and safety at work using risk assessment, or in food safety using HACCP (hazard analysis of critical control points), it is a factor that influences enforcement activity. Take, for example, the area of food safety. Code of Practice 9 on food hygiene inspections gives guidance on the priority planning and programming of inspections. Food authorities are obliged to adopt a programme of inspections and ensure, so far as is practicable, that inspection visits are carried out in accordance with that programme. Such a programme should be constructed to recognize that certain premises will pose a higher risk than others and are therefore to be inspected more frequently than other, lower risk, premises. The code in Annexe 1 gives an inspection rating scheme for food premises, and obliges a food authority to adopt this or a similar scheme to determine minimum inspection frequencies. It takes no great thought to see how frequency of inspection is an enforcement tool. Regular inspection is likely to make those subject to that inspection more aware of the need to comply with the law and more inclined to do so. In fact, Code of Practice 9 states that food authorities should also advise the

proprietor of a business of the inspection rating allocated to the business and be prepared to discuss the scoring applied. Inspections, or the threat or anticipation of them, may themselves secure compliance with the law or may give rise to other enforcement activity aimed at securing the same outcome. However, for such inspections to be productive an officer must first gain entry to the premises concerned.

Entry One key statutory power given to EHOs is the power to enter premises. Because of the wide range of duties undertaken, the range of powers of entry, search and seizure is equally extensive. Self-evidently, routine entry into premises will be with permission. This ‘express permission’ ensures that the officer concerned does not enter the property as a trespasser and thus enters and remains on the property as a lawful visitor. Any unauthorized entry by any person, including an EHO, into private premises is an actionable trespass. Therefore, EHOs who enter a building with permission, but are subsequently told to go must do so or leave themselves, and perhaps their employer, open to an action for trespass. Entry on to land, however, may be lawful without there having been any express permission given, e.g. there may be a right of way across land that makes it lawful for a stranger to be on that land. However, for the EHO the power of entry is statutory. Here a specific statutory provision provides for officers to enter private premises for the execution of specified activities. Such statutory provisions do not provide an unlimited right of access for all persons to all premises at all times. Any empowering statute will inevitably stipulate the conditions precedent for the exercise of a power of entry, by whom the power is exercisable, and the limits of its application. Every officer seeking to use any power of entry under any statutory provision must first be authorized by the relevant authority for that purpose and have the authorization document available. There is no national format for these documents and therefore their precise form and layout vary across the country. Copyright © 1999 Taylor & Francis Group LLC

Officers must be clear about the extent of their authority and it must never be assumed that an officer has been authorized. Being employed to do a job is not the same as being authorized for the purposes of an act; to confuse the two is to invite disaster. Because of the range of provisions, there is no single, uniform procedure for gaining entry to premises. Each one of the statutory provisions giving the power to enter displays common features, but there is not sufficient uniformity to permit EHOs to assume that familiarity with one provides an adequate knowledge of all. Each is required to be understood in its own right and it is up to the EHOs to ensure that they know the relevant requirements of the power of entry they are seeking to use. For example, where the power to enter requires the officer to have reasonable grounds, just what constitutes reasonable grounds varies from case to case and will, in the final analysis, remain a question for an officer’s professional judgement. What is clear, however, is that officers must understand that the test is an objective one. The use of the words ‘reasonable grounds’ imposes the condition that such reasonable grounds must in fact exist and be known to the officer before the conditional power in question can validly be exercised. EHOs must understand that the issue is not whether they believed there to be reasonable grounds but, when looked at objectively, whether there were reasonable grounds. The credibility in terms of the quantity and, particularly, quality of information required to establish ‘reasonable grounds’ must necessarily be less than that that would be required to institute proceedings or take other statutory action. Nevertheless, EHOs must ensure that they can satisfy the central objective test. This means that all officers should record clearly those facts that lead them to conclude that they have reasonable grounds for their belief. This has a twofold benefit. First it ensures that officers have approached the issue correctly and satisfactorily addressed this threshold test for entry. Second, it ensures that, if subsequently questioned, officers have clear and defensible reasons for coming to the conclusion they did. Other conditions, such as those relating to the need to give prior notice, must similarly be

acknowledged and accommodated by EHOs. For example, any prior notice of entry must be specific about its purpose, should identify the relevant authority, and should be specific about the relevant statutory provision concerned. A failure to comply with the stipulated requirements for prior notice will render any dependent entry invalid and any subsequent application for a warrant impossible.

Recording of information Once inside any premises it is important that officers ensure that all information acquired is accurately and thoroughly recorded. A common method for this is the notebook. Often referred to as ‘PACE’ (Police and Criminal Evidence Act 1984) notebooks, these books can prove vital to the professional functioning of EHOs. Their significance, in terms of the preparation of reports, statements and memory refreshing in the witness box, is major. The record of events, if it is substantially contemporaneous, may, by the application of the ‘memory refreshing rule’, be used by EHOs to refresh their memory when later giving evidence to a court. If EHOs are to rely on their notebooks in this way, they must be kept in a disciplined fashion, particularly as the defence in any criminal case will be entitled to examine the notebooks to establish that entries are consistent with the evidence being given. Guidance previously given to police officers on the completion of notebooks has proved to be entirely appropriate for EHOs as well. An alternative or an addition to the notebook as a means of recording information is the preprepared inspection sheet. As for a notebook, it is essential that accuracy is observed at all times, for it is from the observations recorded in a notebook or inspection proforma that any subsequent statements may be composed and thus prosecution instigated. It is therefore vital that inspection proformas are completed with the same discipline as for a notebook. The aim of any officer inspecting premises should be to record all relevant information in such a manner that it: Copyright © 1999 Taylor & Francis Group LLC

• will inform any subsequent enforcement decision • will be permissible under the memory refreshing rule • will allow a colleague examining the inspection findings, but not having previously visited the premises, to be able to understand and make a reasonable assessment of the conditions. It is therefore important that EHOs take note of all possible sources of information. However, it is unwise to take everything at face value. For example, if told the property being inspected was rewired 2 years ago, this should not be recorded as a fact in the inspection findings. To record that ‘the property was rewired 2 years ago’ without further investigation is unsustainable and evidentially is hearsay. Generally, a systematic approach to inspection will pay dividends, both in savings of time and effort and in ensuring that a higher quality of information is recorded. Take, for example, the inspection of a house. The accurate recording of findings is critical. It is never wise to trust to one’s memory. An inspection checklist or sheet can help as it can ensure that the inspecting officer keeps to the discipline of a properly planned schedule of inspection while providing an immediate and obvious way of ensuring that no important element is overlooked. When recording defects, the use of words such as ‘broken’ or ‘defective’ should be avoided. Without further elaboration these words convey little information about the exact nature of the problem identified. Words such as ‘cracked’, ‘missing’, ‘holed’ and ‘rotten’ all convey a clearer picture of the conditions found. Equally, it is appropriate to attempt to quantify the extent of the defect noted. For the same reasons as those applying to the keeping of a notebook, EHOs should aim to avoid leaving blank spaces on any inspection form used. If an element of the structure is sound, record its presence and mark it as such; a blank space in any inspection report might be taken to indicate that no defect was present or that the inspector forgot to look at that particular thing. For a house inspection, the following should be considered as the minimum information to be recorded:

• • • • • • • • •

• • • • •

the address and location of the property the name of the inspecting officer the date of inspection the time of day the weather conditions the approximate age of the house the type of property: terraced, back-to-back, semi, etc. the type of construction: traditional, timber frame, etc. the occupiers of the property: these details should include: names, ages, sexes, relationship, how long they have lived there, if tenanted in whose name is the tenancy, what rent is paid, to whom is the rent paid, is there a rent book, and was the rent book inspected the type of occupancy of the house: house in multiple occupation (HMO), single household the name and address of any managing agent and the name and address of the owner details of any mortgagee accommodation: number of rooms, type of rooms method of orientation for the purpose of recording inspection findings.

With appropriate amendments, the same approach could be adopted for all inspections by EHOs. In addition to relying on information obtained directly, EHOs might also have to rely on information obtained by others. Thus when dealing with members of the public it is vital to make clear all instructions about how they should complete any record they might make. First, the potential legal significance of what the person is doing should be made clear. It should be explained that he or she may be asked to give evidence in court based on any notes made. It is therefore vital that matters about memory refreshing are fully explained. Clarity and precision must be emphasized from the outset. Potential witnesses must have explained to them both the type and significance of the information they are to record. For example, they must make sure of the source of any alleged nuisance rather than assume it.

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Investigative powers It is clear that to be able to select an enforcement option EHOs must be prepared to use all investigative alternatives to inform their decision to take action and what action to take. For example, if that action is to serve a notice they must then decide what to include in the notice specification. To do otherwise is to run a number of risks. The risk of selecting the wrong notice, or of serving a notice improperly, the risk of failing to specify with sufficient particularity, or the risk of imposing conditions that are more onerous than are truly required. EHOs are given extensive investigative powers under a wide range of statutory provisions. For example, consider Section 20 of the Health and Safety at Work, Etc. Act 1974 relating to the powers of inspectors. This section of the Act gives inspectors an extensive list of investigative tools or powers backed up by criminal sanctions. Anyone seeking to restrict the correct exercise of these powers is committing a criminal offence. 1. An inspector has the power to enter any premises at any reasonable time for the purposes of carrying into effect any of the relevant statutory provisions. If he is of the opinion that the situation is or may be dangerous, he may enter the premises at any time, and if the inspector has reasonable cause to apprehend serious obstruction in the execution of his duty he may take with him a constable. 2. An environmental health officer authorized under Section 20 may be accompanied by any other person duly authorized by the inspector’s enforcing authority. He is also entitled to take on to the premises any equipment or materials which may be required for any purpose for which the power of entry is being exercised. The powers allow the environmental health officer to make such examination and investigation as may be necessary to carry into effect any of the relevant statutory provisions. An officer using these powers may also direct that any premises that he has entered or any part thereof is to be left undisturbed for so long as is reasonably necessary for the purpose of any examination or investigation.

3. The environmental health officer may take measurements, photographs and recordings and also samples of any articles or substances found on the premises. In the case of any article or substance which has caused or is likely to cause a danger to health or safety, an authorized officer may have it dismantled or subjected to any process or test. Further, the officer may take possession of the article and detain it for so long as is necessary to examine it, to ensure that it has not been tampered with and to ensure that it will be available as evidence in any proceedings. 4. Under this section the inspector acquires powers to question any person whom he believes to be able to give information relevant to an investigation. The inspector is able to require the production of documents required to be kept by virtue of any of the statutory provisions and any other book or document necessary for him to see as part of his enquiries. 5. The environmental health officer may require any person to afford him such facilities and assistance with respect to any matter or thing within that person’s control as is necessary to enable the inspector to exercise any of the powers conferred on him. 6. Finally, Section 20 gives a residual or ‘catchall formula’ that gives the authorized officer any power necessary for the purpose of carrying into effect any of the relevant statutory provisions. Officers should not view the use of these powers and similar ones contained in other statutes as optional. The question ought not to be ‘which one of these shall I use?’ but ‘which of these is it not appropriate to use?’. Information so gained may be the key to the correct selection of an enforcement option. It may also reveal some defence that makes the proposed enforcement action, such as the service of a notice, of questionable validity. The service of a notice under Section 80 of the Environmental Protection Act 1990 on a business may be inadvisable when a best practicable means defence exists. The only way to anticipate such matters properly is to use all appropriate investigative powers to the extent necessary to act in an informed manner. Copyright © 1999 Taylor & Francis Group LLC

It is only in this way that the decision to prosecute or to serve notice can hope to withstand a challenge of this nature.

NOTICES There is little doubt that one of the most useful enforcement options available to EHOs is the statutory notice. A wide range of statutes provides for the service of legally enforceable notices under many differing circumstances and there exist very sound reasons for this particular form of enforcement mechanism. The Robens Committee report [12] recognized the weakness of the preexisting law relating to the enforcement of health and safety at work. It stated: ‘The criminal courts are inevitably concerned more with events which have happened than with curing the underlying weaknesses which have caused them.’ The report noted that the penalty of imprisonment was hardly ever sought and that the then maximum level of fines was derisory. Examining this enforcement pattern the committee decided not to recommend changes that would involve an increase in prosecutions, preferring instead to recommend a ‘constructive means of ensuring that practical improvements are made and preventative measures adopted’. These were to be ‘non-judicial administrative techniques for ensuring compliance with minimum standards of safety and health at work’. New powers were recommended to give inspectors power to issue notices on their own authority, thereby achieving the stated aim. Although the Robens report was concerned with safety in the workplace, its findings offer an insight into the nature of many other forms of statutory notice. The use of a notice allows the option of enforcement without reference to a court, with the advantages that it is speedier, more flexible and less costly than the cumbersome operation associated with a criminal prosecution, while still achieving the aim of the relevant legislation. The statutory notice represents one in a number of points in a continuum of options available to EHOs to deal with unsatisfactory situations. It

offers an intermediate step between inactivity (here meaning no formal action based on the properly guided use of discretion) and prosecution. Although the use of the enforcement notice does represent a position short of prosecution, it would be wrong not to recognize the legal significance of the notice and the need to approach the selection, drafting and service of such documents with complete discipline and thoroughness. Statutory notices are basically of two types: those whose service is dependent on there having been a breach of a specific statutory provision; and those that are triggered by the existence of a ‘substandard’ state of affairs. Under the former category would come notices under provisions such as: Section 21 of the Health and Safety at Work, Etc. Act 1974 or Section 10 of the Food Safety Act 1990. The latter category would embrace notices such as Section 80 of the Environmental Protection Act 1990 and Section 189 of the Housing Act 1985. All categories would generally carry a penalty for non-compliance with the notice itself, but only in the former is the trigger event also a breach of the law. So, for example, there is no offence of causing a statutory nuisance but there is the offence of failing to comply with the terms of an abatement notice under the Environmental Protection Act 1990. Clearly there may be one or two notices that do not sit easily in either of these categories, but as a general categorization the classification is sound. A statutory notice is not a prosecution and its service does not invite the same standard of proof. For many statutory notices there is therefore no need to have obtained evidence ‘beyond a reasonable doubt’ about the state of affairs alleged. However, that is not to say that an officer can base the service of a notice on just any evidence. To be able to draft a valid and defensible notice, EHOs must be prepared to use all investigative options to inform their decision both to serve the notice and what to include in it. To do otherwise is to run the risk of serving a notice improperly. EHOs are given extensive investigative powers under a wide range of statutory provisions. Officers should not view these as optional. Again, the question ought not to be ‘which of these shall I use?’ but ‘which of these is it not appropriate to use?’. By considering all investigative options, and

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then positively rejecting those that are inappropriate, an officer can be sure that he will not overlook valuable information. This information may be the key to the correct drafting of the notice, as it may identify what the central issue in the problem is, and thus, when viewed within a developed enforcement policy, help the officer to decide on the appropriate specific remedial works. It may also reveal a defence, raising a question mark against the service of the notice in the first place. Any enforcement policy relating to the use of a statutory notice must accommodate some of the significant changes in the ‘preliminaries’ that are necessary before the service of certain notices. There was, for example, the ‘minded to’ procedures. More correctly these were ‘Notices of Intent’ and flowed from the provisions of the Deregulation and Contracting Out Act 1994, which provided for the improvement of enforcement procedures and advocated codes of practice for regulatory agencies. Most ‘minded to’ procedures were revoked on 1 April 1998, but during the time they were extant they were a legally essential precursor for the service of many notices and therefore one that authorities ignored at their peril. Power to charge for enforcement action Perhaps the need for more transparent enforcement is greater now that, in certain areas of work, provision is starting to be made to allow an authority to charge when a notice is served. The Housing Grants, Construction and Regeneration Act 1996 states that a local housing authority may now make such reasonable charges as it considers appropriate as a means of recovering administrative and other expenses incurred in taking action of the following kinds: • serving a deferred action notice or deciding to renew such a notice • serving a repairs notice • making a closing order • making a demolition order. In the Housing (Maximum Charge for Enforcement Action) Order 1996, the maximum charge was

specified as £300. The expenses that may be recovered are those incurred in: • determining whether to serve/renew the notice or make the order • identifying the works to be specified in the notice • serving the notice or order. It is evident that arbitrary or unstructured enforcement policies are inconsistent with defensible charging regimes.

THE CAUTIONING OF OFFENDERS As already stated, an EHO has a number of options in any given situation, ranging from taking no formal action, through the service of a notice, to prosecution and beyond. A further option on this enforcement continuum is the administration of a formal caution under the guidance to be found in Home Office Circular 18/1994. The purpose of the circular is to provide guidance on the cautioning of offenders, and in particular to: • discourage the use of cautions in inappropriate cases, such as for offences that are triable on indictment only • seek greater consistency • promote the better recording of cautions. Though obviously aimed at police officers, the circular is nevertheless appropriate for those involved in environmental health enforcement. Formal cautioning can be successfully incorporated into an enforcement policy and is relevant across the whole range of the work of the EHO. However, to be most effective this enforcement option must be deployed as part of an enforcement policy and not considered in isolation. Circular 18/94 recognizes the difficult interface that exists between informal warnings and formal cautions, and between formal cautions and prosecutions. To attempt to utilize the formal caution outside of a framework of guidance would be to run the risk of misusing a valuable enforcement tool. However, properly applied cautioning can be regarded as an effective form of disposal. Copyright © 1999 Taylor & Francis Group LLC

The decision to caution is always one for an enforcing authority, and should never be merely a matter of routine. The proper use of discretion, as has been said, is a matter to be guided by a thorough and refined enforcement policy, having regard to whether the circumstances are such that the caution is likely to be effective, and appropriate to the offence. Circular 18/94 identifies that the accurate recording of cautions is essential in order both to avoid multiple cautioning and to achieve greater consistency. A formal caution so recorded will then be expected to influence an authority in deciding whether to institute proceedings if the person should subsequently offend again. Additionally, and advantageously, an earlier caution may be cited in subsequent court proceedings for other offences if the person is found guilty. Before a caution is given, departmental or other records should be checked to ascertain if the offender has received any such warnings previously. It is both possible and permissible for a person or organization to be cautioned on more than one occasion, although the policy implications of this should be acknowledged. The authors of the circular, aware that multiple cautioning may bring this option into disrepute, advise that cautions should not be administered to an offender in circumstances where there can be no reasonable expectation that this will curb his offending. Guidance suggests that it is only in the following circumstances that more than one caution should be considered: • where the subsequent offence is trivial; • where there has been a sufficient lapse of time since the first caution to suggest that it had some effect. This is consistent with the identified purpose of formal cautioning, which is to deal quickly and simply with less serious offenders, to divert them from the criminal courts and to reduce the likelihood of their reoffending. Recognizing that there will be, in any enforcement policy, the option of simply giving a verbal warning, the circular is clear that there is no intention of inhibiting this practice. Care should be taken, however, to ensure that this informal warning is not recorded as a

formal caution. Unlike such a caution, a verbal warning may not be cited in subsequent court proceedings. It should therefore be clearly understood that a formal caution is not a sentence of the court and cannot be made conditional on the completion of a specific task. Because of the seriousness of the decision to caution, it should not be taken lightly. In recognising this, the circular stipulates certain conditions that must be met before a caution should be given: • there must be evidence of the offender’s guilt sufficient to give a realistic prospect of conviction • the offender must admit the offence • the offender must understand the significance of the caution and give informed consent to being cautioned. Those proposing to use this method of disposal are warned to ensure that consent to the caution is not to be sought until it has been decided that cautioning is the correct course. The significance of the caution must be explained to the offender. The offender must understand that a record will be kept of the caution, that the fact of a previous caution may influence the decision of whether to prosecute if the person or company should offend again, and that it may be cited if the person or company should subsequently be found guilty of an offence. Where the evidence does not meet the required standard, the circular is clear that a caution cannot be administered. Nor will it be appropriate where a person does not make a clear and reliable admission of the offence. Cautioning is an alternative to a prosecution and therefore ought not to be administered where a prosecution could not be commenced.

Public interest principles In the giving of a caution, as in any prosecution decision, public interest considerations apply that will inform the decision whether to administer a caution. Described in the Code for Crown Prosecutors (see later), these public interest principles are: • the nature of the offence Copyright © 1999 Taylor & Francis Group LLC

• the likely penalty if the offender were to be convicted by a court • the offender’s age and state of health • previous criminal history • attitude of offender towards the offence, including practical expressions of regret. The guidance in the circular was clearly formulated with the more mainstream criminal activities in mind, particularly when it considers the role and views of the victim when administering a formal caution. Yet there is no reason why this guidance should not also be viewed as applicable to EHOs. For example, it advises that before a caution is administered it is desirable that any victims be contacted to establish their view of the offence and the nature and extent of any harm or loss suffered. These views should then be assessed, relative to the victims’ circumstances, and consideration should be given to whether the offender has made any form of reparation or paid compensation. In some, though obviously not all, environmental health offences this would be sound guidance to follow. If a caution is being considered, it is little more than common sense and courtesy that its significance should be explained to any victim. The code suggests that police officers administering cautions should be of a certain rank, and considers that it may be appropriate to nominate suitable cautioning officers. The concept of an officer of ‘rank’ is inappropriate for EHOs, although seniority is certainly a more accessible concept. It is important that the giving or receiving of a caution is not seen as a soft option. This is why all formal cautions must be recorded and thorough records kept. As stated, formal cautions may be cited in court in subsequent proceedings if they are relevant to the offence then under consideration. This will occur after a guilty verdict, and although the existence of a prior caution cannot be relevant to any finding of guilt or innocence, it may have direct bearing on any sentence imposed. Care must be taken to distinguish previous cautions from previous convictions. Although the circular clearly envisages face to face formal cautioning, there appears to be no bar on the use of a formal cautioning system that relies on acceptance of the caution by letter.

PROSECUTION Sayre [13] identified that the criminal law, which from early times had been used to punish those threatening the public health, was seized upon in the last century as a convenient instrument for the enforcement of a number of new regulations. This had little to do with moral disapproval or a heightened sense of the immorality of, for example, pollution, it was simply a question of convenience rather than legislative policy: using the criminal law to enforce social regulation in new fields of activity. The criminal law continues to be used in this way, and has its ultimate manifestation in a criminal prosecution. Section 1 of the Prosecution of Offences Act 1985 created the Crown Prosecution Service (CPS). The CPS is a national prosecution agency for England and Wales and is responsible for the conduct of all proceedings instituted on behalf of a police force. No such similar agency exists for prosecutions brought by other public agencies. However, Section 6 of the Prosecution of Offences Act 1985 did preserve the right for private individuals and certain statutory bodies to commence criminal proceedings, thus allowing local authorities to be able to prosecute on relevant criminal matters independently of the CPS. In this respect, local authorities are very much their own masters when it comes to decisions relating to prosecution, and thus there are many occasions when a local authority will find itself a party to criminal proceedings. These proceedings will most commonly arise when an authority is undertaking one or more of its many enforcement activities under numerous statutory provisions. The general power of a local authority to institute proceedings is to be found in Section 222 of the Local Government Act 1972, which states that where a local authority considers it expedient for the promotion or protection of the interests of the inhabitants of its area, it may: • prosecute or defend or appear in any legal proceedings, and in the case of civil proceedings may institute them in its own name • in its own name, make representations in the interests of the inhabitants at any public inquiry Copyright © 1999 Taylor & Francis Group LLC

held by or on behalf of any minister or public body under any enactment. The prosecution of an offender is, at one level, merely another facet of the work of the EHO. It has its role and its purpose, both for the matter in hand and for the more general protection of health and the environment. However, it is clearly a serious step and one that should be undertaken only after appropriate consideration guided by a well-thought-out policy. The Environment Agency, for example, will consider prosecution where: • it is appropriate in the circumstances as a way of drawing attention to the need for compliance and the maintenance of standards, especially where prosecution would be a normal expectation or where deterrence may be a consideration • there has been potential for considerable environmental harm arising from the breach • the gravity of the offence, taking into consideration the offender’s record, warrants it. Currently the HSE may seek prosecution if the breach carries significant potential for harm, regardless of whether it caused an injury. In deciding whether to prosecute, the HSE and those local authorities adopting the HELA guidance, will also consider: • the gravity of the offence • the general record and approach of the offender • whether it is desirable to be seen to produce some public effect, including the need to ensure remedial action and, through the punishment of offenders, to deter others from similar failures to comply with the law • whether the evidence available provides a realistic prospect of conviction. In these respects the HSE and the Environment Agency are clearly guided by the Code for Crown Prosecutors published by the CPS. In its Code for Crown Prosecutors, the CPS offers useful guidance on when proceedings are appropriate. The code, which is issued under Section

10 of the Prosecution of Offences Act 1985 and is a public document, is based on principles that have hitherto guided all who prosecute on behalf of the public. These principles obviously apply with no less vigour to EHOs; indeed the code makes it clear that it contains information that is important to all who work in the criminal justice system. The code stipulates two main tests to be borne in mind when considering a prosecution: the evidential sufficiency tests and the public interest test.

Evidential sufficiency The Code for Crown Prosecutors states that a prosecution should be neither started nor continued unless the prosecutor is satisfied that there is admissible, substantial and reliable evidence that a criminal offence known to the law has been committed by an identifiable person or persons. The test to be applied is whether there is a realistic prospect of a conviction. A realistic prospect of conviction is identified as an objective test, and describes those circumstances when a jury or magistrates, when properly directed in accordance with the law and aware of all relevant facts, are more likely than not to convict the defendant of the charge alleged. There are therefore certain matters that those considering a prosecution are expected to consider when evaluating evidence. These include: • the requirements of the Police and Criminal Evidence Act 1984 • any doubt on any admissions by the accused due to age, intelligence or apparent understanding of the accused • the reliability of witnesses; has a witness a motive for telling less than the whole truth?; might the defence attack his credibility?; are all the necessary witnesses available and competent to give evidence?

The public interest criteria If the evidential requirements are met, the CPS proposes that a prosecutor must then consider Copyright © 1999 Taylor & Francis Group LLC

whether the public interest requires a prosecution. In this the CPS is guided by the view expressed by Sir Hartley (later Lord) Shawcross when he was Attorney General: It has never been the rule in this country—I hope it never will be—that suspected criminal offences must automatically be the subject of prosecution. Indeed, the very first regulations under which the Director of Public Prosecutions worked provided that he should…prosecute ‘wherever it appears that the offence or the circumstances of its commission is or are of such a character that a prosecution in respect thereof is required in the public interest’. That is still the dominant consideration…the effect which the prosecution, successful or unsuccessful as the case may be, would have upon public morale and order, and with any other considerations affecting public policy. The factors that may lead to a decision not to prosecute will of course vary from case to case. However, the CPS broadly recognizes that the graver the offence, the less likelihood there will be that the public interest will allow a disposal rather than prosecution. The code gives guidance on a number of matters in the decision whether to prosecute. Such matters include the following. • The likely penalty When the circumstances of an offence are not particularly serious, and a court would be likely to impose a purely nominal penalty, prosecutors should consider carefully whether the public interest would be better served by a prosecution or some other form of disposal. • If the offence was committed as a result of a genuine mistake or misunderstanding. This may be a factor against prosecution but it must be balanced against the seriousness of the offence. • If the loss or harm caused can be described as minor and was the result of a single incident This would be particularly relevant if the harm was the result of a single misjudgement.

• Staleness Prosecutors are advised to be careful of prosecuting if there has been a long delay between the offence and the probable date of trial, unless the offence is serious or the delay has in part been caused by the defendant, or the offence has only recently come to light, or the nature of the offence has required there to be a long investigation. Generally, the graver the allegation, the less significance will be attached to the element of staleness. • The effect on the victim’s health A prosecution is less likely to be needed if it is likely to have a very bad effect on the victim’s physical or mental health, always, of course bearing in mind the seriousness of the offence. • Old age and infirmity The older or more infirm the offender, the more reluctant the prosecutor may be to prosecute, unless the offence is serious or there is a real possibility of the offence being repeated. It may also be necessary to consider whether the accused is likely to be fit enough to stand trial, and regard should be paid to any medical reports. The prosecution must balance the desirability of diverting a defendant who is suffering from significant ill health with the need to safeguard the public. • The defendant has put right any loss or harm In certain cases it will be appropriate for the prosecutor to have regard to the actions of a defendant in voluntarily compensating a victim. It is important, however, that this is not seen as offering offenders the opportunity simply to buy their way out of trouble. Each case will be different and, as the CPS points out, it should never become simply a matter of adding up the number of factors on each side of the argument. Although each of the foregoing factors is certainly relevant to the EHOs when formulating a policy and deciding upon a course of action, EHOs must decide on the importance of each factor on a case by case basis. The approach so far would facilitate a more uniform pattern of prosecution but does not consider all factors at play. One reason for the non-use of prosecution as a means of enforcement is that there may be a belief that the available sanctions are neither appropriate not effective. This Copyright © 1999 Taylor & Francis Group LLC

is not simply a case of fines being too small [2]. Sometimes the fine may be, in the opinion of the officers, too large, thereby removing the possibility of money being spent on preventative measures [10]. In more marginal cases where EHOs cannot readily decide whether to recommend prosecution or not, their view of the court as an ‘awful place’ [1] may even be decisive. The reason for this opinion of the court as an awful place may be complex. Croal [14] notes that EHOs and other officers assume that offenders are dealt with sympathetically and leniently in court. This treatment is attributed to the fact that, in addition to the common use of strict liability in the framing of offences, there exists a ‘cultural homogeneity’ between the offenders and the personnel of the court. This, Croal records, has, arguably, led to the marginalization of offences through a denial of moral blameworthiness. Hawkins [1] observes that officers of environmental enforcement agencies often regard the courts as remote from and unsympathetic to the real problems of enforcing the law. Where pollution control is concerned, and arguably elsewhere, magistrates are often regarded as ignorant laymen, possessing neither the knowledge nor experience of field staff, ignorant of the causes and treatment of pollution, and lacking the technical and scientific awareness to make informed decisions. Hawkins [1] notes that there are situations where the courts are perceived by the regulating authority as not ‘understanding pollution’. Hawkins puts this down to the existence of two discrepant views: that of the magistrates is the product of matters raised in court; that of the regulators is the product of the experience of the regulator with this case and more generally. Hawkins claims that magistrates see a cross-section of reality, whereas enforcement agencies have a longitudinal view of career. All too often enforcement officers can feel that when a case does come before the court the true issues are, in practice, obscured by the rules of evidence and procedure applicable to a criminal court. EHOs must recognize this; to fail to do so is to view the system of prosecution through the courts not as the sum of its parts, but as an end point.

Here any or all perceived deficiencies are focused into a single event (a hearing or trial), and it is this single event and those who participate in it who are to blame if any deficiencies surface. This, for a professional, is too narrow a vision. It fails to recognize the complexity of the issue. The court is but one part in a complex and interrelated mechanism, affected by and in turn affecting the other parts.

Proceeding to a prosecution If the option of a prosecution is taken, then the pathway of a case to a court is relatively straightforward. Individuals or companies appear before a court either because they have been charged with an offence or because a summons has been issued. The charging of a person will follow an arrest; this is not a power available to EHOs and therefore it is the latter process only that will be discussed below. The means by which a person is called before the magistrates’ court to answer criminal matters is by a summons, and this is obtained by the laying of an information before the court.

Laying information An information is essentially the means by which the court is informed of an alleged offence. It will ultimately form the charge that the accused will be obliged to answer at any subsequent trial. An information is therefore required to describe the offence in ordinary language. The Magistrates’ Courts Rules 1981 set the detail of what an information must contain. They require that every information and summons is sufficient if it describes the specific offence with which the accused is charged, in ordinary language, without necessarily stating all the elements of the offence. Although it is unlikely that an EHO would lay the information, there is no prohibition against this. The Magistrates’ Court Act 1980 provides that any person authorized by the prosecutor may lay an information before a Justice of the Peace (JP). The Act also stipulates that, upon an information being laid, the JP may issue a summons Copyright © 1999 Taylor & Francis Group LLC

requiring the person accused to appear before a magistrates’ court to answer the information, or issue a warrant to arrest that person and bring him before the court. An information may be laid either orally or in writing. As a matter of practice all informations laid in connection with an environmental health offence will be in writing. The information is accepted as being laid when it is received at the office of the clerk to the justices. It is not necessary for the matter to be put before the clerk of the justices personally. Any EHO laying an information would be well advised to record the date and time that the information was handed to the office. There have certainly been cases where this has proved vital in establishing that the subsequent proceedings had not become time-barred under the Magistrates’ Court Act 1980, Section 127.

Time period for proceedings There is no time limit for proceedings for an indictable offence, although Section 127(1) of the Magistrates’ Courts Act 1980 requires that, in the absence of an express statutory provision to the contrary, proceedings for summary matters must be commenced, that is the information must be laid, within six months of the offence having been committed. For a summary offence this six month period runs to the date the information is laid, not to the date when the accused actually appears in court. Therefore where an offence is triable only summarily, this is the relevant period and is an important limitation. The interdepartmental inertia that can arise when a prosecution file is passed from one local authority department to another may result in the unwary falling into the trap of attempting to prosecute on time-expired matters. In calculating the relevant time period the date on which the offence was committed is to be excluded (Marren v. Dawson Bentley & Co. [1961]). Thus for an offence committed on 1 January, the last date for laying an information is 1 July. Were the offence to be committed on 31 March, the deadline would be 30 September. For continuing offences the time period runs from each day the offence is committed. It is important to note that this six-

month time limit does not apply to an indictable offence and therefore not to summary proceedings where the offence is triable either way.

should contain the nature of the information and the time and place at which the accused is required to appear. Although containing essentially the same information whatever the offence, the precise format of a summons may vary.

Duplicity It is essential that an information and summons does not charge more than one offence. The Magistrates’ Court Rules 1981 states that magistrates’ courts shall not proceed to the trial of an information that charges more than one offence. Such an information is bad for duplicity and the court is prohibited from convicting on the matters alleged. If the duplicitous matters are identified during the trial, the court is obliged to request that the prosecutor elect which offence to proceed upon. Once identified, other matters are struck out and the trial proceeds on the amended information. It is not duplicitous to set out common factual and legal matters in a preamble to the summons and then set out the various offences charged in numbered paragraphs if the offences are contrary to the same statutory provisions. In Shah v. Swallow [1984], a shop owner was convicted under the Food Hygiene (General) Regulations 1970 of four out of five offences contained in an information. The five offences were contained in a single information. The first paragraph of the document contained allegations of fact in relation to each of the offences; and the second paragraph identified the regulations that created the offences. The House of Lords found that the document was a single document that contained five informations. The fact that the preamble contained details that were common to a number of separate allegations did not tie them so as to make the information duplicitous.

Summons As already indicated, Section 1 of the Magistrates’ Court Act 1980 states that upon an information being laid before a JP that any person has, or is suspected of having, committed an offence, the JP may issue a summons requiring the person concerned to appear to answer the information. The summons Copyright © 1999 Taylor & Francis Group LLC

Complaint Part II of the Magistrates’ Court Act 1980 deals with the civil jurisdiction of the magistrates’ court. It indicates how it is possible to obtain a summons from the court by the making of a complaint. A complaint is a written or verbal reference to a JP or justice’s clerk that a person or a corporation has committed a breach of the law that is not criminal. As for an information, once the complaint is received at the office of the clerk the complaint is accepted as having been duly made. Section 52 of the Magistrates’ Court Act 1980 stipulates that where a complaint is made, a JP may issue a summons directed to that person requiring him to appear before a magistrates’ court acting for that area to answer the complaint. This is the means for commencing a civil action in a magistrates’ court where, according to Section 52 of the Magistrates’ Court Act 1980, the court has jurisdiction. It is not very common for EHOs to be party to such proceedings but it is possible. For example, Section 82 of the Environmental Protection Act 1990 allows an individual aggrieved by the existence of a statutory nuisance to bring an action in a magistrates’ court. The statute provides that a magistrates’ court may act under this section on a complaint made by an aggrieved person. In fact, in a number of cases it has been found that the procedure contained in Section 82 of the Environmental Protection Act 1990, although commenced by complaint, is in fact criminal in nature (Herbert v. Lambeth LBC [1991]; Botross v. London Borough of Hammersmith and Fulham [1995]).

CONCLUSION EHOs may all too often feel that they have little control once matters have reached a court, and though this

may be true, it is equally true that the activity of enforcement, when viewed as a process rather than merely an outcome, reveals the role of EHOs to be pivotal. Few public officials have vested in them the powers available to EHOs. If public confidence is to be maintained, these powers, and especially the powers of enforcement, must be used wisely.

8.

9.

REFERENCES 10. 1. Hawkins K. 1984 Environment and Enforcement: Regulation and the Social Definition of Pollution, Clarendon Press, Oxford. 2. Hutter, B.M. (1988) The Reasonable Arm of the Law. The Law Enforcement Procedures of Environmental Health Officers, Oxford Socio-Legal Studies, Clarendon Press, Oxford. 3. Carter, H. (1992) The criminal law as a tool for environmental protection. Environmental Law, 6(1). 4. Vogel, D. (1986) National Styles of Regulation, Cornell University Press, USA. 5. Carson, W.G. (1970) White collar crimes and the enforcement of factory legislation. British Journal of Criminology, 10, 383–98. 6. Audit Commission (1991) Towards a Healthier Environment, Managing Environmental Health Services, Audit Commission, HMSO, London. 7. DTI (1994) Local Government Enforcement, Report of the Interdepartmental Review Team,

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11.

12.

13. 14.

Department of Trade and Industry, HMSO, London, p. 35. Rowan-Robinson, J. and Ross, A. (1994) Enforcement of environmental regulation in Britain: strengthening the link. Journal of Planning and Environmental Law, March, 200. HSE (1996) Choice Of Appropriate Enforcement Procedure 1996, LAC 22/1, Health and Safety Executive. Local Authority Unit, London. Richardson, G., Ogus, A. and Burrows, P. (1982) Policing Pollution, Oxford Socio-Legal Studies, Clarendon Press, Oxford. Health and Safety at Work, Etc. Act 1974: Enforcement Policy Statement, HSC(G)2, 17 July 1995. Robens Committee (1972) The Report of the Commission on Safety and Health at Work, Cmnd 5034, HMSO, London. Sayre, F.B. (1933) Public welfare offences. Columbia Law Review, 33, 55. Croal, H. (1988) Mistakes, accidents and someone else’s fault: the trading offender in court. Journal of Law and Society, 15(3).

FURTHER READING Bassett, W.H. (1998) Environmental Health Procedures, 5th edn, E. & F.N.Spon, London. Moran, T. (1977) Legal Competence in Environmental Health, E. & F.N.Spon, London.

9

Fundamentals of information technology and its application in environmental health Paul B.Paddock

INTRODUCTION Over the past four decades, organizations have been developing computer-based information systems. Throughout the 1960s, 1970s and early 1980s the vast majority of issues were associated with how to ‘supply’ information systems to organizations. As these issues have become better understood, and with many of the basic organizational systems having been automated, attention has turned to more imaginative and fruitful applications for information technology and the ascertaining of the ‘demand’ for information systems in organizations. In essence, organizations have witnessed a revolution in the way people do their jobs and in the development of new systems. The computer keyboard and screen are now familiar desk-top tools in many offices. This may be a computer terminal used to access a remote mainframe computer or a personal computer used for word-processing and spreadsheet calculations or, increasingly these days, a combination of both. With this ‘explosion’ in information technology has come a plethora of technical terms, many of which are unknown to, or poorly understood by, the end-users—the people receiving the printouts and manning the computer workstations, as well as those who order and pay for the technology. A basic understanding of the fundamentals and Copyright © 1999 Taylor & Francis Group LLC

terminology of information technology will assist end-users to utilize the power of the computerized information systems introduced into an organization. In general terms, the objectives of information technology in any organization are to make the organization more efficient, to make managers more effective, and to achieve a competitive advantage for business (or to avoid being disadvantaged).

DATA AND INFORMATION The terms ‘data’ and ‘information’ are used interchangeably in everyday speech to mean the same thing. However, for managers and information specialists these terms have specific meanings. Data are facts, events and transactions that have been recorded; they are the raw input materials from which information is produced. Information is data that have been processed in such a way as to be understood by and useful to the recipient. The mere act of processing data does not itself produce information. Fig. 9.1 outlines a model that is applicable to all information systems, whether manual or computerized, and that illustrates the important distinction between these two terms. The characteristics of good information are identified in Table 9.1.

Managers at all levels within an organization need relevant information to assist them to plan, control and make decisions. Relevant information increases knowledge, reduces uncertainty and is usable for the intended purpose. A suitable management information system should provide managers with relevant information.

FUNDAMENTALS OF INFORMATION TECHNOLOGY

Fig. 9.1 An information systems model.

What exactly is a computer? A computer is a machine that, under the control of a stored program, automatically accepts and processes data, and supplies the results of that processing. A computer can be viewed very simply using a ‘systems’ model (Fig. 9.2) —inputs are processed and transformed into outputs. The inputs can be provided using a keyboard or a mouse, for example, while the outputs can be displayed on a monitor or printed out on a printer or plotter. Traditionally, there have been three types of computers: mainframe, mini- and personal or microcomputers. However, this distinction is becoming increasingly blurred due to the increasing power of personal computers (PCs). The majority of computers used in environmental health departments are of the microcomputer variety based on the IBM PC, and it is this type of machine that forms the basis of the discussion in this chapter. Computer systems are made up of both hardware and software; either one of these elements is useless on its own. The hardware is the physical

Table 9.1 The qualities of good information

Fig. 9.2 Systems model of a computer. Copyright © 1999 Taylor & Francis Group LLC

component—the bits you can touch—while the software is a list of coded instructions that convert the hardware from a box of electronic bits into an accounting machine, a word-processor or a drafting system, for example.

is loaded into the computer when it is switched on—a process often referred to as booting up. Closely associated with the operating system are the utilities that provide a range of facilities associated with general housekeeping, such as taking copies of data and deleting redundant data.

Hardware components Table 9.2 summarizes the principal hardware components, explains their function, and also gives some guidance about current standards for ‘entrylevel’ personal computers. However, Gordon Moore, the Chairman of Intel, has stated that ‘the performance of computer [semi-conductor] chips doubles every 12–18 months, and will continue to do so for more than a decade’. This will mean that the processing power and capabilities of computer hardware will see substantial advances being made which, in turn, will require more powerful and flexible applications software to be developed.

Graphical user interfaces (GUIs) This is an important software development affecting the way people interact with computers. Such programs use drawings (often referred to as icons), boxes and characters to represent objects on the screen. A mouse is used to select the object required and so allow the user to issue instructions, e.g. to launch a particular piece of software. The most well-known examples of this type of interface are Microsoft Windows 3.1® and Windows 95®.

Application software Software components Operating system software The operating system controls nearly every aspect of the basic operation of the computer and provides two major interfaces: • between the user and the computer • between the application program being executed and the various pieces of hardware available. A number of basic tasks are carried out by most application programs: • • • •

transferring data to and from disks transferring data to the printer detecting when a key has been pressed loading programs from disk into RAM (random access memory) • detecting disk errors • displaying messages on the screen.

Substantial developments in the range of application software programs available have taken place over the past few years. Originally, systems revolved around transaction processing characterized by the simple processing of highly structured data; payroll, accounts receivable, and stock control are a few examples. Such applications enabled the inherent benefits of computer-based systems to be achieved: speed and accuracy applied to large quantities of data. Nowadays, application software covers a wide range of activities: wordprocessing, spreadsheet and statistical analysis, database management, data communications, desktop publishing and graphics/drawing to name but a few. More specialized software applications include project management, computer-aided design (CAD), survey analysis, questionnaire design, analysis systems (such as satisfaction and customer care surveys), and simulation software. Networking of computers

The operating system is a collection of ready-written software supplied with the computer that application programs can use for common tasks rather than having to ‘reinvent the wheel’. The operating system Copyright © 1999 Taylor & Francis Group LLC

The power and flexibility of information technology (IT) in many organizations derives from a combination of the capabilities of the individual

Table 9.2 Hardware components

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Table 9.2 continued

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Table 9.2 continued

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machine and the ways in which machines are linked and combined. Many computer systems installed in environmental health departments form parts of networks and are extensively involved in data communication.

Networks Networks are communication systems that link together computers, storage devices, wordprocessors, printers and even the telephone system. There are a number of different types of network with names that describe the geographical area over which their different components are spread: • wide area networks (WANs) span separate locations that may be many miles apart and use the general telecommunications network • metropolitan area networks (MANs) span a single city—they require special cables that are currently being laid in some cities to provide high speed communications in order to cope with the increasing graphical content of IT and the expected growth in the transmission of video and voice data • local area networks (LANs) are usually restricted to a single or a few buildings and are linked by direct cables rather than by general telecommunication lines. Each type of network may be comprised of one or more types of computer system (Figs 9.3 and 9.4) with geographical links through circuits provided by the national postal, telegraph and telephone authority (PTT). These circuits could be ordinary dial-up telephone lines or dedicated circuits (leased lines) used exclusively for computer communications. Within organizations, the simplest type of network is one where it is possible to share disks and printers between several computers. Peer-topeer networks allow any computer to make its disks and printers available to any other computer on the network. The advantage of this type of network is its simplicity and its low cost. However, as performance is likely to suffer, many organizations have installed networks using dedicated servers which supply the requested services. Each computer Copyright © 1999 Taylor & Francis Group LLC

on the LAN needs to be connected to the network through an appropriate interfacing card, which is dependent on the type of network installed, typically Ethernet® and Token Ring® networks. For LANs to work efficiently, network management programs are required. Examples of these are Novell NetWare®, LAN Server® and LAN Manager®. Critical to network operation is an effective server-based backup strategy, usually provided by tape drives. It is essential to institute daily backups in order to avoid disasters!

MAJOR DEVELOPMENTS IN INFORMATION TECHNOLOGY Several major developments have taken place over the past few years: • the Internet and the World Wide Web • electronic mail • video conferencing.

The Internet and the World Wide Web (WWW) The Internet is a global network of computer networks. It started at the end of the 1960s when the US military began to appreciate the vulnerability of its communication systems. The US Defense Department developed the idea of a computer network that would be able to withstand an attack on the system. If part of the network was disabled, information would still be able to find its way around the damaged part and communication lines would be secure. This development became known as ARPANET (Advanced Research Projects Agency Network). The computers that were developed for this system were, and still are, responsible for addressing and checking the communications, rather than the network itself. The computer data that was sent over the ARPANET was bundled into standard packages called Internet Protocol (IP) packets, each of which contained information about the addresses of the originating and destination computers. During the 1970s and 1980s many academic institutions linked into ARPANET. However, it

Fig. 9.3 Components of a mainframe WAN.

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Fig. 9.4 Components of a PC LAN.

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was in the late 1980s that the US Government’s National Science Foundation (NSF) set up five supercomputer centres which users were able to access from anywhere in the country. NSF created its own network, NSFNET, which used the same IP technology as ARPANET. Soon after, the system expanded rapidly, and with hardware upgrading of both computers and telephone lines, the network was opened up to commercial traffic in the early 1990s. This network of computer networks uses a language called TCP/IP (transmission control protocol/Internet protocol) which enables different computers to communicate with each other more easily. The World Wide Web (WWW) is one of the main reasons for the considerable increase in the use of the Internet. It was developed at the European Laboratory for Particle Physics in Switzerland in 1990 and during the early part of 1995 it became the most popular means of accessing information on the Internet. The WWW allows users to ‘browse the net’ by the use of hyperlinks. All web pages are created using HyperText Markup Language (HTML), which started as a simple way of formatting text but has now expanded to include commands for integrating pictures, video, sound and even forms that can be filled in online. HTML is a standard language that all parties on the web have implemented, allowing the presentation of

formatted text with images that look good across different computer platforms, and providing quick access to other Internet sites through hyperlinks (‘hot’ areas of text which open other HTML documents, irrespective of their location on the net). A program popularly known as a web browser is needed to access the WWW. Two of the most popular are Netscape Navigator® and Microsoft Network ® . These programs allow access to addresses, also called Uniform Resource Locators (URLs), on the web. All web addresses start with http://, which stands for HyperText Transfer Protocol. There is also a newer version called https:/ /, which incorporates data encryption enabling the secure transmission of data over the web. Examples of useful Internet sites with an environmental health perspective are given in Table 9.3. The final essential element required to gain access to the Internet is known as an Internet Service Provider (ISP), companies that sell connections to the net. Examples of ISPs include CompuServe™, AOL™ and Microsoft Network™. Obviously, the choice of an ISP depends on the level of service required and the costs involved. Information is provided in Table 9.4 on how to search effectively on the Internet. Table 9.5 provides some examples of different Internet search engines. Anyone searching for information on the

Table 9.3 Some useful sites on the Internet for environmental health

*URL, uniform resource locator; a method of addressing resources available on the Internet in a standard way. All of these sites provide hot links to other related Internet addresses. Copyright © 1999 Taylor & Francis Group LLC

Table 9.4 How to search effectively on the Internet—getting the best results from your searches

Table 9.5 Some of the most popular Internet search engines

Internet would be well advised to employ several search engines.

Electronic mail Electronic mail (e-mail) is an expanding development of the Internet. Any computer connected to the telephone network via a modem can leave messages at a central computer. These messages may be collected by others. All subscribers have their own ‘pigeon hole’/‘mail box’ and can dial up the central computer to check to see if a message is waiting. It is possible to e-mail many people at one time and it is fast and cheap, e-mail messages can have two or three components. The Copyright © 1999 Taylor & Francis Group LLC

first is the header, which contains the addressing information, a description of the contents and a list of the recipients. The second component is the text of the message, and the third is an optional attachment. It is possible to attach virtually anything to a message—a word-processed file, an image and so on. E-mail addresses are easy to understand and comprise a number of components. An example of an address would be [emailprotected] The part after the @ is known as the domain name, uk means the domain is on a computer in the UK (every country has a two letter code, the top-level domain code). gov means the domain belongs to a government organization, in this instance the Health and Safety Executive (hse). another is the username. It is important to get the e-mail address correct, otherwise the mail will be returned with a message from a mail server that the address was not recognized.

Video conferencing Video conferencing is a method of communication that allows people to have face-to-face interaction

over long distances and is set to change from an isolated function to a core element of most business functions. It is important to note that video conferencing does not negate the need for face-to-face meetings as it is important for people to meet on a regular basis. However, it does allow people to collaborate more often than they otherwise could, and to do so in a more satisfactory manner than just using the telephone. It is also useful for ad hoc communications, such as technical support tasks or to allow professionals to give more comprehensive advice. This technology is still very much in its infancy, but is developing at a considerable rate. In video conferencing, both data and video are interactively shared between various locations. The signal can be carried by a variety of means: the LAN; the Integrated Services Digital Network (ISDN), a digital mobile telephone (GSM) or the Public Switched Telephone Network (PSTN). At present, because video signals are large, the networks struggle to cope with the information required to provide a real motion video connection. Another current issue involves the development of video conferencing standards depending on the medium over which the communication is taking place. Information on the video conferencing standards can be found at http://www.imtc.org/.

MANAGEMENT INFORMATION SYSTEMS AND INFORMATION TECHNOLOGY It is essential for any business, whether in the private or public sector, to have a strategy for its information and systems that is driven by the requirements of the business. If a business does not develop an information systems (IS) strategy, then this could result in the business being seriously disadvantaged within its business environment and/or incurring significant expenditure on IT investments but achieving few business benefits. The principal components of such a strategy and the relationships between them are summarized in Fig. 9.5. The term ‘management information system’ (MIS) has become almost synonymous with computer based data processing. However, a more open interpretation is ‘a system to convert data from internal and external sources into information and to communicate that Copyright © 1999 Taylor & Francis Group LLC

information, in an appropriate form, to managers at all levels in all functions to enable them to make timely and effective decisions for planning, directing and controlling the activities for which they are responsible’. The emphasis of this definition is on the use of the information and not on how it is produced. However, it is recognized that the vast majority of organizations use information technology to generate the information required by managers and decision-makers. According to an Audit Commission report ‘… a clear vision of the next generation of IT is emerging’ [1]. This vision has three interlinking strands. 1. A more competitive hardware and software market, including the development of consistent standards such as the International Standards Organization’s Open Systems Interconnection (OSI) standards as a basis for all future IT products 2. Changing methods of delivering management information to the users, such as by the combination of information from different systems and by the development of geographical information systems (GIS). 3. Changing working methods in the office through the extensive use of office automation, the analysis of information flows and the possible consideration of business process redesign/reengineering (BPR). Although the boundaries between them are blurred, it is possible to distinguish three major areas of application of IT in information systems: • office support systems: text handling, data storage and reference, computing, telecommunications • end-user systems: decision support systems, expert systems, executive information systems, search and retrieval of information, text handling, etc. • data/transaction processing. These categories overlap and interrelate. With the developments in microelectronics and telecommunications described earlier, office work is

Fig. 9.5 Inputs and outputs to IS/IT strategy. TQM, total quality management; 3 Es=efficiency, economy and effectiveness. (Adapted from [5].)

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being transformed, which is, in turn, influencing the availability and type of information that managers use.

THE USE AND APPLICATION OF INFORMATION TECHNOLOGY IN THE DELIVERY OF ENVIRONMENTAL HEALTH SERVICES Computers have played an important role in local government for many years and have helped to determine the way local government operates. Over the past decade, the level of investment in IT has increased greatly, with the Audit Commission estimating a 700% increase in expenditure on IT equipment (excluding salaries) when compared with similar expenditure over the previous decade [2]. The Audit Commission calculated that local government expenditure on information technology exceeded £600 million per annum. Another Audit Commission report [1] revealed an average central IT expenditure in 1994 of £2.2 million per authority, which represented 2% of Net General Fund Expenditure plus Housing Revenue Account (HRA) income (Table 9.6). These figures are impressive when it is realized that at the same time local government was (and still is) under severe pressure from central government to reduce costs. In order to meet the challenges they now face, many local authorities have looked to information technology for answers. In fact, without the use of such technology, changes such as the rapid introduction of the Council Tax would have been impossible. The effective use of Table 9.6 Central IT Expenditure

Source: [1]. HRA=Housing Revenue Account. Copyright © 1999 Taylor & Francis Group LLC

information technology has now become essential to local authorities. However, as highlighted by the Audit Commission, ‘IT changes often imply major organizational change’ [2].

Office support systems Text handling Word-processors are a common feature in most offices and can be either a stand-alone or dedicated word-processor, or a general purpose microcomputer utilizing a word-processing program. Such programs allow documents to be typed, and then altered or manipulated at will without having to retype the entire document. The document is usually stored on disk so that it can be recalled for use at a later date. Word-processors are invaluable for producing ‘individualized’ standard letters or for lengthy reports that require extensive editing and revision. They can improve productivity dramatically while at the same time improving quality. Facilities found in most word-processors are insertion and deletion of text, automatic reformatting when margins are altered, tabulations and columns, type styles, moving blocks of text, pagination, standard paragraphs and spelling checks. The various letters with predominantly standard paragraphs, and committee and management reports that abound in environmental health departments can be easily produced using such software. Developments in software and in laser printers have enabled the growth of desktop publishing (DTP), which allows more extensive layout and

graphics facilities to be incorporated into documents. This has allowed reports and other documentation to be produced to a professional standard ‘in-house’ by departments without the need for traditional typesetting.

Data storage, referencing and manipulation The ability to store and access vast volumes of data is an undoubted benefit of IT in all organizations, not just environmental health departments. All local authority departments need to maintain records for all their activities and to produce management and statistical information as required, not just by their own authorities but by various government agencies (e.g. Department of Environment, Transport and the Regions) and professional institutions (e.g. the Chartered Institute of Public Finance and Accountancy) as well. In the past, many departments designed their own databases, initially on paper, and subsequently using software such as dBase III Plus®. However, there are now a number of specifically designed integrated modular systems that provide useful management tools for the effective and efficient management of environmental health departments. Such systems allow properties within the authority’s area to be assigned a unique code, thereby allowing the collation of all data associated with that property. Data can also be collated with regard to specific types of property, such as commercial buildings or houses in multiple occupation. Once stored, the database of the property and action-related information is available as and when required, subject to user-defined levels of individual access, i.e. passwords. Departmental activities such as complaints received, surveys, inspections, correspondence, enforcements, prosecutions and, in some cases, time monitoring, are also maintained through modular systems. Various modules, such as those for food and health and safety, incorporate risk assessment procedures whereby it is possible to prioritize inspections on the basis of certain criteria. Modular systems also cater for the import/export of data not just between the various modules but also from other application software such as word-processors. Copyright © 1999 Taylor & Francis Group LLC

By allowing the flow of data in such a manner, a computer system should render all but the initial entry redundant, as once entered into the system it could be merged with a diary, or record a visit automatically. It should be borne in mind that the collection and use of such electronic data is subject to the provisions of the Data Protection Act 1984. Consideration should be given to the users of any system, and proprietary systems should be evaluated in relation to the data that needs to be input and the queries to be handled. This will then assist in ensuring that the system is workable in relation to the day-to-day workload. The ability of a good software solution to deal with the automatic generation of, for example, complaint or visit-related correspondence will in itself mean that staff may more effectively create and print their own letters directly. However, computers and software, no matter how powerful, will not run themselves; goodwill and commitment are a necessary ingredient. It is therefore imperative that end-users are involved in the selection of any computer system to be installed.

Telecommunications Database interrogation The information requirements demanded by environmental health departments cannot always be provided internally. Frequently, information must be sought from external sources such as online databases. For environmental health departments to search online databases, the necessary connections need to be made through a WAN, with appropriate hardware in the department, and with access being controlled by a hierarchy of passwords. Over the past few years there has been substantial growth in the offering of online databases by many organizations (Table 9.7). The costs of searching such databases varies from host to host and is made up of telecommunication charges, time spent searching and charges for displaying and printing records. The advantages of online searching are considerable due to the extensive range of databases and resources available.

Table 9.7 Online databases

Table 9.8 Databases available on CD-ROM

Source: [3].

Further detailed information about the online databases and CD-ROMs listed in Tables 9.7 and 9.8 can be found in Environmental Health Information Sources: How To Use Them [3]. This book also provides substantial information about literature searching and highlights a varied selection of environmental health information sources.

Groupware Source: [3].

However, the search needs to be comprehensively structured as the costs can quickly mount up. Further sources of information pursued by many departments are provided by specialized CD-ROMs (Table 9.8). The range of titles is rapidly growing and they have the advantage of being straightforward and easy to use after a little tuition. These services are also regularly updated so as to incorporate, for example, new legislation, approved codes of practice and guidance. Many of the titles will allow ‘downloading’, the transference of some of the text from the CD-ROM into a wordprocessor or on to a disk to be saved for use at a future date. Copyright © 1999 Taylor & Francis Group LLC

This is a term used to cover software aimed at supporting groups of people and includes e-mail, diaries, scheduling, conferencing and bulletin boards. Many environmental health departments have now instituted e-mail systems across their LAN, allowing messages to be communicated by electronic means rather than by paper. Messages are displayed on a desk-top terminal and incoming and outgoing messages are filed electronically, if required. The facilities of a WAN are required in order to gain access to the Telecom Gold service. This is an electronic mail network widely used by public authorities and private businesses alike. Within the local government sector major users include trading standards departments, social services departments and environmental health departments. Most users

of Telecom Gold are organized in private networks so that information distributed between them can be controlled and managed. This also ensures confidentiality. Within environmental health, Telecom Gold is regularly used for exchanging technical information and for more urgent matters such as food hazard warnings. It can also be used as a research tool to access technical reference libraries or to request information from colleagues. Examples of databases that are accessible directly via Telecom Gold are Profile (which includes the full text of most major newspapers), Justis (which contains the complete text of UK and European Union (EU) law reports and other related legal information) and HSELine (the HSE’s abstract database of information on occupational health and safety). Another database accessible through Telecom Gold on a subscription basis is Environmental Health Briefing. This offers subscribers the chance to set up their own in-house environmental health database that is updated each week. It also offers ready prepared reports on topical issues and an awareness service on current legal and technical topics. A further recent development has been the introduction of EHCnet, the Environmental Health Communications Network, which aims to support environmental health officers with a fast communications link and to give them access to a wealth of professional information. Another example of an electronic mail network is Epinet (Epidemiological Network) controlled by the Public Health Laboratory Service (PHLS) at Colindale in London. The network provides links for various bodies involved in communicable disease control including hospitals, the PHLS, environmental health departments and others.

Facsimile transmission (fax) Substantial use is made of this technology by environmental health departments. Fax allows the transmission of an exact copy of an original document including diagrams, pictures and text. New systems on the market allow faster transmission and do not need to use special thermal paper, which fades over time. Increasingly common now is the Copyright © 1999 Taylor & Francis Group LLC

installation of fax cards in computers, which means that the transmission can be brought directly into a machine where it can then be incorporated into a word-processor or another application program.

End-user systems End-user computing is a large and growing field. This situation is true of many environmental health departments where managers, professional and office staff have adopted a direct, hands-on approach to computers. Such usage can assist people to develop systems that help them to perform their functions more effectively. Staff are using IT to support their provision of what is, after all, a people-centred service—one in which experience, local knowledge and professional judgement is supported, and not replaced, by technology. Management, particularly senior management, has an important part to play in encouraging a positive attitude towards technology, especially as the value of informal learning is often underestimated. One of the most effective methods for individuals to gain confidence and to overcome any feelings of anxiety is to allow them to ‘play’ on the computer. Although this may involve investing extra time in such people, this investment often pays off as these individuals may bring fresh ideas and new ways of looking at problems. The allocation of time for training is also an important issue to be borne in mind by managers. Both informal learning and training will increase technical awareness and will promote the tendency for staff to use the information systems and technology. When implementing any computer system in a department, it is necessary to consider the implications and impact of computer hardware. Who is to be given a terminal? Where should terminals be positioned? The current trend is to attempt to give everyone a terminal on their desk as this enables the system to be used more efficiently.

Hand-held technology The use of hand-held technology has now been introduced in a number of local authority

departments in order to maximize the use of IT. Hand-held computers (i.e. laptops and palmtops), coupled with portable printers, enable officers to automate letter and notice production on site, improving the quality, quantity and speed of service achieved. Files generated out on the district can then be downloaded on to the office system through simple cable links once an officer returns to base.

CONCLUSIONS The Audit Commission report Towards a Healthier Environment: managing environmental health services [4] identified the need for the computerization of environmental health records and the creation of property registers relating to the main function areas. The problems of implementing such a process were also highlighted in the report: The introduction of a computerized record system to environmental health departments is a substantial undertaking. Successful implementation demands clear commitment, the allocation of significant resources to bring it about and a fundamental review of information flows. [4, p. 32] The present use of computers in the delivery of environmental health services can be viewed on two levels. 1. Operational systems: the management of departments can be assisted by the computerization of certain operational functions, such as registers of commercial premises and records of inspections. 2. Strategic systems: where the use of computers can assist in the setting of or achievement of the department’s strategic objectives making a direct impact on the service delivered to customers. The development of strategic IT systems should relate to and support the department’s objectives, as detailed in service plans, and should identify several subsystems: the core systems (finance, Copyright © 1999 Taylor & Francis Group LLC

payroll), office systems (word-processing, e-mail, etc.) and strategic systems (complaints registers, staff monitoring, etc.). A properly designed computer system should assist departments to operate at levels of increased efficiency, while effectively reducing the workload on staff by removing a vast amount of work that is duplicated with manual systems. However, a suitably designed system requires all users to be trained as appropriate if its capabilities are to be fully realized and exploited. Managing IT and realizing its potential are tasks made more difficult by the increasing pace of change. IT in all organizations, including local government, has progressed from a highly centralized activity to one of a mixture of central and departmental computer systems. The adoption of ‘open systems’ is enabling a number of other important developments: • suppliers to provide components to a number of different hardware manufacturers • the same software to be run on a variety of hardware • information held on different machines to be communicated to other users on the same network • databases to be ‘interrogated’ and data abstracted to provide managers with timely information • staff using powerful PCs and user-friendly software to analyse and present information in an accessible manner, to integrate data and text, and to store, retrieve and communicate the information with relative ease [1, p. 75]. Some of the ways in which departments that provide environmental health services are using IT have been briefly discussed in this chapter. IT is used for a multitude of purposes at both operational and strategic levels. Increasingly, the monitoring and control of costs is vital when operating in an increasingly competitive environment. With the current and future changes departments face in the business/operating environment, such as Value for Money (VFM), it is important that systems are in place to cope with, control and anticipate future developments. The

increasing need to provide services that represent best value, the requirement for performance indicators, increased legislative provisions, the pressure for statistical returns, and the continuing need to work towards quality service provision are all issues to be considered in a climate of diminishing resources. IT and computerization can assist environmental health departments in facing up to these challenges. The Audit Commission [1, p. 76], however, has some salutary advice: In scoping the future of IT, councils will wish to brief themselves on the potential of the new technologies and to decide on a direction for their IT strategies. They will wish to develop plans which avoid the risk of being ‘at the leading edge’, whilst still availing themselves of the new opportunities…Realizing the vision of userempowerment through linked, open systems depends on the way that IT is managed as well as the technology…Technical changes and unforeseen events will continue to oblige local authorities to review their IT strategies frequently.

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REFERENCES 1. Audit Commission (1994) High Risk/High Potential, HMSO, London. 2. Audit Commission (1990) Preparing an IT Strategy: making IT happen, Management Paper No. 7, February 1990, HMSO, London. 3. Ford, N., Page, G. and Rennie, D. (1992) Environmental Health Information Sources: How To Use Them, Chartered Institute of Environmental Health, London. 4. Audit Commission (1991) Towards a Healthier Environment: managing environmental health services, HMSO, London. 5. Edwards, C., Ward, J. and Bytheway, A. (1995) The Essence of Information Systems, 2nd edn, Prentice Hall Europe, London.

FURTHER READING Gunton, T. (1988) End User Focus, Prentice Hall International (UK) Ltd, Hemel Hempstead. Lucy, T. (1995) Management Information Systems, 6th edn, DP Publications Ltd, London.

Part Three Public Health and Safety

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10

Health and environmental promotion Peter Allen

DEFINITION OF HEALTH PROMOTION

Health education

In The Politics of Health Education [1] Naido gives an inclusive definition of health promotion: ‘Health promotion includes a range of methods from personal education, mass media, advertising, preventative health services and community development, to organizational developments and economic and regulatory activities.’ Health promotion is not the same as health education. Health promotion is broader and wider. It includes personal education and it also includes regulatory activities. This latter point is important because there is still misunderstanding about it and a tendency among some to see the regulatory or enforcement duties as the environmental health officer’s ‘proper’ job and health promotion as something that can be done if time and resources are available. In terms of the Naido definition, enforcement and education are both important parts of health promotion. Put another way, it would be foolish to pursue a vigorous inspection and prosecution programme and ignore the fact that much food poisoning stems from poor understanding of food hygiene principles. Advancing food hygiene and safety needs to take both elements into account. Enforcement and education complement each other.

Environmental health officers are generally clear about what the regulatory element has to offer, but what is the contribution that health education can make? Ewles and Simnett [2] sum it up thus: ‘Without education for health knowledge and understanding there can be no informed decisions and actions to promote health…Knowledge is power and without health knowledge, people are powerless to change their health themselves because they do not have the knowledge of alternatives and therefore cannot make informed health choices.’ Therefore health education is individualist by nature, and this is both a strength and a weakness. It is a strength when it provides decisionmakers and individual members of the public with health knowledge and understanding. However, it can become a weakness if it is seen as health promotion per se. Then the individualism of health education discounts the structural factors Naido mentions, such as the socioeconomic aspects, and health promotion becomes individualistic. Thus if a person drinks heavily, then the focus is on the individual and the habit, rather than the power of the drinks industry and other structural factors such as poverty, stress or even poor housing. This is often referred to as the ‘blame the victim’ approach.

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The fact that we still have designated health education officers, health education units and a central body called the Health Education Authority (HEA) blurs the reality of the situation, for an analysis of their work shows it to be wider than simply an individualistic approach. The designations are more a fact of history and political expediency than logic and practice. Health promotion then is about health advancement and includes a wide range of methods for achieving that end. These methods include both individualistic and structuralist approaches; the merits of neither should be discounted.

Key elements of good health So much for methods, but what are the key elements that provide good health and what is the relationship between them? Hancock has devised a model that enables us to analyse this question [3]. As Fig. 10.1 illustrates, the three main elements are the community, the environment and the economy. For example, if the economy is not right then it impacts on health. We see this in some eastern European countries which, because of their poverty, have been forced to welcome multi-national companies that take advantage of low wages and rudimentary health controls. The result: poor health. Hence the need for equitability, sustainability and liveability. However,

when all these elements are brought into harmony good health emerges. See also Fig. 1.1.

THE HEALTH OF THE NATION Health promotion was put firmly on the national agenda with the publication by the Department of Health in June 1991 of a green paper entitled The Health of the Nation [4]. The green paper’s approach was to focus debate on a number of alternative objectives and targets. It stimulated an extensive public debate and more than 2000 individuals and organizations sent in their views. Dozens of conferences, seminars and workshops were held. Newspaper and journal articles were written debating the issues raised.

The white paper The white paper of the same name was published in July 1992 [5]. It set out the government’s strategy for health by: • selecting five key areas for action • setting national objectives and targets in the key areas • indicating the action needed to achieve the targets • outlining initiatives to help implement the strategy • setting the framework for monitoring, development and review. The key areas for action and national targets were: • • • • •

Fig. 10.1 Interrelationships: the economy, the community and health. (Source: [3].) Copyright © 1999 Taylor & Francis Group LLC

coronary heart disease and stroke cancers mental illness HIV/AIDS and sexual health accidents.

In the main, the targets related to the year 2000. Within the key areas, emphasis was placed on risk factors such as smoking and dietary imbalances. The white paper stressed that ‘everyone has a part to play if the strategy is to be successful’. Another

aspect of the white paper was the recognition that health promotion needs to take place in a variety of ‘settings’ such as healthy cities, healthy schools or healthy hospitals, and that specific action needed to take place in the workplace and the environment.

Healthy alliances The importance of active partnerships between the many organizations and individuals that can come together to help improve health was also highlighted with the new term ‘Healthy Alliances’. The white paper saw the main ‘stakeholders’ as: • The government itself—taking a range of practical measures to support the strategy as well as setting up a ministerial cabinet committee on health strategy to co-ordinate government action and oversee implementation and development of the strategy in England. • Local authorities—responsible for a wide range of public services, many of which are linked with the strategy set out in the white paper. These responsibilities include ‘education, environmental control, environmental health and food safety, transport, housing and social services’. • Voluntary organizations— ‘between them they cover the whole range of health-related activity from the highly specialized to the general’. • The media— ‘have a crucial role to play in providing individuals with the information necessary to make healthy choices’. • The HEA—which carries out national programmes of public education and provides a national stimulus for local activity in a variety of settings. (Interestingly, the HEA was founded in 1927 by officers from local government and funded to a large extent by local authorities. It passed to an independent body following the Cohen Committee’s Report in 1964 [6] when government assumed responsibility for full funding. In 1986 it was changed from a relatively free-standing, independent organization to a special health authority and became an integral part of the National Health Service (NHS), directly responsible to the Secretary of State.) Copyright © 1999 Taylor & Francis Group LLC

• Employers—who ‘have long been required to provide safe working conditions. Increasingly they are also recognizing the benefits of a healthy workforce’. • Health professionals— ‘crucial to the success of the strategy’. • The NHS—was recorded as having a ‘central role’. Regional Health Authorities ‘will lead in ensuring that objectives are achieved regionally’, ‘Hospital and community units, and primary and community health care services will need to be involved in working towards these objectives’. Praise and criticism What the Health of the Nation initiative did do was to provide a national strategy for health, the first time a national strategy for health as opposed to health services had ever been produced. It also put health promotion firmly on the agenda nationally. Moreover, in encouraging healthy alliances it empowered organizations such as local authorities and local health authorities to get together on health promotion. Both the green and white papers were not without their critics. Ewles summed up the main criticism as ‘its failure to acknowledge the socioeconomic determinants of health, and its emphasis on the now-familiar government style of health promotion: individual lifestyle change’ [7]. A further disappointment, Ewles recorded, was that no money was attached to the strategy: ‘Once again, the David of prevention would have to fight the Goliath of treatment and care services for resources—but without a divinely-inspired catapult.’ What was also to prove fatal was that there was no real provision to increase local democratic accountability. Results of the Health of the Nation (See also DoH, The Health of the Nation—a Policy Assessed, TSO, London, 1998, which presents the findings of two studies on the impact of the HOTN initiative.) More than five years on, new changes are being adopted, but before we turn to those it is worth looking at the results of

Table 10.1 Comparison of health targets (source: [8])

the Health of the Nation. Apart from a handful of much publicized successes, the approach, as predicted, has been a dismal failure. Table 10.1 gives an indication of how far the reality has fallen short of the hype using the government’s own figures for three of the main targets: obesity, teenage smoking and heavy drinking [8]. A combination of an individualist, top-down approach mixed with few resources and minimal democratic input has proved disastrous, so much so that a new start was seen to be necessary.

OUR HEALTHIER NATION—A NEW START The problem In February 1998, the new government published its green paper Our Healthier Nation [8]. This is aimed, as the title implies, at remedying the defects of the previous approach. Like its predecessor, it homes in on the need for major change. It recognizes that almost 90000 people die every year before the age of 65 years. Of these, more than 32000 die of cancer, and 25000 die of heart disease, strokes and related illnesses. Many of these deaths could be prevented, the report says. Unlike the previous strategy, it emphasizes the impact of health inequalities. (See Independent Inquiry into Inequalities in Health, TSO, London, 1998, ISBN 0-11-322173-8.) It describes how the poorest in our society are hit harder than the well off by most of the major causes of death (Fig. 10.2). Copyright © 1999 Taylor & Francis Group LLC

In improving the health of the whole nation, a key priority will be better health for those who are worst off. Moreover, it does not forget the economic argument: there are sound business reasons for improving our health as 187 million working days are estimated by industry to be lost every year because of sickness—a £12 thousand million tax on business. Treating ill health is also expensive: heart disease, strokes and related illnesses cost the NHS £3.8 thousand million every year. Unlike the previous report, it brings the socioeconomic factors into focus. It sees poor health as having complex causes. Some are fixed, such as ageing or genetic factors, but it also sees the structural factors such as poverty, unemployment and poor environments as playing their part.

Tackling the problem Tackling these health issues, says the green paper, will involve a range of linked programmes including measures on welfare to work, crime, housing and education as well as health itself. Putting aside victim blaming on the one hand and nanny state social engineering on the other, the green paper puts forward the ‘national contract for better health’. Under this contract, the government, local communities and individuals will join in partnership to improve everyone’s health. • Government will help assess the risk to health by making sure that people are given information on health that is accurate, understandable

Fig. 10.2 Life expectancy by social class (males, at birth, England and Wales, 1972–91. (Source: [8].)

• •

and credible. Where there are real threats to health it will not hesitate to ‘take tough action’, although regulation and legislation will be the exception not the rule. Health authorities will have a key role in leading local alliances for the development of ‘health improvement programmes’ that will identify local needs and translate the national contract into local action. Local authorities will have a new duty to promote the economic, social and environmental well being of their areas. Businesses can bring new skills to bear, including marketing and communications, as well as improving the health and safety of their own employees. Voluntary bodies can act as advocates to give a powerful voice to local people. Individuals can take responsibility within this framework for their own health.

The Chief Medical Officer has also made a contribution, publishing in February 1998 his interim report entitled Project to Strengthen the Public Health Function. Targets This green paper, like its predecessor, also has ‘settings’ (healthy schools, healthy workplaces and Copyright © 1999 Taylor & Francis Group LLC

healthy neighbourhoods) and targets. By the year 2010, it aims to: • reduce the death rate from heart disease, stroke and related illnesses among people aged under 65 years by at least a further one-third • reduce accidents by at least one-fifth • reduce the death rate from cancer among people under 65 years by at least a further one-fifth • reduce the death rate from suicide and undetermined injury by at least a further one-sixth.

Critique What can be said about Our Healthier Nation is that its rhetoric is better than that of its predecessor. Its acknowledgement of the socioeconomic factors, its notion of ‘contracts with the people’, and its eschewing of victim blaming are commendable. But is it so very different from its predecessor? At heart it is still a top-down model. It is still the Department of Health (DoH) through local health authorities (despite the protests to the contrary) playing a nannying role even to the point of ‘naming’ the local government officer who should sit on the local health authority. Not surprisingly, therefore, it misses out on the real issues: there is no target, for example, on reducing health inequality, nor is there any strategy for tackling

issues such as the affordability of wholesome food, and local government’s role is still very much that of a junior partner. Once again the opportunity has been lost to set up elected regional bodies to run the health service and to bring a democratic perspective to the issue of choices in health and legitimacy to much needed health reforms. Local people through their locally elected representatives have been denied the opportunity to draw up relevant and needful local public health plans. The Environmental Health News summed up the problem neatly when it lamented in its lead headline: ‘green paper—a step to improving public health when a leap is needed’ [9]. HEALTH PROMOTION IN PERSPECTIVE In order to make sense of these health initiatives, we need to see them in historical perspective. Health promotion is not just a phenomenon of the 1990s; it has a long history. A reading of the mosaic health laws in the Old Testament book of Leviticus confirms this. That aside, the promotion of health since the mid-nineteenth century can be seen to fall into four discernible periods. Each period is characterized by a special emphasis given to a particular type of intervention (Table 10.2). From the 1830s to 1880, prompted by the ravages of infectious disease and popular outcry, there was sanitary intervention, when the thrust was at a very basic sanitary level of providing clean water and an adequate sewerage system, plus occasional forays into bad housing and bad food. From 1880 to 1930 there was personal and social intervention, which was fuelled by the health study of army recruits for the Boer War that showed that many of them had to be turned Table 10.2 The discernible periods of health promotion

down as unfit for service. The development of the schools meals service, school medical service, health visitor and district nursing and midwifery services are all features of this period. From 1930 to 1970, following the discovery of antibiotics and other ‘drug breakthroughs’, came the therapeutic intervention period, during which vaccines and contraceptives had a profound effect on health as well as on forming the view that there was ‘a pill for every ill’. However, since the late 1970s the evolution of health in the UK has been characterized by a new period of holistic intervention. This recognizes that if we are to have positive health all factors need to be taken into consideration, including such matters as poverty and inequalities associated with social class, gender, ethnicity and geographical location. These health determinants were brought starkly to life by the Black Report [12]. The corollary of this is that no single organization or profession has all the answers, that if health is to advance there is a need to welcome and encourage inputs from all directions, not least from the community itself.

WHO’S HEALTH FOR ALL/HEALTHY CITY PROJECT World Health Organization’s (WHO) ‘Health for all by the year 2000’ Alma-Ata declaration in 1977 [13], which has been brought to life by the Healthy City project, is a movement born out of this new phase. (WHO has reviewed this strategy in its European region several times. See, for example, WHO, Health in Europe, TSO, London, 1998.) In its strategy for attaining the goal of health for all by the year 2000, the WHO’s European regional office has identified 38 targets, eight of which concern the provision of a healthy environment: 1. 2. 3. 4. 5. 6.

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multisectoral policies (target 18) monitoring and control mechanisms (target 19) control of water pollution (target 20) control of air pollution (target 21) food safety (target 22) control of hazardous wastes (target 23)

7. human settlements and housing (target 24) 8. working environment (target 25). A number of organizations, including the Chartered Institute of Environmental Health (CIEH) and the Faculty of Public Health Medicine, endorsed the ‘Health For All’ concept. The great strength of the initiative was that it put health promotion on the international agenda for awareness and action. Its weakness was that, on its own, it tended to be a top-down approach and therefore had the inherent danger of becoming merely a paper exercise. Not surprisingly therefore, the ‘Health for All’ initiative did not really kindle enthusiasm at community level until the emergence of the WHO’s Healthy City project in such places as Toronto and Adelaide. The Healthy City project focused on the local community and its health needs within the broad umbrella of the ‘Health for All’ objectives. The weakness of the Healthy City approach was that the early emphasis on the city did for a time preclude the notion that the project should also include towns and villages as well. The recent national and international health initiatives can therefore be seen as a response to the holistic period stimulated by international and local pressures.

LOCAL AUTHORITY HEALTH PROMOTION Turning from the macro to the micro, it will be noted that the Health of the Nation [5] saw local authorities as major stakeholders in health promotion. It also went on to say: ‘Environmental health departments have a particularly important part to play and the Department of Health is developing even closer links with them and the environmental health profession.’ The nature of the services that local authorities provide and the close democratic relationship with the local communities does mean that the local authority should be a major stakeholder in health promotion. Much will depend on the vision and priorities of members and officers. Since 1974, when the medical officer was relocated to the health authority, the environmental Copyright © 1999 Taylor & Francis Group LLC

health officer (EHO) has been the officer most readily identifiable with health. That is not to say that other officers such as personnel officers do not have health functions, it is simply that the EHO is clearly seen as most closely identified with health. Therefore where local authorities have been developing their potential in this field of health promotion, with few exceptions it has been the EHO who has been the lead officer [14]. The local authority’s role in health promotion is summarized below. 1. Enforcement of mandatory legislation Local authorities’ environmental health officers enforce a wide range of mandatory health legislation covering air, ground and traffic pollution, food hygiene and safety, housing standards, health and safety at work, etc. Enforcing mandatory standards is an important form of health promotion that should not be ignored. In order to get health advanced, legal enforcement is sometimes necessary. 2. Work in connection with discretionary powers Unitary and district councils already exercise a wide range of discretionary powers. Fairly wide ones are given in the Public Health Act 1964 and the Home Safety Act 1961. Activities cover HIV/AIDS, alcohol and drug addiction, nutrition, women’s health, men’s health, heating and energy advice, home safety, occupational health and health aspects of poverty. 3. Health promotion work in connection with health and safety and food hygiene Faced with the critical need to stem the rising tide of food poisoning, there has been a massive demand for training. This has largely been met by environmental health officers, most of them from within the local government setting. 4. Role model In terms of the employment market, local government forms a substantial segment. If local authorities take action to introduce effective health policies they do not only provide their internal community with an opportunity for better health but they also provide a role model for local commerce and industry. Many have followed this approach on specific health promotion issues.

5. Campaigns and projects Local authorities and their EHOs can also take action by way of campaigns and health promotion projects: (a) Heartbeat Award Restaurants, cafés and hotels are regularly inspected by EHOs under the Food Safety Act 1990 and these officers are therefore in a strong position to encourage people to go further than the statutory minimum standards. The Heartbeat Award scheme, introduced jointly by the HEA and individual local authorities, has provided a means for promoting and establishing healthy eating options and no smoking areas in catering premises. (See DoH, Smoking Kills: A White Paper on Tobacco, Cm. 4177, TSO, London, November 1998.) (b) Going further Some local authorities have gone further and established their own food awards for the catering industry, which enhance the ‘Heartbeat’ standards and encourage additional health facilities such as baby changing accommodation. (c) Commercial premises Premises used for other purposes than catering can also be encouraged in a similar fashion. In 1992, Oxford City Council and the local health authority introduced a ‘Health Award’. In order to attain the award, a company must comply completely with the Health and Safety at Work, Etc. Act 1974 and, in addition, commit itself to three approved ‘green’ policies and three approved healthy lifestyle policies. 6. Participation in national campaigns Local campaigns and projects are good but they are even better when interacting with a national campaign. Such central organizations as the HEA and the DoH can set the national agenda by getting national media coverage. They can also provide expertise to give a campaign direction and flair. Nevertheless, good as it can be, a central campaign on its own can sometimes alienate the very groups that are targeted. For instance, some teenagers may not necessarily want to be associated with society as a whole and may take it as a symbol of their independence to act Copyright © 1999 Taylor & Francis Group LLC

contrary to the message of a national campaign. It is here that local authorities can use their extensive local networking to adapt and ‘earth’ a central campaign. 7. Provision of local health promotion accountability The Secretary of State for Health is responsible for all the key appointments to the regional and district health service structures, and is responsible to parliament for the effectiveness of the NHS. Therefore accountability is essentially upwards. In contrast, a local council’s accountability is to the local people who elected it. Therefore accountability is essentially downwards to the local community. 8. Opportunity to comment Given this, the local council is in the best position to provide local people with the opportunity to comment and participate in national health promotion initiatives. Through their local councils and national organizations such as the Local Government Association, local people can bring a local voice to government discussions. 9. Local health promotion strategies To bring it all together, local councils can also develop local health promotion strategies through their EHOs. An increasing number of local authorities are already doing this. The best strategies have the following characteristics: (a) they provide a local health database (b) they activate other local authority departments into seeing their health contribution (c) they seek healthy alliance with other local organizations (d) they involve the internal community (staff) and the external community in the development of the strategy. 10. Unitary authorities An increase in the number of unitary authorities, which at local level brings services such as social services and education together with environmental health, housing and recreation, means the impact of such local health strategies will be enhanced considerably. Thus local authorities can make a major contribution to health promotion through their EHOs.

MANAGEMENT OF LOCAL HEALTH PROMOTION Plan and strategy Health promotion, like any other function in environmental health, needs to be properly managed. In recent years there has been a considerable tightening up of the management systems within departments, including the production of business or health plans. The environmental health department’s health promotion policy and strategy should find its place within those departmental plans. Organization In one sense all members of the environmental health department should be health promotion activists, but experience is now showing a need for specialists. Surveys by the CIEH indicate that it is now not uncommon for departments to employ officers specializing in such matters as HIV/AIDS, drug and alcohol abuse, home safety, food and safety education, and heating and energy, as well as health promotion generally. The trend has also been for these officers to be formed into a specialist unit. In a few local authorities, these units have been placed in the chief executive’s department. There are some advantages in this approach, especially initially when the local authority is seeking to develop a corporate approach to health promotion. However, such units can become isolated and lose touch with the operational services. On balance, health promotion units are best located within the environmental health service where the unit’s expertise can be readily accessed. Training and education For the environmental health service, a further implication of the practice of health promotion is in terms of training and education. The Acheson Report [15] said: ‘We believe that the most significant changes which need to be made to basic postgraduate training in public health medicine are those relating to epidemiology, behavioural Copyright © 1999 Taylor & Francis Group LLC

science and control of communicable disease and infection’ (this author’s emboldening). In highlighting the need for public health medicine consultants to draw on the behavioural sciences, the Acheson Report highlighted the need for all natural science-based professionals involved in health promotion to do likewise. This includes EHOs. In relation to student EHOs, some useful shifts in attitude and behaviour have occurred in recent years, among both teaching staff and students and those members of the CIEH who sit on the regulating education committee. In addition, recent years have seen local authority human resources departments develop in-house training in a variety of communication skills, including working with the media, which can be readily adapted to health promotion. Support Environmental health staff should be able to look for health promotion support to the specialists in health promotion. HEALTH AND ENVIRONMENTAL PROMOTION So far we have looked at health promotion in terms of health, albeit in its broadest sense which includes the environment. However, in recent years we can see that a separate movement, the ‘environmental’ movement, has also been growing in strength and dimension. This reached a high point in 1992 at the UN conference on environment and development (‘the Earth Summit’) held in Rio. Over 150 nations including the UK endorsed a 500 page document, Agenda 21 [16], which set out how both developed and developing countries can work towards sustainable development. (This has been neatly summarized in a booklet by the Local Government Management Board [17].) Agenda 21 singles out local government as having a special role. Two-thirds of the actions in Agenda 21 require the active involvement of local authorities. Chapter 28 of Agenda 21 called on them to initiate local Agenda 21 processes —partnerships for sustainable

development at a local level—by 1996. (By the end of 1996 roughly three-quarters of them had published action plans.) The government has now relaunched the strategy. Agenda 21 says that sustained development requires humanity to: • reduce our use of energy and raw materials, and the production of pollution and wastes • protect fragile ecosystems • share wealth, opportunities and responsibilities more fairly between north and south, between countries and between different social groups within each country, with special emphasis on the needs and rights of the poor and disadvantaged. Agenda 21 also argues that we will only be able to achieve these aims through planned, democratic and co-operative processes. The environmental movement expressed in Agenda 21 is different from the ‘health’ movement but at the same time there is a lot of common ground. As the Commission on Environmental Health [18] puts it: ‘Health and the environment have always been intimately related’. EHOs, with a foot in both the environmental and health camps, being part of the local democratic process and having had the recent experience of advancing Health for All, are well placed to move the local Agenda 21 plan forward. Indeed, a number of local authorities have transformed their health promotion units into health and environmental promotion units in order to capitalize on existing experience and know-how.

SUSTAINING CHANGE In considering these changes, it is useful to review a model of change [14] to get an objective view of how change takes place in health and environmental issues. It will be seen that change for the better is by no means automatic but is determined by a number of factors. Any health or environmental issue could be used to illustrate the model so let’s look at smoking. The societal model of change is set out in Table 10.3. As it shows, for a Copyright © 1999 Taylor & Francis Group LLC

Table 10.3 Model of societal change

societal change to take place there must be a gain that can be perceived and it must be at a cost worth paying. In terms of smoking this element is certainly satisfied. Then there must be the capacity for change. A powerful group in society has few problems in making changes. However, what happens if you wish for change yet the pressure group you belong to lacks muscle? This happened in the campaign to remove lead from petrol, so how was that change brought about? Des Wilson set out the strategy in his book The Lead Scandal [19]. It was done by building up a broad-based coalition among all sorts of organizations and across political parties. This was also done in terms of smoking. The number of smokers dropped significantly in the early 1990s, and it became possible to go into public meetings or places of entertainment without being engulfed by a fog of tobacco smoke. However, the most challenging element in change is how to sustain it when the original campaign has run out of steam and it is no longer smart to campaign. Again, looking at the model gives us the answer. We need to recognize that if one group in society gains through change it is likely that another group will lose and will then bide its time until the fires burn low under the initial campaign. The ‘losers’ in the initial stages of change push back. That is why in the early 1990s we saw, under the guise of ‘deregulation’, an attempt to roll back the environmental and food safety law made in the 1970s, and this is what we are seeing now in connection with smoking. This time teenagers are targeted. The model in Table 10.3 does, however, highlight the factor that can sustain change: the counteropposition. In the case of smoking there is good news because the healthy alliances on the non-

smoking issues now being built up between local authorities, business generally, government and the health authorities are becoming ‘structural’ and will form a tough counter-opposition. Nevertheless, the model shows that change for the better is by no means automatic, and it has to be sustained.

CONCLUSION The Department of Health’s then Chief Medical Officer, Kenneth Calman, commenting on the Health of the Nation initiative and looking to the future said: ‘It is important to have commitment from everyone to achieve the major health gains aimed for in this strategy’ [20]. Promoting health is everybody’s business. The implications are illustrated in the Oxford health wheel (Fig. 10.3) [11]. In the centre is the community, showing clearly that the community should have the central role

in health (and environmental) promotion. Around the rim are the various health and non-health professionals, and organizations that have a contribution to make. Holding the wheel together are the ‘spokes’ or politicians, both local and national. Again we should note the key position politicians occupy: they provide the environment for promotion to take place; they can provide encouragement or discouragement; they can provide or withhold essential resources; and they can provide constitutional direction and thrust. Between the spokes are the different areas of health and environmental concerns. These will differ from place to place and from time to time. Once the wheel starts moving, different groups that hitherto felt they had no contribution to make in a particular area suddenly find they do have something very valuable to contribute. It is when recognition dawns that health and the environment is, indeed everybody’s business that the wheel of health starts moving. EHOs are in a unique position to share this particular gospel.

Fig. 10.3 The Oxford health wheel. WHO, World Health Organization; CIEH, Chartered Institute of Environmental Health; FPHM, Faculty of Public Health Medicine; GP, general practitioner; RM, regional microbiologist; DPH, director of public health; HV, health visitor; EHO, environmental health officer Copyright © 1999 Taylor & Francis Group LLC

IMPROVING COMMUNICATION SKILLS Effective communication is one of the most important skills for environmental health staff to possess, and not least in relation to health promotion, where it will not happen unless we effectively communicate our health message. The following points should be considered in giving a talk.

Preparation Questions to ask the organizer 1. What is the nature of the group? 2. How long is the session and for how long do you wish me to speak? 3. What is it they are hoping to hear from me? 4. Where will it be held and what visual aid equipment is available? 5. Plus a question for yourself: do I really have something valuable to contribute to this gathering? Give yourself time to think over the invitation. It may be to everyone’s benefit if you graciously refuse! If you decide to do the talk, then you enter what should be a very pleasurable phase of the talk—the preparation proper.

Researching the subject thoroughly You may already know a great deal about the issue, but giving a talk is an opportunity to develop your own thoughts and your own knowledge, and look for ways to share them with your audience. The danger here is overload: getting lost in a welter of information to the extent that joy goes out of the window. Most experienced speakers tend to clear their own minds first before looking further afield. I find Buzan’s ‘mind mapping’ approach extremely helpful [22]. This consists of getting one sheet of blank paper, writing the central topic in the middle, and then building up with the other topics around it. The advantage of this approach is that the relative importance of the various ideas Copyright © 1999 Taylor & Francis Group LLC

falls into place, and the links between different key concepts are immediately recognizable. It also stops you getting bogged down in detail, and frees your mind to be creative. The added bonus is that a good structure for the talk often emerges naturally when using this approach.

Structure The structure of presentation has three parts: the beginning, the body and the end. A common mistake among speakers is failing to get the first and last bits close enough together! There are many textbooks that will give students a way of opening and closing a presentation and it is well worth experimenting. Keeping to time is also vitally important. Making a presentation is not unlike selling a product. A well-known formula that is used in the selling world goes under the mnemonic AIDA: Attention, Interest, Desire, Action. This method can be used with great benefit in structuring a presentation. 1. Attention: in the opening seek to secure identification with the audience. 2. Interest and Desire: build these into the main body to develop the audience’s interest and commitment to the subject. And then go for: 3. Action: whether you are lecturing to a basic food hygiene course or a group of medical students, it is worth building in the action points. It gives the audience something to bite on and gives you something to aim at.

Should you write it out? Reading out a prepared text is the death knell to communication. It is much more enjoyable and rewarding to use ‘confidence’ cards or a sheet of paper listing the main points. This enables you to be free to pick up on the audience’s reactions and signs of interest, or disinterest as the case may be. Similarly, memorizing a text is equally disastrous and anchors you in the past rather than freeing you to share with the audience in the present.

Experienced speakers put their main points and essential facts and phrases on to a card or sheet of paper. They live with these, adding or subtracting as new ideas and new insights come to them. Then, when the time comes to stand on their feet, they do not have a written barrier standing between them and the audience, yet at the same time they know exactly where they are coming from.

Presentation Having invested a great deal of time in preparing a talk it would be sad to see that investment wasted at the point of delivery. So what can psychological research tell us about delivery? Research by a Mehrabian [23] suggests a 55:38:7% principle: in our communications with one another, 55% of what is communicated is communicated visually, 38% what it sounds like and only 7% by the words being used. Even with the latter, we tend to focus on ‘buzz’ words or phrases. So how we present ourselves and our material visually does matter. Should we be formal or informal? We need to think in terms of the group and the occasion. What might be absolutely right for one occasion could be quite wrong with another group or on another occasion. But above all, we should be ourselves. Audiences can soon spot a ‘poseur’. Similarly, we need to give special attention to visual aids. Will they help or will they hinder? Will they assist your communication with the group or will they act as a barrier? These days every environmental health department should be developing its own picture library. Pictures can be drawn upon either as slides or as computerized images. Since 38% of the communication is determined by the sound of the communication, it certainly helps to sound confident. The evidence will transmit itself to the audience and encourage them to want to communicate with you. On the other hand, fear of failure not only makes you, the speaker, feel very uncomfortable, with such symptoms as a dry mouth or heaving stomach, but it also quickly transmits itself to your audience. The topic gets lost as the audience gets nervous, wondering if you are going to make it to the end. If you have that problem, take heart. A lot of famous Copyright © 1999 Taylor & Francis Group LLC

communicators have had it too. Singer and actor Howard Keel was so dry-mouthed before appearing in a Royal Command Show that his assistants even had to Vaseline his lips; Angela Rippon said she was so nervous before compèring the Eurovision Song Contest that she felt sick. Barbara Castle records that when she first stood up in Parliament she was lost for words. Afterwards a kind friend said to her, ‘Don’t worry, the last person who did that went on to become Prime Minister.’ And that gives us the clue to tackling our nerves. Psychologists tell us nerves come from our fear of failure, that somehow when we stand up on our feet we will not be able to communicate and our personal world will come tumbling down around our ears for all to see. The best antidote to this is not a spot of salt in your pocket to keep your mouth moist, although that can help, but good preparation and practice. The more you do of both, the more confident you will become. Then you will find that you will really enjoy the experience and so will the audience.

Communicating apart from on your feet I have deliberately dwelt upon environmental health staff communicating on their feet because not only is it an important area if we are to promote health, but it also brings out the two main principles that underline effective communication, whether it be with large groups, small groups, on a one-to-one basis, with the media or by letter or committee report. The first principle that should undergird all our communication is the 55:38:7% principle. I have already mentioned it in terms of giving a presentation, but it is equally important in other settings —even radio. True, the 55% visual element is lost, but that means we have to pay special, or greater, attention to the remaining 45%, especially the tone and manner of our verbal communication. With the advent of local radio, both BBC and commercial, in most places and given the topicality of our work, environmental health officers are continually presented with opportunities to go ‘live’, and it is useful to bear this first principle in mind if we are to maximize these useful opportunities for health promotion.

The second and the most crucial point of all is that communication is not just a one-way business, a question of getting a message across. Communication is a two-way process. It follows from this that we need to think constantly in terms of the other person or people—to be open to their reactions and their needs. Harold Macmillan, one of the first Prime Ministers to appear on television just before a general election, was told as he sat down before the camera: ‘There will be 12 million people watching tonight’, but he later wrote; ‘I just had the sense to say to myself, no, no, no, two people, at the most three.’ Instead of adopting a grand public speaking style suitable for 12 million people, which would have seemed odd to the small groups watching at home, his presentation was quietly conversational. The positive response by the public to this approach showed that the master of communication certainly knew how to be an outstanding success. For this and similar insights into how Prime Ministers have faced the media, Cockerill’s book Live from No. 10 is warmly recommended [24].

REFERENCES 1. Naido, J. (1992) The Politics of Health Education—The Limits of Individualism, Routledge & Kegan Paul, London. 2. Ewles, L. and Simnett, I. (1992) Promoting Health—A Practical Guide to Health Education, John Wiley, Chichester. 3. Hancock, T. (1995) Supportive Environments for Health, WHO, Copenhagen. 4. Department of Health (1991) The Health of the Nation: a consultative document for health in England, HMSO, London. 5. Department of Health (1992) The Health of the Nation: a strategy for health in England, HMSO, London. 6. Report of a Joint Committee of the Central and Scottish Health Services Council (1964) Health Education, HMSO, London. 7. Ewles, L. (1993) Paddling upstream for 50 years. Health Education Journal, 52(3).

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8. Department of Health (1998) Our Healthier Nation: a contract for health, HMSO, London. 9. Anon (1998) Green paper. Environmental Health News, 13(5). 10. Kickbusch, I. (1986) Health promotion strategies for action. Canadian Journal of Public Health, 77(5), 321–326. 11. Allen, P. (1991) Off the Rocking Horse, Greenprint, London. 12. Black, D. (1981) Inequalities in health. British Medical Journal, 2 May. 13. WHO (1977) Health for All by the Year 2000, World Health Organization, Geneva. 14. Allen, P. (1994) Local authority action. Royal Society of Health Journal, 14(2). 15. Report of the Committee of Inquiry into the Future Development of the Public Health Function (1988) Public Health in England, HMSO, London. 16. UN (1992) Earth Summit. Agenda 21: The United Nations Programme of Action from Rio, United Nations Department of Information, New York. 17. LGMB (1993) Local Agenda 21: Principles and Process: a step by step guide, Local Government Management Board, Luton. 18. CIEH (1997) Agendas for Change, Chartered Institute of Environmental Health, London. 19. Wilson, D. (1983) The Lead Scandal, Education Books, London. 20. Department of Health (1993) On the State of the Public Health, HMSO, London. 21. MacArthur, I.D. and Bonnefoy, X. (1998) Environmental Health Services in Europe— Policy Options, WHO, Copenhagen. 22. Buzan, T. (1982) Use Your Head, BBC Publications, London. 23. Mehrabian, A. (1980) Silent Messages, Wadsworth Publishing, California. 24. Cockerill, M. (1989) Live from No. 10, Faber & Faber, London.

FURTHER READING Foster, M. (1993) Camden and Islington HIV Prevention Strategy, Camden Borough Council, London.

Mackay, J. (1993) The State of Health Atlas, Simon & Schuster, London. O’Neil, P.D. (1990) Health Crisis 2000, WHO, Geneva.

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Tones, B.K. and Tilford, S. (1994) Health Education: effectiveness and efficiency, 2nd edn, Chapman & Hall, London.

11

Risk assessment and risk management Liz Falconer, Norma J.Ford, Kath Ray and Denise M.Rennie

INTRODUCTION Environmental health practice is fundamentally concerned with minimizing adverse effects on human health. This task is complex because resources are finite and the understanding of many of the risks affecting health are incomplete. The appropriate direction of resources therefore demands that the risks that are presented by a variety of activities are assessed and managed in order to determine the priority that should be afforded to each. Formal risk assessment is increasingly recognized as a means of making consistent, objective and reliable judgements and, therefore, informing well founded decisions concerning risks in many situations. There are sound scientific, economic, political and sociological reasons for using risk assessment techniques, not the least of which is their potential to facilitate accountability and transparency [1]. The value of risk assessment as a tool to guide decision-making for those whose task it is to balance safety, public concerns and expenditure may explain why risk assessment underpins much UK and European Union (EU) legislation. The application of risk assessment is commonplace in two areas of the environmental health practitioner’s work: as a technique to determine the distribution of resources between Copyright © 1999 Taylor & Francis Group LLC

different environmental health functions, e.g. priority planning; and as a requirement of various pieces of environmental health legislation. The aim of this chapter is to enable environmental health students and practitioners to appreciate and understand both the advantages and limitations inherent in the development of risk management strategies as a means of selecting environmental controls and interventions. It addresses the definitions of the major terms and principles of understanding and identifying risk. The discussion identifies the components of approaches available for risk estimation, and explores the significance of risk perception and approaches to risk communication.

HAZARD AND RISK In the seminal work Risk: Analysis, Perception and Management [2], the Royal Society defines the terms hazard, risk, risk assessment and risk management as follows. A hazard is a property or situation that in particular circumstances could lead to harm. Risk is the probability that a particular adverse event occurs during a stated period of time, or results from a particular challenge

(where an adverse event is an occurrence that produces harm). Risk assessment is the term used to describe the study of decisions subject to uncertain consequences. It has two components: risk estimation and risk evaluation. Risk estimation includes: • the identification of outcomes • the estimation of the magnitude of the associated consequences of these outcomes • the estimation of the probabilities of these outcomes. Risk evaluation is the complex process of determining the significance of the estimated risks for those affected. It therefore includes the study of risk perception and the trade-off between perceived risks and perceived benefits. Risk management flows from risk estimation and risk evaluation, and is the making of decisions concerning risks and their subsequent implementation. [2] These definitions have been used as the basis for policy development in a variety of applications including the Department of the Environment’s Guide to Risk Assessment and Risk Management for Environmental Protection [3]. However, it is important to recognize that the definitions, while authoritative, do not meet the whole requirements of engineers and scientists who specialize in risk studies. They have been adopted as the basis for risk studies but they are adapted to suit the particular needs of the subject. British Standard (4778 1991 Part 3), for example, defines risk in terms of availability, and is designed to be used in conjunction with Quality Assurance Standards. The increased focus on risk as a basis for the legislative control of hazards in a variety of settings has also resulted in a proliferation of the terms used to describe the various risk assessment techniques, and there is evidence of confusion about the nomenclature and meaning of various terms. The term risk analysis is defined by the Department of Trade and Industry (DTI) [4] as the process of discovering what risk is associated with any particular factor by identifying hazards and estimating the Copyright © 1999 Taylor & Francis Group LLC

probability and consequences of the hazards occurring. In contrast, risk analysis has been identified as a structured approach to the reduction of risk including risk assessment, risk management, risk communication and risk monitoring [1]. The Health and Safety Executive (HSE) does not use the term within its nomenclature of risk. Acknowledging the proliferation of terms, in 1995 the HSE issued a discussion document that aimed to bring about convergence of the explanations of terms and concepts [5]. Its focus was the definition of terms used to describe the risk assessment process as it applied to risks to safety, health and environmental quality, and it attempted to develop generic definitions of the main terms used to describe forms of risk arising from the industrial process. At the time of writing, responses to the proposals made have not yet been published and there remains no commonly agreed set of definitions. Thus there is a range of working definitions of terms, but a more important distinction is that which is framed by the perspective from which risk is viewed. Historically, research has been compartmentalized according to the discipline of the researchers and the nature of the hazards being investigated. Engineers and scientists have tended to see risk as a quantifiable entity whereas social scientists (particularly psychologists and sociologists) have argued that risk cannot be viewed as a one-dimensional objective concept. The work of social scientists has been mainly concerned with individual and societal responses to risk, and the importance of these reactions is increasingly acknowledged by policy-makers and businesses.

RISK PERCEPTION The Royal Society devoted extensive coverage in its 1992 report [2] to the advances in the social scientific theories of risk. In a previous report, in 1983 [6], it had maintained a distinction between ‘objective risk’ as a quantifiable measure calculated by experts, and ‘subjective risk’ as the (inaccurate) perceptions of risk held by lay people. The lack of consensus over these competing conceptions of risk was reflected in the fact that the chapters in the 1992 report were attributed to individual groups of authors, rather

than to the Royal Society as a whole [7]. Although quantitative conceptions of risk are still dominant in safety and risk management literature, developments in social scientific thinking about risk have resulted in a partial displacement of the quantitative definition of risk (the probability of adverse events occurring) as the sole one, and have instead emphasized risk as a multifaceted concept with a number of different qualitative dimensions. These additional dimensions include psychological and socially influenced aspects, and political, economic and ethical characteristics [8, 9]. One of the defining characteristics of social science approaches to risk has been the stance that there is no singular correct assessment of risk to which people’s perceptions can approximate to a greater or lesser degree. Instead, risk in itself has a variety of different meanings to different individuals and groups in society. Thus, expert calculations of risk based upon the quantitative assessment of the probability of adverse events occurring constitute merely one approach to risk assessment. These developments in understanding about risk perception have important implications for the tasks of risk management and risk communication, since risk perception necessarily affects how people will respond in the face of new hazards and what societal and personal risks they will consider to be acceptable or tolerable. The need for the public’s viewpoint to be considered has been increasingly recognized. Reports on tolerability of risk following the Layfield Inquiry into the Sizewell B nuclear power station emphasized that the ‘opinions of the public should underline the evaluation of risk’ [10]. The understanding of public opinions of risk are informed by social scientific work, which has conventionally been divided into psychological and cultural approaches. Only very recently have there been some moves towards an integration of these two approaches.

PSYCHOLOGICAL THEORIES OF RISK PERCEPTION Psychological work on risk perception has a long and well-established history based upon Copyright © 1999 Taylor & Francis Group LLC

considerable amounts of supporting empirical data. Early work comprised studies comparing lay assessments of quantitative risk, e.g. the number of fatalities arising from a variety of stated hazards within a specified time period, with the actual reported number of fatalities (e.g. [11]). The risks of those activities that had the highest number of fatalities were generally underestimated by the respondents, and those that had the lowest numbers of fatalities were generally overestimated. This has been explained by psychologists by the notion of ‘cognitive heuristics’, or ‘mental rules of thumb’, which are used by respondents to arrive at judgements of probability. A strategy called the ‘availability heuristic’ was considered to be particularly important in determining respondents’ judgements of fatality frequencies. This suggests that the more information or images that are available for recall about an event, the more likely respondents are to judge it likely to happen. Events that are particularly imaginable are those of which one has personal experience, and also those that have been given widespread or particularly vivid media coverage. An example of the effect of this was the considerable level of consumer resistance to the proposals to lift the prohibition on food irradiation in the UK in the late 1980s following the 1986 Chernobyl accident [12]. Resistance to consumption of genetically modified food might similarly be heightened by media attention to the potential for cloning of animals and human beings. A further ‘heuristic’ is the desire for certainty, which causes people to estimate the probability of a certain course of events rather than face uncertainty [13]. Investigations into why lay estimations of the frequency of adverse events occurring differed from the actual frequencies of these events retained the quantitative concept of risk. Slovic, Fischoff and Lichtenstein [14] identified a number of qualitative scales of various hazards. Survey methods were used to ask respondents about their perceptions of risk and the qualitative characteristics that they perceived various hazards to have. The numerous dimensions or characteristics of risk expressed by the respondents were grouped by the researchers into three factors that had a particular impact upon the risk perceptions elicited. Two of these factors,

‘dread risk’ and ‘unknown risk’, are shown in Fig. 11.1. The ‘dread risk’ factor includes dimensions of risk such as controllability, potential of fatality, equity of risk, catastrophic potential, risk to future generations, and voluntariness of exposure. Hazards that rated high on this scale included crime, warfare and terrorism, and nuclear power. The ‘unknown risk’ factor included knowledge about the risk, latency of effect, observability and the novelty of the risk. Hazards that rated high on this scale included space exploration, DNA research and food additives. Motor vehicles, alcoholic beverages, mountain climbing, and downhill skiing, all of which are perceived by experts to be relatively high risk in terms of the probability of fatalities or injuries occurring, were perceived by respondents to be low on both the scales of ‘dread risk’ and of ‘unknown risk’. The results showed that risks that rated low on the dread and unknown scales, i.e. risks that were familiar, voluntary, and had well known and immediate consequences, were more tolerable to respondents than risks that rated highly on these scales [9]. Drawbacks associated with this psychometric tradition of risk perception research include the fact that there are a variety of hazard sets, rating scales and multivariate statistical techniques that can be used, and these vary according to the particular study in question [8]. There is also the problem, common to all social scientific empirical research, that the way in which questions are presented can have a significant bearing on the responses people give regarding their perceptions of risk. The use of standard hazard sets, in order to compare across studies, does not allow respondents to identify for themselves which risks are the most important to them. Despite these methodological drawbacks, it is clear that the identification of a range of qualitative dimensions of hazards that impinge upon risk perception has contributed greatly to our understanding of the complexity of risk perception and tolerability. The findings have important consequences for those responsible for assessing and managing risk in society since they suggest that the results of quantitative risk assessments using, for example, accident probabilities, annual mortality rates or Copyright © 1999 Taylor & Francis Group LLC

mean losses of life expectancy are not the only, nor even the most important, factors to be taken into account when assessing and managing risk.

CULTURAL THEORIES OF RISK Cultural theories of risk are often cited as an alternative to the psychometric tradition of risk perception research because of their focus on the individual as a social being rather than as an isolated individual. Cultural theories of risk emphasize that not only is risk a multifaceted concept with numerous qualitative dimensions, but the perception and assessment of the characteristics of risk will vary according to the culture of the perceiver. The general principle of cultural theories of risk is that individuals within societies participate in numerous social relationships within large and small-scale social and institutional arrangements. It is through such relationships that people’s attitudes, beliefs and values, and thus their ‘world views’, are constructed and maintained. These ‘world views’ are important determinants of risk perception, causing people to emphasize selectively certain elements of a risk [8]. The emphasis is on studying the individual, located within particular social networks and contexts, as an active receiver and interpreter of information about hazards. The cultural theory of risk postulates that people’s ‘world views’ can be classified into four types (Table 11.1). The types reflect beliefs about human nature, the physical environment, equality and competition [15]. The implications for the management of risks in society are fundamental, in that they suggest that disagreements over risk acceptability cannot necessarily be resolved by recourse to scientific evidence. People’s ‘world views’ will also determine whether the evidence presented to them is regarded as trustworthy or unreliable. Indeed, the selection of certain risks for attention is one means by which individuals defend their preferred way of life and place blame on other groups. The cultural theory of risk emphasizes the issue of trust in the institutions that are responsible for managing risk as an integral element of people’s

Fig. 11.1 Locations of 90 hazards on Factor 1 (dread risk) and Factor 2 (unknown risk) of the three-dimensional factor space derived from the interrelationships among 18 risk characteristics. Factor 3 (not shown) reflects the number of people exposed to the hazard and the degree of personal exposure. (Source [14].) Copyright © 1999 Taylor & Francis Group LLC

Table 11.1 Categorization of people’s world views

Source: [15].

‘world views’. This issue was also highlighted as an important element in risk perception in Wynne’s study of the Windscale inquiry in the UK [16]. Wynne suggested that the expert and public perceptions of the risks involved differed due to their different frames of reference. The expert point of view focused on only the technical aspects of risk management, thus taking the trustworthiness of the institutions concerned for granted, while it was the very lack of trust in the institutional arrangements for risk management at the plant that framed the opponents’ perceptions of the risks concerned [8]. Power differentials between different social groupings may explain varying levels of trust in the institutions engaged in managing risk, as marginalized groups have less control over and are less likely to receive the benefits of a variety of risk-creating activities. These issues are significant in relation to the relative power held by managers and workers, government and the population, enforcement agencies and businesses, etc. Cultural theorists recognize that people’s interpretative ‘world views’ or frameworks are not stable and coherent but contain inconsistencies Copyright © 1999 Taylor & Francis Group LLC

and ambiguities and can thus be expressed quite differently according to context. Responses to hazards may be determined by the behaviour of significant others such as friends, family, colleagues and public figures. Alternatively, risk perceptions that are identified by research studies may in fact be post hoc rationalizations of behaviour [13]. Adams [7] recognizes that the value of cultural theory lies in its attempt to discern order and pattern in what is necessarily an infinitely complex and fluid world. The model of four ‘cultural types’ is too static and the risk-taking behaviour of individuals varies greatly according to time and place. Adams suggests a model of risk-taking behaviour that combines a risk compensation theory with some of the insights from cultural theory. Risk compensation theory is premised upon the principle of the ‘reflexivity’ of risk, i.e. that risks are not accurately quantifiable because people respond to the assessment and management of risk by modifying their behaviour, and thus the probability of a predicted outcome will change. If perceived risk increases, then people take ‘avoiding action’ and the risk decreases. A study of risks of accidents to children on a Glasgow housing estate found that parents had a strong sense of their safe-keeping responsibilities and a detailed local knowledge of the risks, which resulted in the application of a range of preventive strategies [17]. An attempt to integrate ideas from both psychological and cultural theories of risk exists in the social amplification of risk theory. This focuses on the means by which risks are communicated to people and how the level of risk is intensified or attenuated through a variety of psychological, social and cultural processes [8, 9]. The ways in which information about risk is communicated to individuals—via scientific communications, government agencies, politicians, community activists, ‘significant others’, the mass media, etc. — are crucial to understanding risk perception. Each of these channels can act as a ‘social amplification station’, either emphasizing or downplaying certain elements of a hazard depending upon a variety of factors. There is no single true picture of risk, which is then distorted by the existence of a number of ‘social amplification stations’, but it is through these stations that risk

is constructed culturally. One drawback of the social amplification approach to risk is that it overemphasizes the oneway flow of information from risk communicators to their receivers and thus underplays the interactive nature of the information exchange that takes place. In summary, there are several clear theories of risk perception within which there are areas of agreement and disagreement. Environmental health practitioners must therefore recognize that risk is a multifaceted concept with a number of different qualitative dimensions. There is a need to acknowledge the differing perceptions of risk and the way in which they impinge upon their professional judgements. They are also an important factor in determining the responses of the stakeholders that they interface with in their work.

QUANTIFYING RISK Since the mid-1980s, increasing interest in and investigation of risk have enlivened debate about the value and validity of the methods available to assess, manage and communicate risk. The underlying concept of risk assessment is that of seeking to identify in some quantitative or at least comparable way the connection between hazards and actual exposure to harm. It depends on an identification of hazards and damages, and consists of an estimation of the risks arising from them with a view to their control or avoidance, or to a comparison of risk. The detail, scope and complexity of a given assessment will vary depending on factors such as the availability of time (relative to the urgency of action), the perceived seriousness of the hazard, available resources, and the outcomes and possible consequences of any decisions [1]. In many environmental health situations it will not be possible to conduct a full risk assessment because, for example, the preliminary information and time available are inadequate. Nevertheless, decisions that have been informed by even a short, wellfocused assessment, using whatever information is available, will usually be better (and more defensible) than uninformed judgement. Risk Copyright © 1999 Taylor & Francis Group LLC

assessment, comprising risk estimation and risk evaluation, results in identification and prioritization of those risks that matter most, with a view to their reduction where this is reasonably practicable. A scheme of risk management measures tailored to the priorities can then be introduced. Despite recognition of the debate about qualitative and quantitative approaches to risk, the quantified approach to risk remains widely practised, and many techniques that form the basis of this approach have been developed over the past 30 years. All of these techniques have an element of subjectivity involved in them; nevertheless, they are considered by specialists in the field to be objective techniques. Crossland et al. [18] suggest that risks may be classified into at least three groups, those for which: • a clear, deterministic link exists between the risk and its outcome; in these cases statistics of resulting harm are available • there is evidence of a link between risk and outcome but a deterministic link cannot be made • experts estimate the probability of future events. Human judgement plays a fundamental role in all risk estimation. It is consequently argued that to suggest risk exists in a finite, measurable form is much too simple a view [19]. Lewis [20] has argued that quantitative techniques that use scientific methods are fundamentally sound, being an implementation of logic. However, Groeneweg [21] contests this by suggesting that the inevitable inadequacy of the information available to analysts results in logical methods of risk estimation simply identifying ‘islands of knowledge in a sea of unknown events’ [21, p. 138]. With respect to scientific uncertainty, Adams [7] argues that the majority of assessments of risk are not based on conclusive scientific evidence since the statistical evidence for accurately judging the probability of harm occurring is usually absent or unreliable. In these circumstances it is essential to rely on assumptions that do not derive directly from the evidence but from human judgement. Quantitative calculations of risk are based on

particular theoretical premises and mathematical extrapolations which are just as subjective (in the sense that they rely on human judgement) as the judgements of individual, non-expert risktakers [9, 13]. The difference is that the theoretical models used by experts are evaluated and legitimized by the scientific community. For instance, animal experiments are usually used to assess the risks of toxic chemicals. In these experiments, animals are subjected to high doses of a chemical over a short period of time, and then the results are used to extrapolate to the effects on humans, who are generally subjected to very low doses of a chemical over long periods of time [13]. Different results can be obtained from these experiments depending on which assumptions are used in extrapolating from the low-dosage to the high-dosage cases. A ‘supralinear model’ assumes that responses will remain high even as the dosage is reduced, while a ‘threshold model’ assumes that under a certain dosage there will be no response at all. Despite its limitations, risk assessment is an increasingly important management activity, and the quantification of probability through techniques of risk estimation remains an important element of risk assessment. Risk assessments are required or implied by law in many areas of environmental health practice, so environmental health professionals need an understanding of the various techniques that industry and employers might use to estimate and assess risk. Those charged with the responsibility for carrying out risk assessments need a framework to approach the task, and various sequential models exist. The environmental health examples that follow share common steps of hazard identification, consideration of the consequences, evaluation, decision-making about appropriate controls, and monitoring of both risk and the effectiveness of the controls. An EU directive on hygiene of foodstuffs [22] following hazard analysis and critical control points (HACCP) principles requires the following to be incorporated into management of food safety: 1. Analysis of the potential food hazards in a food business operation. Copyright © 1999 Taylor & Francis Group LLC

2. Identification of the points in those operations where food hazards may occur. 3. Deciding which of the points identifiable are critical to ensuring food safety. 4. Identification and implementation of effective control and monitoring procedures at those critical points. 5. Periodic review of the analysis of food hazards, the critical points and the control and monitoring procedures. Similarly, Gardiner and Falconer [23] identify five steps to assessing and controlling occupational health risks: 1. Recognizing that hazards may exist in the particular environment. 2. Identifying those hazards and understanding their characteristics. 3. Evaluating the risk that those hazards may pose, i.e. assessing the likelihood of harm occurring and how severe that harm may be. 4. Identifying and applying controls that eliminate those risks, or reduce them so far as is reasonably practicable/achievable. 5. Monitoring and review of the effectiveness of control measures. The Department of the Environment [3] identifies five preliminary strategies necessary for the derivation of an environmental risk assessment. These are: • • • • •

description of intention hazard identification identification of consequences estimation of magnitude of consequences estimation of probability of consequences.

In following any of these schemes, risk evaluation may be undertaken using a combination of qualitative and quantitative approaches, depending on the circumstances. Even if a purely quantified approach is taken to risk estimation, the total assessment of the risk would also involve qualitative issues such as the tolerability of the risk. This general approach is equally applicable to risks in the areas of food safety, health and safety at work,

residential accommodation or environmental protection. As the ability to identify potential risks is the first priority of those involved in carrying out risk assessments, it is necessary to recognize the role of hazard classification systems as an aid in the risk assessment process. The purpose of a classification system is to give the risk assessor a framework for identifying and evaluating hazards that may cause harm. Classification systems have been developed in a number of environmental health spheres. For example, workplace hazards can be grouped as: • • • •

chemical and radiation biological physical psychosocial and organizational.

Table 11.2 Fault tree symbols

Copyright © 1999 Taylor & Francis Group LLC

In the food safety field hazards likely to cause harm to the consumer can be categorized as: • microbiological • chemical • physical. A classification system allows assessors to work within a framework of hazard identification that can be applied in quantification techniques. There are several mathematical and engineering approaches to hazard analysis and risk estimation that apply qualitative methods to the identification of hazards and then apply quantitative methods to estimate the risk. This process can be tackled in one of two ways: top-down, in which the process begins from the consideration of a failure and deductive analysis is applied to determine what happened; and bottom-up, where the sequence is

from cause to effect and the task is to predict what failures might result from a particular situation. An example of each of these approaches is described below. Fault tree analysis (FTA), is a well known example of a top-down technique. This approach could be applied to an outbreak of food-borne disease, a release of a damaging substance into the environment, or an industrial accident. In constructing a fault tree, the top event is first identified and then the question ‘What caused (or could cause) this to happen?’ is asked. The answer could be in terms of either component failure or operator action. As with most ‘trees’ of this type, symbols are used to describe what is happening at certain points on the branches. The meaning of some of the commonly used symbols is shown in Table 11.2.

Fig. 11.2 Fault tree diagram. Copyright © 1999 Taylor & Francis Group LLC

Fig. 11.2 shows the construction of a fault tree for a situation where a pressure vessel ruptures causing a release of an environmental toxin. This could be due to several causes, including a faulty pressure valve, the operator ignoring danger signals, or a misunderstanding between two operators who might each think that the other was taking action. The aim is to find the root causes of why the pressure vessel ruptured. Beginning with the top event, the pressure vessel ruptured, and the analyst looks for possible causes as to why it did so. Initial causes in this case might be: • pressure relief valve failed • an uncontrolled rise in pressure took place. Taking the first of these, the analyst asks ‘Why did the valve fail?’ The identified causes for this event

are faulty manufacture, faulty fitting, or poor maintenance. Moving to the other identified cause, the question is ‘Why did the pressure rise uncontrollably?’ The identified causes for this event are the operator failed to notice the rise and the automatic pressure limiting device failed. Once again, each of the causes is repeatedly subdivided until the causes are found. Another analyst may disagree with the root causes shown here on the grounds that these can be analysed into reasons why the failures took place, but one has to decide when it is not worth continuing the analysis. Only faults are shown in the tree, not remedies for those faults. These ‘stopping rules’ are a fundamental part of using deductive analyses such as FTA. The assigning of stopping rules is a subjective decision on behalf of the analysers. The decision can be influenced by the time available for the analysis, issues outside the control of the analysers or simple expediency. So ‘root causes’ should always be interpreted as shorthand for root causes for the specific purposes of this analysis. This technique can also be used to calculate the probability of certain events occurring. If the probabilities of events below a logic gate are known, then the probability of the event above the gate can be calculated. The combination rule for and gates is: Probability of event {p(E)}=p(A)×p(B)× p(C) …p(n) The combination rule for or gates is: p(E)=p(A)+p(B)+ …p(n)-p(A and B and …n) In contrast with top-down approaches to hazard analysis, bottom-up approaches move from cause to effect. Instead of asking ‘What caused this failure?’, the question is ‘What failures might this cause?’. Failure mode and effect analysis (FMEA) has been developed to identify critical areas and enable planners and analysts to modify designs to reduce the probability of failure [24]. In FMEA, the analyst considers what effects on the output will occur when there is a failure of Copyright © 1999 Taylor & Francis Group LLC

input or components. Alternatively, each individual component of a system might be considered for each of its failure modes. It is then possible to assess the probability of failure rates for each component and hence for each system failure mode. A classic example that explains the technique of FMEA is shown in Fig. 11.3 [25]. The following failure modes and effects can be identified in it. • Bellows: fails to safety as it would lead to loss of pressure in the bellows and the electrical contacts would open. • Loss of pivot: fails to danger as electrical contacts remain closed. • Break in large spring: fails to danger as the electrical contacts remain closed. • Failure in electrical switch: º º º

break in mechanical parts of switch fails to safety as contacts open break in connection of electricity fails to safety as current is cut break in switch spring could fail both to safety or danger, but is more likely to fail to safety, i.e. the switch will tend to open in most modes of failure. It is assumed here that, for the purposes of this example, failure to safety occurs 75% of the time for all modes of switch failure.

The total failure probabilities are known for each component and are shown in Table 11.3. The pressure switch is an example of a typical series system. In other words, failure of any one of the components will cause failure of the whole system. This equates to or gate logic in a fault tree (if component 1 fails or component 2 fails, etc.). The probability combination rules for series systems (or gates) is the addition rule: p(E)=p(A)+p(B)+ …p(n)-p(A and B and …n) In this case, multiplying the probabilities to calculate p(A and B and…n) would produce an extremely small number, so the probabilities in Table 11.3 have simply been added. The table shows that the system is more likely to fail to safety rather than fail to danger.

Fig. 11.3 Schematic diagram of a pressure switch, (a) Pressure applied; (b) pressure removed; (c) pivot displaced; (d) return spring fractured. (Source: [25].)

The accuracies of both FTA and FMEA are dependent upon the accuracy of the probability data used, as well as on the questions asked and the shape of the resulting diagrams. Groeneweg [21] found, on presenting the same data and scenario to several groups of specialist assessors, that their Copyright © 1999 Taylor & Francis Group LLC

final assessments varied considerably, Similar techniques have been applied to the assessment of human reliability (e.g. [26]), particularly in potentially hazardous processes such as the nuclear and chemical industries. While these techniques have been used with some success in these

Table 11.3 Failure probabilities for components

industries, the paucity of probability data on certain types of human error can make quantification problematic.

RISK MANAGEMENT Risk management involves applying a set of measures relevant to a particular set of significant risks with the intention of restricting and maintaining risks within tolerable limits at proportionate cost [5]. Risk management is also the process of weighing policy to accept, minimize or reduce assessed risk and to select and implement appropriate actions [27]. Management of risk thus necessitates selecting from the range of available measures with which to control and reduce risk. Social and cultural theories of risk draw attention to the variety of social, political and ethical dimensions of decision-making that impinge on risk management and suggest that there is no single safe level of risk that can be determined on the basis of quantitative assessments of the likelihood of deaths or injuries. Social, political and ethical dimensions, for instance, are all inextricably related to people’s perceptions of the trust that should be placed in institutions involved in the management of risk. Debates over the acceptability of risk accruing from the activities of industry in relation to workplace conditions, emissions from premises, or foods produced will all be affected by whether it is believed that effective control measures will be implemented and maintained and also on the actions of enforcement agents if controls are not applied. Other political and ethical dimensions of risk acceptability might include conflicting value judgements over the Copyright © 1999 Taylor & Francis Group LLC

benefits of risk-creating activities, such as improved health care, improved economic growth, increased power of businesses and enhanced national independence. For example, there is much more support for the use of genetic modification techniques to improve medical treatment of diseases such as cystic fibrosis than there is for its use in food production [28]. The increasing requirements in many areas of environmental health legislation for organizations to manage risks effectively have given rise to much advice for managers. For example, in the field of occupational safety and health, British Standard 8800:1996 offers two models of safety management. One is based on the HSE’s booklet Successful Health and Safety Management [29], and the other is based on BS EN ISO 14001 [30]. The rationale of BS 8800 is to apply similar management practices in health and safety as in other corporate matters, thus enabling organizations to integrate the management of occupational risks into existing management systems, or indeed to use the occupational risk management systems to stimulate other management systems within the organization. Essentially the advice is the same whichever system is used, i.e. that an effective risk management system includes the steps of planning, implementation and review. Risk management decisions inevitably involve an aspect of cost. Recognizing that a zero risk society is impossible to achieve, decisions in risk management revolve around questions of tolerability. The ALARP/ALARA (as low as reasonably practicable/achievable) principle in environmental protection accepts the need for a trade-off between risks and benefits. The Health and Safety at Work, Etc. Act 1974, Section 2, places duties on employers to do certain things to reduce risks to their employees

so far as is reasonably practicable. Case law has defined this as a balancing act between the quantum of risk on the one hand and the cost of remedying the risk on the other. The Food Safety (General Food Hygiene) Regulations place requirements on the operators of food businesses where these are appropriate and/or necessary for the purposes of ensuring the safety and wholesomeness of food. Similarly the selection of the best practicable environmental option (BPEO) acknowledges the impact of costs on the feasibility of environmental protection measures. In placing risk and cost on a balance it becomes clear that, in order to decide which side of the balance weighs heavier, both sides must be measured in the same units. This means measuring both cost and risk in either qualitative or quantitative terms. Adams [7] notes that the view that if a risk exists it must exist in some quantity and can therefore be measured has been adapted by economists who say the only practicable measure is money. In this way reason is reduced to calculation. In current environmental health practice, this is often the case. Organizations concerned with risks to the environment and public health and safety are required to make risk management decisions that evaluate the magnitude of the risk and compare it with the magnitude of the cost of corrective action. Adams further argues that neither the dangers nor the rewards that may accrue from risk decisions can be reduced to a single measure, since perceptions and meanings of rewards and dangers will vary according to the perceptions of the decision-makers. Despite the problems, organizations must still make risk decisions. Cox and Tait [31] offer an objective setting model that itemizes the steps an organization might take in managing the safety of work systems (Fig. 11.4). They use the term safety broadly, in the recognition that this model can be used to manage risks in work systems generally. The decision sequence diagram shows how assessment of risks includes reference not only to the system itself, but also to the wider environment. Risks therefore do not exist in isolation, but affect and are affected by the context in which they are situated, and decisions regarding risks encompass the benefits that may come from taking the risk. Copyright © 1999 Taylor & Francis Group LLC

Since risk management at the institutional level is subject to a complex division of labour, the management strategies that are proposed and adopted reflect a wide range of influences. These range from the ‘world views’ of the civil servants responsible for drafting policy documents, to the views of the politicians commissioning the reports, to the views of the public who make up the constituencies of the politicians, and the lobby groups that exert pressure on them. Of course, risk decisions are taken on a daily basis by all members of society, not just by professionals, and not all decision-making about risk involves extensive public debate. In situations where scientific uncertainty is low and the consequences of taking a wrong decision about risk are also low, then debates over risk management usually occur on a purely technical level. Where there is more scientific uncertainty, or the consequences of potential mistakes are higher, then the debate may also move into the realm of managerial competence. Finally, where scientific uncertainty and the consequences of being wrong are both very high, then the question of social values and ‘world views’ comes into play in debates about risk management. The seriousness of the consequences of taking the wrong decision in risk management cases is similarly a matter of contested interpretation. Neither the dangers nor the rewards from risktaking behaviour can be reduced to a single measure, since perceptions and meanings of rewards and dangers will vary according to both qualitative characteristics and the ‘world views’ of individuals. As an example, Adams [7] cites two different measures of road safety: fatality rates and injury rates. These two dangers are qualitatively different and cannot be combined on a single scale. Road safety measures, such as the straightening of roads and improving the cambers on roads, are designed to reduce the potential for accidents; however, at the same time they can have the effect of increasing driving speeds and thus potentially increasing the number of fatalities. There is no objective basis for deciding whether the safety measures are beneficial since there is no single measure that can combine these outcomes and say which represents the most loss or the most gain.

Fig. 11.4 An objective setting model for the ‘safety’ of System X. (Source: [31].)

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RISK COMMUNICATION Fischhoff [32] identifies a number of developmental stages in the study of risk communication beginning with a concern over conveying ‘accurate’ messages about risk to the public and moving on to a concern with the format of risk messages and with the trust that people hold in the institutions promoting messages about risk. It is important to acknowledge that it is not only the content but also the format of communications that has an influence. See, for example, DoH, Communicating about Risks to Public Health, TSO, London, 1999, ISBN 0-113222 57–2. The way in which the potential outcomes of hazards are expressed can affect people’s perceptions of activities significantly. Simply reiterating that adverse events will not occur because of safety features, i.e. conveying quantitative risk ‘accurately’, can actually have the counterproductive effect of causing alarm rather than reassurance. This is because the communication may actually increase the imaginability of the risk to the receivers of the message and they will thus judge it more likely to occur. Public tolerability of risk is determined by the process by which risk decisions are made, the equity of the distribution of risk in society, the trustworthiness and accountability of institutions controlling risk, the voluntariness of personal exposure, and the probability of accidents or injuries occurring. An example of taking such concerns into account in the area of food safety might be that of labelling of food products. This does not reduce risk in the sense of changing the probability of adverse events occurring per se, but has the potential of increasing consumer control over exposure to risk. As ‘voluntariness of exposure’ is an important component of the ‘dread factor’ of risk perception, increasing control over exposure can change the public perception of risk. The political dimension of risk on the other hand is characterized by an absence of general agreement over values. It is therefore vital that the rationale for choices made in risk management is clearly articulated to the public, thus increasing the accountability and trustworthiness of those institutions involved in managing risk [9, 13]. Copyright © 1999 Taylor & Francis Group LLC

The principle of using comparative figures in risk communication strategies has been found to be more meaningful to recipients than using absolute numbers about risk probabilities. However, making comparisons across risks is very difficult given the multidimensional nature of risk perception. Mortality rates are often used as a point of comparison, but this does not take into account either the differential benefits of ‘risky’ activities or the perceived qualitative dimensions of various hazards. The qualitative characteristics of hazards render each hazard unique, and thus comparisons of hazards may not be at all meaningful to lay individuals. Such presentations provide only a small element of the total information that is used by the public in risk-related decision-making [13]. Sandman, Weinstein and Miller [33] examined means of conveying risk magnitudes to the public and found that the presentational format of a ‘risk ladder’ was most effective at explaining the relative magnitudes of risk. Respondents received information about differing levels of radon and asbestos in the home, smoking and other risks in a variety of formats. The response to the location of the hazard on the risk ladder was clearer and more logical than reaction to absolute numbers or to other comparative figures. Risk communication must also focus on the wider social and cultural contexts within which individual messages about risk are formulated and embedded. Suitable approaches acknowledge the complex web through which messages are communicated to the public as well as the cultural ‘world views’ that come into play in the interpretation of messages. Cultural theories of risk suggest that beliefs will determine the way in which evidence about risk is received and interpreted. Evidence that is congruent with beliefs is likely to be accepted, while that which conflicts with beliefs is more likely to be rejected as unreliable, unrepresentative or irrelevant [9]. It is impossible to present risk information in a neutral manner, and thus selecting between different presentational strategies necessarily invokes a goal. This may be either the allaying or the enhancing of people’s concerns over the hazards in question depending upon the ‘world views’ and

political values of those communicating the message. Accordingly, this raises ethical concerns and, as Sandman, Weinstein and Miller [33] note, the boundary between respectful communication and manipulation is ambiguous and contested.

SUMMARY Approaches developed in an attempt to measure and describe risk can be divided into two groups, those that use primarily quantitative methods and those that follow mainly qualitative techniques. Quantitative risk assessment is a risk assessment that incorporates numerical estimates. These may be extensive and complex and may involve an integration of the various risks to provide a single measure of risk from a hazardous agent. They are usually based on predicting the statistical probability of a particular event occurring. In making predictions, evidence from the past is analysed and preventive or protective actions introduced where the potential damage to environment or health is considered great. Qualitative approaches are often criticized as being less precise and based on subjective rather than objective judgements. This criticism is unjustified given that quantitative measures of risk are used as the basis for policy decisions made by individuals or groups applying personal or professional judgements after interpreting the data available. Public perception of risk has varied over time, between cultures and in the light of prevailing economic conditions. There is suspicion of authorities that have taken inadequate action to control risks in the past. Industrial and military operations in particular are seen to have a direct interest in underassessing or underreporting the risk of activities in order to achieve their primary objectives at the least economic cost. The parameters measured are also contentious. It is clearly difficult to equate death rates with less severe social impacts. The aim of risk management is therefore usually to control hazards to a tolerable level in the context of the benefits associated with a particular activity or process. Copyright © 1999 Taylor & Francis Group LLC

As risk knowledge continues to expand, the techniques of risk assessment and reviewing the effectiveness of risk management practices are likely to take on even greater importance in environmental health. Current developments in approaches for the determination of housing fitness in the UK and the proposed mandatory requirement for HACCP in high risk food businesses exemplify this. Policy-makers and enforcement agents must recognize the influences on public risk perception, particularly the impacts of levels of trust in institutions, the relative ability to exert control over sources of risk, and the content and delivery of risk communication messages.

REFERENCES 1. Advisory Committee on Dangerous Pathogens (1996) Microbiological Risk Assessment: An Interim Report, HMSO, London. 2. Risk: Analysis, Perception and Management. Report of a Royal Society Study Group (1992) The Royal Society, London. 3. Department of the Environment (1995) A Guide to Risk Assessment and Risk Management for Environmental Protection, HMSO, London. 4. Department of Trade and Industry (1993) Regulation in the Balance, A Guide to Risk Assessment, HMSO, London. 5. HSE (1995) Generic Terms and Concepts in the Assessment and Regulation of Industrial Risks. Discussion Document, HSE Books, London. 6. Risk Assessment: Report of a Royal Society Study Group (1983) The Royal Society, London. 7. Adams, J. (1995) Risk, UCL Press, London. 8. Pidgeon, N., Hood, C., Jones, D. et al. (1992) Risk perception, in Risk: Analysis, Perception and Management. Report of a Royal Society Study Group, The Royal Society, London. 9. Soby, B.A., Simpson, A.C.D. and Ives, D.P. (1994) Managing food-related risks: integrating public and scientific judgements. Food Control, 5(1), 9–19. 10. Health and Safety Executive (1988) The Tolerability of Risk from Nuclear Power Stations, HMSO, London.

11. Lichtenstein, S., Slovic, P., Fischoff, B. et al. (1978) Judged frequency of lethal events. Journal of Experimental Psychology (Human Learning and Memory), 4, 551–578. 12. Ford, N.J. and Rennie, D.M. (1987) Consumer understanding of food irradiation. Journal of Consumer Studies and Home Economics, 11, 305–320. 13. Slovic, P. (1987) Perception of risk. Science, 236, 280–285. 14. Slovic, P., Fischoff, B. and Lichtenstein, S. (1980) Facts and fears: understanding perceived risk, in Societal Risk Assessment: How Safe is Safe Enough? (eds R.C. and W.A. Albers), Plenum Press, New York. 15. Douglas, M. and Wildavsky, A. (1983) Risk and Culture: an essay on the selection of technological and environmental dangers, University of California, Berkeley. 16. Wynne, B. (1982) Rationality and Ritual: The Windscale Inquiry and Nuclear Decisions in Britain, British Society for the History of Science, Chalfont St Giles. 17. Roberts, H. Smith, S.J. and Bryce, C. (1995) Children at Risk? Safety as a Social Value, Open University Press, Buckingham. 18. Crossland, B., Bennett, P.A., Ellis, A.F. et al. (1992) Report of a Royal Society Study Group. Estimating engineering risk, in Risk Analysis, Perception and Management, The Royal Society, London. 19. Watson, S.R. (1981) On risks and acceptability. Journal of the Society for Radiological Protection, 1(4), 21–25. 20. Lewis, H.W. (1978) Risk assessment review group report to the United States Nuclear Regulatory Commission, NUREG CR 0400, US Nuclear Regulatory Commission, Washington, DC.

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21. Groeneweg, J. (1996) Controlling the Controllable, 3rd edn, DSWO Press, Leiden. 22. EC Directive on the hygiene of foodstuffs 93/ 94/EEC. 23. Gardiner, K. and Falconer, L. (1996) Introduction to occupational health, in Management of Health Risks (ed. L.Falconer), Croner Publications, Kingston upon Thames. 24. Andrews, J.D. and Moss, T.R. (1993) Reliability and Risk Assessment, Longman Scientific and Technical, Harlow. 25. Hensley, G. (1970) Reliability analysis of mechanical equipment and systems. Nuclear Engineering and Design, 13, 222. 26. Kirwan, B. (1994) A Guide to Practical Human Reliability Assessment, Taylor & Francis, London. 27. MAFF (1998) The Food Standards Agency: A Force for Change, Cm 3830, The Stationery Office, London. 28. Tait, J. (1988) Nimby and Niaby: public perception of biotechnology. International Industrial Biotechnology, 8, 5–9. 29. HSE (1993) Successful Health and Safety Management, HS(G)65, HSE Books, London. 30. BS EN ISO 14001 (1996) Environmental Management Systems, British Standards, Milton Keynes. 31. Cox, S.J. and Tait, N.R.S. (1991) Reliability, Safety and Risk Management, an integrated approach, Butterworth Heinemann, Oxford. 32. Fischoff, B. (1995) Risk perception and communication unplugged: twenty years of process. Risk Analysis, 15(2), 137–144. 33. Sandman, P.M., Weinstein, N.D. and Miller, P. (1994) High risk or low—how location on a risk ladder affects perceived risk. Risk Analysis, 14(1), 35–45.

12

Pest control Veronica Habgood

NTRODUCTION The control of pests is a long-established public health function of local authorities. A pest may be defined as a creature that, in a particular situation, is seen as undesirable, whether for health and hygiene purposes, or for aesthetic or economic reasons. Pest control is the term applied to activities designed to identify, reduce or eliminate pest populations in any given situation. Control of pests through local authority intervention is primarily concerned with preventing a risk to public health in whatever situation a pest may be encountered. Diseases caused by bacteria, viruses, protozoa and fungi may be transmitted actively through a bite or a sting, or passively via contaminated food or from contaminated food preparation surfaces and equipment. Insects and rodents are the most common pests associated with risks to public health. Rats and mice have been shown to transmit salmonellosis and leptospirosis (Weil’s disease) to humans; cockroaches and pharaoh’s ants can transmit pathogenic bacteria; fleas and bedbugs may cause infection at the site of a bite, in addition to transmitting pathogenic organisms to a host’s blood. Feral pigeons and seagulls may be carriers of Salmonellae and their presence, particularly close to food premises, is undesirable. Within local authorities, the function of pest control is most often the responsibility of the environmental health service because of the intrinsic link to health and hygiene. The execution of the pest control function, however, varies considerably between local authorities. For many local authorities, Copyright © 1999 Taylor & Francis Group LLC

the pest control function amounts solely to the provision of advice together with the enforcement of the provisions of the Prevention of Damage by Pests Act 1949, the Public Health Act 1936 and the Food Safety Act 1990, and an assortment of minor legislation. Many local authorities have now contracted out their pest control function, although the service is not the subject of compulsory competitive tendering. Others still provide a full advisory and treatment service. The policy on charging for treatments varies between local authorities and with the type of pest infestation.

LEGAL PROVISIONS A miscellany of legislation of direct and indirect relevance to pest control has been produced. Generally, from a public health stance, the legal provisions provide for: • the duties of local authorities • the prevention of risk to health, and nuisance • health and safety in the use and storage of pesticides • applications of relevance to particular pests. The following is a summary of the most relevant provisions in respect of pest control. Prevention of Damage by Pests Act 1949 The Prevention of Damage by Pests Act 1949 is primarily concerned with the control of rats and

mice and the prevention of loss of food through infestation. Infestation is defined as the presence of rats, mice, insects or mites in such numbers or under such conditions that there is a potential risk of substantial loss or damage to food. A duty is placed on local authorities under Section 2 to ensure that their district is kept free from rats and mice. To this end, local authorities are required to: • carry out inspections from time to time; • destroy rats and mice on any land that the local authority occupies, and keep that land free, so far as is practicable, from rats and mice • enforce the provisions of the Act in respect of the duties of the owners and occupiers of land. A duty is also placed on the owner or occupier of land to notify the local authority in writing when substantial numbers of rats and mice are living on their land, excluding agricultural land. The expression ‘substantial numbers’ is not defined. The law essentially places the responsibility for maintaining land free from rats and mice on owners and occupiers. Where local authorities are aware of circumstances where action should be taken to destroy rats or mice on land, or where there is a need to keep the land free from rats or mice, they may serve a notice on the owner or occupier of the land requiring steps to be taken within a reasonable period of time to effect specified treatment, structural repair or other work. The local authority can carry out the work in default of the person(s) on whom the notice was served, and recover the costs. Other provisions of the Act are concerned with infestations in connection with the business of manufacture, storage, transportation or sale of food. These provisions are administered by the Ministry of Agriculture, Fisheries and Food (MAFF), which may delegate powers to the local authority. Further provision in respect of the infestation of food can be found in the Prevention of Damage by Pests (Infestation of Food) Regulations 1950.

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Public Health Act 1936 The provisions of Section s 83–85 of the Public Health Act 1936 deal with action available to local authorities in the case of filthy and verminous premises, articles or individuals. The expression ‘verminous’ includes reference to the eggs, larvae and pupae of insects and parasites. In the case of premises that are considered to be verminous or in such a filthy or unwholesome condition as to be prejudicial to health, the local authority has the power to serve a notice on the owner or occupier of the premises specifying works that are to be effected to remedy the condition of the premises, or to remove and destroy the vermin. Works may be carried out in default of the owners or occupiers with the costs being recovered from them. The application of these powers is not uncommon in many local authorities. Referral may often come from social services departments, which encounter individuals or households in such conditions in the course of their intervention activities. Resolution of many cases requires a firm but sympathetic approach, and the environmental health department working in conjunction with others, such as social services. Some local authorities will employ contractors to effect any work carried out in default; others will have their own ‘dirty squad’. In the case of filthy or verminous articles, similar provisions are available to the local authority to require that those articles be cleaned, purified, disinfected or destroyed, or, if appropriate, removed from the premises to prevent injury or danger of injury to the health of any person. In the case of a verminous person and his clothing, either the local authority or the county council may remove that person, with his consent, to a cleansing station. A court order may be obtained from a magistrates’ court requiring the person’s removal to a cleansing station if he refuses to consent to removal. County councils or local authorities may provide cleansing stations for the purpose of exercising these functions, although many local authorities no longer have access to such facilities within their area.

Public Health Act 1961 Section 37 of the Public Health Act 1961 prohibits any person who trades or deals in household articles (a ‘dealer’) from preparing for sale, selling, offering or exposing for sale, or depositing with any person for sale or preparation for sale any household article known to be verminous. Any household article being prepared for sale, offered or exposed for sale or deposited for sale in any premises can be disinfected or destroyed on or off those premises under the authorization of the proper officer of the local authority.

Food Safety Act 1990 The provisions of the Food Safety Act 1990 are not directly concerned with pests and pest control. However, under Section 8 it is an offence to sell food that is unfit for human consumption or so contaminated that it would not be reasonable to expect it to be used for human consumption. Food contaminated as a result of a pest infestation may therefore be construed as being unfit for human consumption, although each case should be considered individually. The Food Safety (General Food Hygiene) Regulations 1995 make some specific references to the control of pests. In Chapter I of Schedule 1, the layout, design, construction and size of food premises must be such as to protect against external sources of contamination, such as pests; and in Chapter IX of the same schedule, adequate procedures must be in place, generally, to ensure that pests are controlled. Remedial activities can be effected through the service of an improvement notice issued under Section 10 of the Food Safety Act 1990.

Other legal provisions Powers are given to local authorities under Section 74 of the Public Health Act 1936 to deal with nuisance or damage caused in built-up areas through the congregation of house doves, pigeons, sparrows or starlings. No bird that has an owner can be seized Copyright © 1999 Taylor & Francis Group LLC

or destroyed. All reasonable precautions must be taken to ensure that birds are destroyed humanely, and nothing may be done that is contrary to Part I of the Wildlife and Countryside Act 1981. Provisions exist to deal with the presence of rodents, insects and vermin on ships and aircraft, where their presence may be a threat to public health. The Public Health (Aircraft) Regulations 1979 and the Public Health (Ships) Regulations 1979 are applicable in these circumstances. Powers are exercisable by the director of public health, not the local authority environmental health function (see p. 287). Where rats are threatened by or infected with plague, or are dying in unusual numbers, the Public Health (Infectious Diseases) Regulations 1988 require the local authority to report the situation to the chief medical officer for England (or Wales) and to take all necessary measures for destroying rats in its area and to prevent rats from gaining entry to buildings. The Public Health (International Trains) Regulations 1994 make provision for the ‘deratting’ of international trains leaving the UK in the unlikely event that rats from a plague control area are or are suspected of being on board. There is a wide range of other legislation, dealing largely with the control of particular species. These requirements are concerned with ensuring the humane destruction of wild animals, health and safety for pest control operatives and the public, protection of the environment and limitations on the control of certain species.

PLANNED PEST CONTROL Pest control can be expensive, whether it takes the form of the eradication of pests, the provision and maintenance of measures to prevent an infestation, or the implementation of legal controls. Where pests are to be controlled through the application of chemical, physical or biological measures, a planned, co-ordinated approach is essential to maintain health and safety, reduce poor results and prevent the ill-considered choice of pesticide and its associated undesirable effects. Planned pest control can be considered in five stages using the mnemonic RAPID:

• Recognition that an infestation exists, its extent, nature and identification of the species present • Appreciation of all the factors that may influence the effectiveness of the treatment • Prescription of the exact measures that need to be taken, whether proofing, hygiene control or the application of pesticides, together with the relevant health and safety measures • Implementation of the prescribed measures by trained personnel • Determination of the effectiveness of control, and follow-up where appropriate.

Health and safety considerations All pesticides are inherently dangerous, not just to their target organism but also to humans, domestic animals, non-target groups and the environment. Their safe storage, handling and application is therefore necessary. The advertisement, sale, supply, storage and use of any pesticide is only permitted where approval has been given by the relevant minister under the Control of Pesticides Regulations 1986. These regulations were made under Part III of the Food and Environment Protection Act 1985 and are currently under review. Approvals are normally granted for individual products and specified uses. A pesticide may only be used where an approval has been granted and the manner of use specified in the approval. Approvals are reviewed annually by the Advisory Committee on Pesticides, under the auspices of MAFF, and published by MAFF in A Guide to Approved Pesticides. The Food and Environment Protection Act 1985 also makes provision for information about pesticides to be available to the public and for the publication of Approved Codes of Practice for the purpose of providing sound practical guidance. The Pesticides Act 1998 has amended the 1985 Act with regard to the regulation-making powers dealing with powers of entry by enforcement officers. The Approved Code of Practice has no legal status, but failure to have due regard to the advice is admissible in any proceedings against a person under the Food and Copyright © 1999 Taylor & Francis Group LLC

Environment Protection Act 1985. The Control of Pesticides Regulations 1986 additionally require that employers have a responsibility to ensure that employees are trained in the safe, efficient and humane use of pesticides. Persons handling pesticides must also have due regard to the provisions of the Health and Safety at Work, Etc. Act 1974 (see, for example, HSE (1999) Safe Use of Pesticides on Farms and Holdings, A1531, HSE Books, Sudbury, Suffolk), and in particular to the Control of Substances Hazardous to Health Regulations 1994. Training for those handling pesticides should include not only the preparation of formulations for application, but also the relevant health and safety legislation, first aid and emergency arrangements, the handling of pesticide containers within and outside the store, records of stock, its movement and usage. Guidance has been produced by the Health and Safety Commission (HSC) on the correct use and storage of pesticides for non-agricultural use [1]. The document sets out the criteria for the proper storage of pesticides having regard to the quality and type of pesticides being stored. The criteria relate to: • the siting of the store • the adequacy of its capacity • the construction using fire- and corrosionresistant materials • the provision of suitable means of entrance and exit • the capability to contain spillage and leakages • freedom from damp and frost • lighting and ventilation • precautions against theft or vandalism • organization and provision of suitable facilities to accommodate the intended products. Where handling of pesticides takes place, provision should be made for personal protective equipment, personal washing facilities, protective clothing accommodation, storage of empty containers and waste, and suitably designed and equipped preparation areas. Attention must be paid to stock rotation, maintenance and an awareness of potential hazards.

PEST CONTROL THROUGH DESIGN AND CONSTRUCTION The eradication of infestation is an established function of local authorities. Of equal importance is the provision of advice with regard to the design and construction of buildings. This can be an effective proactive tool. Consideration must be given to the risk of infestation according to the use to which a building may be put, the effect of building location and the acceptability of infestation. Any form of infestation in health care premises would pose an unacceptable risk; food premises would be considered high risk; and domestic, detached or semi-detached buildings, low risk. In general, buildings should be designed to prevent access and harbourage, and building materials should be such that they are unsuitable for nesting purposes. Intervention at the planning approval stage, or during the early design stage of renovation work, will enable good practice in design and construction to be adopted. External walls should be designed and constructed so as to ensure that there are no holes greater than 5 mm and that access to any wall cavity that may offer harbourage is prevented. Airbricks should be protected by wire mesh or possess openings smaller than 5mm. Smooth-faced finishes deter climbing. Internal walls, partitions and ceiling cavities should prevent access to other parts of the building and be designed to prevent harbourage. Hollow spaces behind skirting boards, architraves, decorative moulding and panels are to be avoided. The use of silica aerogel within stud partitions will eliminate insect pests through desiccation. Insulation materials may be used for nesting by rodents; rigid foams have shown less susceptibility to damage than semi-flexible foams. When closed, doors should not permit access or a gnawing edge. Doors closing on to a level threshold will ensure this. Self-closing doors are recommended so as to prevent doors being accidentally left open and thus to reduce the opportunity for rodent access. Birds, particularly feral pigeons, can be discouraged from alighting and roosting by ensuring that the number of ledges is reduced to a minimum, and any remaining surfaces are inclined Copyright © 1999 Taylor & Francis Group LLC

at least 45° from the horizontal. Access to roof spaces can be denied through careful attention to design and construction detail. Ductwork, trunking and service pipes can offer easy access to all parts of a building unless they are closely built in or the openings sealed. Widespread infestation by cockroaches or pharaoh’s ants of many system-built buildings may arise through the migration of insects via communal building components and fittings. Of particular concern are district heating systems, where an ideal warm environment that is conducive to the survival of insects is presented. Cables, pipes, sanitaryware and ducting passing into or out of a building should also be tightly fitted to prevent access or egress of insects. A diverse range of pipe and wire rat guards is available to prevent ingress via soil and rainwater pipework. In multi-occupied buildings, communal facilities such as refuse chutes and lifts can provide access to all levels of a building. Rodents may damage the service components through gnawing. In refuse collection bin rooms, food scraps may encourage infestation. A self-closing, tight-fitting metal door, or a timber door with metal kick plates will act as a deterrent.

Food premises Design and construction considerations beyond those described may be applicable in food premises and other high risk buildings. The elimination of voids, the creation of space around fittings, and the coving or splaying of junctions at walls, floors and ceilings will reduce the potential for harbourage and facilitate effective cleaning. Fly screens at windows are effective in preventing the entry of flying insects, but their design must be conducive to effective cleaning and in any case should not permit the entry of other material into a food room.

RODENTS Rodents are mammals with a characteristic gap between their front and back teeth known as the diastema. The rodents most commonly encountered

Rats and mice will readily infest both domestic and commercial premises, particularly where there is stored food. Entry may be gained through poor design, construction and maintenance of the building fabric, or via containers of food when few precautions are taken during the transportation and movement of goods. Stored food may be eaten or contaminated; packaging, the building fabric, fixtures and fittings may be damaged or soiled through gnawing and defecation, causing economic loss and nuisance; and localized subsidence may occur as a consequence of burrowing activity. An infestation may be indicative of poor standards of hygiene and housekeeping, particularly in food premises, coupled with a lack of awareness of suitable preventive measures. Rodents may also be involved in the transmission of disease. Work at the University of Oxford has identified a variety of zoonoses of wild brown rats (Rattus norvegicus) that can give rise to such diseases as Q fever, leptospirosis, listeriosis, typhus, Lyme disease, cryptosporidiosis and toxoplasmosis [2]. Once established with shelter and a supply of food, both rats and mice will readily breed, giving rise to significant populations within a relatively short space of time. Concern has been expressed at recent reports identifying an upward trend in the number of rat infestations in the UK [3]. It has been suggested that a reduction in sewerbaiting, coupled with ageing sewerage and increased use of plastic pipework is contributing to this increase [4].

greyish belly. The tail is thick and shorter than the head and body, and is nearly always pale below and dark above. An adult may weigh on average 340 g. The snout is blunt and the ears small and furry. Droppings may be grouped or scattered and are ellipsoidal or spindle-shaped. The brown rat is a burrowing animal, and will live indoors, outdoors or in sewers. It enjoys both rural and urban environments. It may frequently be found at landfill sites and railway embankments, and possesses climbing and swimming skills. The diet of a brown rat is that of an omnivore but with a preference for cereals and a need for water. It will rarely venture far from a nest site in search of food—up to 660 m in the case of adult males. Foraging for food takes place mainly at night. All brown rats exhibit a cautious reaction to new objects, and this is an important consideration in developing an approach to the control of an infestation. By contrast, the black rat (Rattus rattus) (Fig. 12.1(b)) has a black or dark brown body with a pale, sometimes white, belly. The tail is thin and longer than the head and body. An adult weighs up to 300 g. The snout is pointed, and the ears large, translucent and furless. Droppings are scattered and banana- or sausage-shaped. The black rat is non-burrowing and is rarely found in sewers. It has superior climbing skills. The diet is omnivorous, with a preference for fruit and vegetables. In common with brown rats, a cautious reaction is extended to new objects. The house mouse (Mus domesticus) (Fig. 12.1(c)) is brownish-grey with a thin tail that is much longer than the head and body. Adults weigh up to 25 g. The snout is pointed and the ears small, with fine hairs. Droppings are scattered, thin and spindleshaped. The house mouse rarely burrows but has good climbing skills. It may be found both indoors and outdoors and is ubiquitous. The diet is omnivorous, with a preference for cereals. Behaviour is erratic, and there is a transient reaction to new objects.

Characteristics

Identifying an infestation

The brown rat (Rattus norvegicus) (Fig. 12.1(a)) is generally brownish-grey in colour, with a paler

Evidence of the presence of rats or mice can be established without necessarily sighting an animal.

by environmental health departments are Rattus norvegicus (the brown, common or sewer rat) and Mus domesticus (the house mouse). Rattus rattus (the black or ship rat) is less common in the UK, and its presence may be confined to port areas. Grey squirrels (Sciurus carolinensis) may be of significance in certain areas of the UK.

Public health significance

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Fig. 12.1 (a) The brown rat (Rattus norvegicus); (b) the black rat (Rattus rattus); (c) the house mouse (Mus domesticus). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 139, Fig. 16.1.)

Typical signs, both inside and outside premises, include damage to building materials, packaging and food from gnawing. Tooth marks may be evident, and will help to indicate if the rodent is a rat or mouse: mice tend to nibble from the centre of a grain, rats often leave half grains or small pieces of debris. Holes, which may be the entrance to a nest, will typically be about 80 mm in diameter in the case of rats, and 20 mm in the case of mice. Copyright © 1999 Taylor & Francis Group LLC

holes may appear in the ground or in floors, walls and the base of doors. Footprints may be evident in dusty environments. Rats are creatures of habit and will regularly use the same run from one place to another. The run will exhibit characteristic ‘smear’ marks, as the grease and dirt from the rat’s fur makes contact with surfaces. Outside, soil and vegetation will become flattened. Droppings will These aid identification of the types

of infestation, and whether or not the infestation is current. A soft, wet appearance is indicative of fresh droppings, becoming dry and hard after a few days. Old droppings have a dull appearance.

Control principles Rodents require food, water and shelter to survive. Preventive measures to repel an infestation in the first instance can be achieved through attention to design, construction and maintenance of buildings, in addition to good housekeeping. The latter is especially important in food and other high risk premises. Effective cleaning of all parts of premises and equipment is essential, together with storage of food in rodent-proof containers, maintenance of refuse storage and collection points in a clean condition, and regular inspection of premises for anything that may encourage rodents or offer harbourage. Where an infestation has been established, the use of a rodenticide will be required until control of the infestation has been achieved. Remedial work in the form of repair and proofing, coupled with a revision of hygienic practices will help to prevent reinfestation. Rodenticides are poisons used to kill rodents following a single or multi-dose of poisoned bait. The chemicals most commonly used are anticoagulants, which interfere with the production of prothrombin, which clots blood quickly when blood vessels are damaged. The animals therefore die from internal or external haemorrhaging. Over time, sublethal ingestion of anticoagulants has given rise to resistance to some of the more common formulations, particularly, warfarin. Multi-dose anticoagulants include difenacoum, diphacinone, coumatetralyl, bromadiolone and warfarin; singledose anticoagulants include brodifacoum and flocoumafen. Other rodenticides interfere with the rodent’s metabolism: alpha-chloralose, effective against mice where temperatures do not exceed 16°C, reduces the body temperature, resulting in death from hypothermia; calciferol causes a fatal disruption of calcium metabolism; norbormide interferes with the blood supplying the vital organs. Rodenticides will only be effective if ingested and therefore tend to be combined with a food that is appealing to the rodent. Foods commonly Copyright © 1999 Taylor & Francis Group LLC

used are cereals and grains. Pellets, pastes and sachets containing poisoned bait may also be employed. Rodenticidal dusts spread along runs will be picked up on the feet and fur of passing animals and ingested during preening. The behavioural characteristics of rodents must be taken into account when laying poisoned bait. Locations should be selected carefully, having regard to the evidence of infestation. Laying unpoisoned bait until the rodents are feeding readily will help to overcome a cautious reaction and ‘bait shyness’. Once feeding is established, poisoned bait can be laid. Care should be taken to ensure that humans and other animals cannot gain access to the poisoned bait, and that foodstuffs will not be contaminated. Use may be made of bait trays or boxes. The bait should be checked every two to three days, and topped up according to the manufacturer’s instructions. Untouched bait should be removed. The infestation may take from a few days to three or four weeks to be eradicated, particularly where multi-dose rodenticides are in use. Where no further ‘takes’ have been recorded for a week, it is likely that the infestation has been eradicated, and all bait should be removed. It may be expedient to maintain permanent baiting sites on farmland, or where effective proofing measures are impracticable. Other treatments that may be applied in particular circumstances include trapping and gassing.

Trapping Trapping can be used to eliminate small infestations or as a temporary means of preventing reinfestation. Approved ‘break-back’ traps are recommended. They should be placed on runs or at the entrance to harbourage. Traps have limited application.

Gassing Gassing is used outdoors to kill rats in burrows. Extreme care must be exercised when using this technique. Tablets are placed in the burrows and the exit holes are sealed. On contact with moisture, a gas is liberated, which kills the rats in the sealed

burrow. Hydrogen cyanide, in the form of a calcium and magnesium cyanide mixture, and phosphine are approved for use in the UK.

Control of rats in sewers The practice of sewer baiting to control rat populations in the sewerage system has decreased in recent years. The responsibility for sewer-baiting rests with the sewerage undertakers (water companies) created by the Water Act 1989. Sewerage undertakers make their own arrangements for sewer-baiting; work may be contracted out to local authorities or undertaken by the sewerage undertaker or its subsidiary company. Within the Thames Water area, all but nine local authorities carry out sewer-baiting on behalf of Thames Water Utilities plc. Test baiting may be used to assess the extent of populations and to target treatment. Access to the sewers is gained via manholes. Test bait or poisoned bait is deposited on the benching alongside the invert. Alternatively, where no benching is present or the angle is too steep, a bait tray can be fixed to the side of the manhole. A rope leading from the bait tray to the benching enables rats to reach the bait easily. Usually, one manhole in each direction from an affected area is baited. In many systems, however, infestations are such that all manhole points are baited. See also The Robens Centre for Public and Environmental Health (1998) Rat Control, Underground Drainage and Public Health, The Robens Centre, University of Guildford, Surrey.

proofing measures must take this into account. Destruction of squirrels may be only a temporary measure, since the area is likely to be recolonized. Approved cage and spring traps can be used throughout the year. Poison baiting can be employed both indoors and outdoors, subject to the statutory provisions of the Control of Pesticides Regulations 1986 and the Grey Squirrels Warfarin Order 1973. The traditional method of squirrel control is shooting and drey-poking, which is usually carried out during the winter months.

COCKROACHES There is a large number of species of cockroach throughout the world but only two are commonly found in the UK: Blatta orientalis (the oriental cockroach) is found throughout the UK, usually in warm indoor environments such as restaurants, hospitals, prisons and other institutional premises; Blattella germanica (the German cockroach) favours similar environments, particularly kitchens, bakeries, district heating systems and other warm, moist areas. It is sometimes known as the ‘steamfly’. The life-cycle of the cockroach is one of incomplete metamorphosis. Females produce egg cases (oothecae) that contain eggs. The eggs hatch into nymphs, which resemble small versions of the adult. The life-cycle progresses through a number of nymphal stages, depending on the species, before the cockroaches become fully grown and sexually mature.

Public health significance Grey squirrels Grey squirrels (Sciurus carolinensis) are common residents in urban areas and will give rise to complaints from time to time. The body is about 250 mm long with a 220 mm long bushy tail. The winter coat is grey with a white underside; the summer coat shorter and brownish-grey above. Grey squirrels have no public health significance, but may be a nuisance due to the damage caused to trees, fruits and the fabric of a building. The animals are determined and ingenious, and any Copyright © 1999 Taylor & Francis Group LLC

Both adults and nymphal stages will feed on a variety of organic foods, including food intended for human consumption, refuse and material in drains. Regurgitation of gastric fluids on to food and indiscriminate defecation contaminate fresh foods and surfaces. Scavenging occurs over wide areas, and tends to take place at night. Cockroaches are unable to survive more than a few weeks without a supply of water or high water-content foods. Both the oriental and German cockroach are known to carry pathogenic organisms such as Salmonellae and Staphylococci, although evidence to suggest

transmission of disease is scant. Their presence in premises will frequently give rise to feelings of revulsion, particularly where large numbers are exposed.

Characteristics Blatta orientalis is dark brown to black in colour and 20–25 mm in length. Males and females differ in appearance, the females possessing small, vestigial wings (Fig. 12.2). Males pass through seven nymphal stages, the females, 10. Between five and 10 dark brown oothecae are produced during adult life, each containing about 15 eggs. Adults can live for up to 300 days. The preferred temperature range is 20–29°C. The climbing ability of oriental cockroaches is not particularly effective, and the species is most likely to be found on horizontal surfaces or rough vertical surfaces. By contrast, Blattella germanica is mid-brown in colour with two distinctive dark longitudinal bands in front of the wings (Fig. 12.3). It is up to 15 mm in length. Males pass through five nymphal stages, the females, seven. Between four and eight oothecae are produced during adult life, each containing about 35 eggs. The female carries the ootheca until just before the eggs hatch. Adult males can live for 120 days; the females’ life is much shorter. German cockroaches prefer temperatures within the range 15–35°C, and a relative humidity of around 80%.

Fig. 12.3 German cockroach (Blattella germanica). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 36, Fig. 6.2.)

German cockroaches move quickly and are adept climbers. During the daytime they will seek harbourage on both horizontal and vertical surfaces. Identifying an infestation Since both species of cockroach will not readily emerge during daytime, and night inspection may be impractical, careful observation is necessary to establish the extent of any infestation. Visual evidence will include the presence of egg cases and faecal spotting. A strong sour smell is frequently noticeable. Pyrethrum sprays can be used to ‘flush out’ cockroaches from less accessible areas such as behind equipment, pipework and voids and crevices within the structure. Cockroach traps with a sticky surface can be left out overnight to determine the extent of infestation, and can also be used to monitor the effectiveness of treatment. Control principles

Fig. 12.2 Oriental cockroach (Blatta orientalis). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 41, Fig. 6.3.) Copyright © 1999 Taylor & Francis Group LLC

Preventive measures should be employed to reduce the likelihood of an infestation in the first instance. Consideration should be given to the design, construction and maintenance of the building fabric, paying particular attention to the avoidance of voids and crevices. The adoption of good hygienic practices in food premises will discourage infestation. Thorough cleaning and removal of food debris should be undertaken.

Where an infestation has arisen, successful control will only be achieved through a planned programme of treatment, coupled with the adoption of preventive measures. The favoured method of treatment is through use of a residual insecticide, applied as a spray. The active ingredient may be fenitrothion, carbamates such as bendiocarb and propoxur, and pyrethrins. Boric acid and hydramethylnon may be incorporated in scatter baits or pastes for use in less accessible areas. Residual sprayed insecticides should be applied to wall and floor surfaces and around places likely to offer harbourage, using a suitable spray nozzle configuration. Cockroaches will be readily ‘flushed’ into other areas of a building or adjoining premises. Treatment should therefore commence at the most distant point of the infestation, working towards the centre of it. Dust injection of inaccessible voids may be used additionally. Follow-up treatment is necessary in the case of the oriental cockroach because the oothecae are resistant to the effects of insecticides. A residual effect should be maintained for up to three months after the initial treatment, to control emerging nymphs. Treatment for German cockroaches should consider harbourage areas at height because of their superior climbing ability. Residual insecticides have the disadvantage of dead and dying insects being in evidence. These should be removed and suitably disposed of on a daily basis. In some situations, the use of insecticides is undesirable. Insect growth inhibitors have recently been introduced with some success, particularly in block treatments in system-built premises. Juvenile hormones applied to the nymphal stages

in the cockroach’s life-cycle inhibit metamorphosis into the sexually mature adult, thus preventing reproduction. The treatment may take a number of weeks to be effective.

FLEAS Adult fleas are ectoparasites of warm-blooded animals. They tend to be host-specific, but will readily feed on other species in the absence of their primary host. The number of local authority treatments for fleas has increased greatly in the past 10 years. Most treatments are carried out in respect of the cat flea (Ctenocephalides felis). The human flea (Pulex irritans) is present throughout the UK, but with improved standards of personal and domestic hygiene it is becoming an increasingly rare occurrence. The rat flea (Xenopsylla cheopis) will infest the black rat (Rattus rattus), acting as the vector for plague. Bird fleas (Ceratophyllus spp.) are generally host-specific and rarely feed on human blood.

Public health significance Fleas are known to act as vectors of human disease such as plague and typhus and may transmit the dog tapeworm (Dipylidium caninum). Human and cat fleas, however, are more likely to give rise to an irritant reaction, where bites are scratched and become swollen and infected. The irritation is thought to be due a reaction to the antibloodclotting agent contained in the insect’s saliva.

Fig. 12.4 Cat flea (Ctenocephalides felis). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 80, Fig. 9.3.) Copyright © 1999 Taylor & Francis Group LLC

Characteristics All fleas are laterally compressed, which allows them to move easily through their host’s hair. The hind legs are long and well-developed for jumping and the eye is black and prominent. A row of stiff, backward-facing spines run along the back. Both human and cat fleas are about 2 mm long and dark brown or mahogany in colour. The cat flea can be distinguished from the human flea by the presence of a prothoracic comb (spines) (Fig. 12.4). The life-cycle is a complete metamorphosis. The cat flea lays oval, white, translucent eggs that are about 1 mm long on the hair of the host. These readily fall off on to bedding, carpets and upholstery. After two to three days, the eggs hatch and white larvae, up to 5 mm long, emerge. The larvae feed off animal debris, and the excreta of adults. After three larval stages, lasting up to four weeks, the larvae spin a cocoon and pupate. The adult flea is ready to emerge within a week, but may not do so until the vibration of a passing blood meal is sensed. In this way, fleas can remain dormant in the cocoon for up to 12 months. This explains how heavy infestations of fleas arise in premises that have been vacant for a period of time. The fleas feed on blood from the host. Cat fleas will also feed from dogs, small rodents and humans. In common with the cat flea, the human flea will lay pearly white, oval eggs of about 0.5 mm in length in the clothing or bedding of its host. The larvae, which emerge two or three days later, are white and bristly, and feed on dust, fluff, shed skin, hair, dandruff and faecal pellets of adults. Pupation follows in the same manner as that of the cat flea. The adult flea will remain dormant in the cocoon until a suitable host passes nearby. Human fleas will live on blood from the host, but spend more time on the host’s bedding or clothing, than on the host itself.

Identifying an infestation The fleas may be seen on the host animal or on bedding or clothing. More commonly, humans will be alerted to the presence of fleas as a result of being bitten. The bites of cat fleas tend to be Copyright © 1999 Taylor & Francis Group LLC

confined to the lower legs and ankles, whereas the bites of human fleas tend to be concentrated around the waist and abdomen.

Control principles Both adults and larvae can be readily controlled provided that both the host and the environment are treated. This generally involves the concurrent use of a contact insecticide (e.g. pyrethrin) and an insect growth regulator (e.g. methoprene), together with efficient vacuuming of carpets and upholstery, and replacement or thorough washing of the host’s bedding or clothing. Aerosols containing both a contact insecticide and an insect growth inhibitor are readily available for public use, although many people prefer the infestation to be dealt with by a trained pest control operator.

BEDBUGS Bedbugs (Cimex lectularius) are ectoparasites of humans, feeding largely during night-time on human blood. During the hours of daylight, they inhabit cracks and crevices in furniture, pictures and wallpaper seams.

Characteristics Adults are about 6 mm in length, with flattened bodies and a red-brown coloration when unfed (Fig. 12.5). Their bodies show a rich mahogany colour as they become engorged with blood, growing up to six times their original size following a blood meal. Adults can survive for six months between feeds. A characteristic almond smell and the presence of faecal spotting is evident during an infestation. Eggs are yellowish-white and laid in crevices. A minimum room temperature of 14°C is required before the eggs will hatch; the optimum being about 25°C. The nymphs pass through five developmental stages, each requiring one or more blood meals. The life-cycle is six to seven weeks, but may be considerably longer under adverse conditions.

ANTS Pharaoh’s ants (Monomorium pharaonis) are a yellow-brown colour and approximately 2 mm in length (Fig. 12.6). They are associated with indoor environments, particularly hospitals, prisons, housing estates with district heating systems and other warm institutional premises. Under optimum temperatures (30°C), the ants will breed prolifically and readily form new colonies when the original one is under threat. Workers will scavenge widely in search of food, and may be found in refuse rooms, the vicinity of drains, food rooms, sterile rooms and in hospital wards. Their mandibles are strong enough to chew through packaging and plastics.

Control principles Fig. 12.5 Bedbug (Cimex lectularius) —life cycle. (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.)

Identifying an infestation Infestations are generally associated with areas of social deprivation and poor standards of personal hygiene. However, bedbugs can easily be introduced into any home following the introduction of infested second-hand furniture and other effects. Much stigma is still attached to the presence of bedbugs in a home, although they have not been implicated in the transmission of disease. Bites will tend to be evident on parts of the body exposed at night, and produce swelling, unpleasant irritation and possible secondary infection.

Control is difficult, and colonies may persist for years in some premises. Conventional treatment involves the use of residual insecticidal sprays containing bendiocarb and poisoned baits containing hydramethylnon. Use of such treatments may not affect the queen, who will continue to produce eggs. Juvenile hormone baits containing methoprene are very effective since the growth regulating hormone will be introduced to the nest, sterilizing the queen and suppressing the development of larvae into adults. Treatment must be

Control principles Treatment with a residual insecticide containing pyrethrins will control an infestation. The insecticide should be applied to all surfaces and furniture over which the bedbugs will crawl. Bedding and clothing can be washed and tumble-dried, which will kill bedbugs and eggs; mattresses may be steam-treated at a cleansing station or disposed of. Copyright © 1999 Taylor & Francis Group LLC

Fig. 12.6 Pharoah’s ant (Monomorium pharaonis) (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 99, Fig. 12.3.)

thorough, ensuring that all colonies are subject to control. Effective control may not be achieved for up to 20 weeks. The common black ant (Lasius niger) may be dark brown or black in colour and 3–5 mm in length (Fig. 12.7). It generally lives outside, but may invade buildings in search of food. Although omnivorous, ants have a predilection for sweet foods. Nests may be found by observing the trail of ants. Common nesting sites are around foundations, under paving slabs, the edges of flower beds and lawns, often where there is sandy soil. To control ants, an insecticidal spray or dust containing bendiocarb is effective. Proprietary insecticidal sprays available to the public will only provide temporary relief in heavier infestations.

House flies The common house fly (Musca domestica) has a well-differentiated head, thorax and abdomen and two broad wings. Adult flies are 6–9 mm in length with a 13–15 mm wingspan (Fig. 12.8). The abdomen is grey and black in the male, but more yellowish and black in the female. The female lays 120–150 eggs at a time on organic matter. These are white and about 1 mm long. Within eight to 48 hours the eggs hatch into tiny larvae. These maggots feed voraciously and pass through the three larval stages in a minimum of four to five days. The larvae then pupate, the pupa hardening and changing in colour from yellow through red to brown and finally to black. This stage takes three to five days under optimum conditions, but may take several weeks in cold or adverse conditions. The adult fly is attracted to breeding sites that will provide food and warmth for larvae. Decaying animal and vegetable matter, human and animal faeces and even fresh foods are favoured sites. The lesser house fly (Fannia canicularis) is similar in appearance and lifestyle to the common

Fig. 12.7 Common black ant (Lasius niger) (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 98, Fig. 12.2.)

FLIES The habits and lifestyle of many flies lead to contamination of food and implicate them as carriers of enteric disease. Flies will feed indiscriminately on faeces, rotting food, refuse and fresh foods. Material from these sources will adhere to leg and body surfaces, and may be deposited during a subsequent feeding stop. During feeding, flies regurgitate the contents of their gut over the food, releasing organisms from an earlier meal. Defecation occurs randomly both during a meal and at rest. A number of flies are of public health significance in the UK. Copyright © 1999 Taylor & Francis Group LLC

Fig. 12.8 Common house fly (Musca domestica). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.)

house fly, breeding mainly in refuse and the soil of chicken runs, but not usually travelling between waste matter and human food. Bluebottles or blow flies (Calliphora spp.) are widely distributed. Their life-cycle is similar to that of the common house fly, preferring decaying animal matter, kitchen refuse containing meat or fish, or fresh meat on which to deposit or ‘blow’ eggs. The adult fly is 10–15 mm long, with a 25 mm wingspan, and has a distinctive dark blue shiny body, large compound eyes and a loud buzzing flight. Greenbottles (Lucilia sericata) have a similar life-cycle and habits to those of bluebottles, but are smaller in size, being about 10 mm long, with a coppery metallic green coloration. Flesh flies (Sarcophaga spp.) are larger than blue-bottles and have a grey chequered colouring. They feed on carrion and decaying animal matter, and may be found in the vicinity of dustbins during the summer months, but rarely venture indoors. Fruit flies (Drosophila spp.) are small flies about 2 mm long, with a wingspan of 3–4 mm and a greyishyellow body. They are associated with fermenting matter such as decaying fruit and vegetables, yeasts and vinegar. Large numbers in food premises are a nuisance and may give rise to contamination of food.

appropriate, fly screens can be installed at opening windows. Self-closing doors or the use of heavy duty plastic door strips can prevent flies from entering food rooms. Electronic flying insect killers attract flying insects to an electrified grid with ultraviolet light. The dead insects are caught in a catch-tray, which must be emptied regularly. These devices should not be sited over open food or food equipment. Sticky fly papers have some application in storage and refuse areas, although they may be considered aesthetically unpleasant, and should be changed frequently. Both ‘knock-down’ and residual chemical treatments containing pyrethroids can be applied, although some resistance has been noted. Fly baits based on sugar and incorporating a housefly pheromone and an active ingredient such as methomyl can be successful. To break the life-cycle, a larvicide, diflubenyuron, has been approved for use in fly control. The application of any insecticide in food premises should be used only as a backup to physical controls. Where treatment is carried out, all food and equipment coming into contact with food should be removed or protected from the insecticide and dead insects.

INSECTS OF STORED PRODUCTS Cluster flies Cluster flies can give rise to a nuisance where large numbers congregate around buildings prior to hibernation in the autumn, or on leaving their hibernation in spring. They will use roof spaces or cavity walls for shelter. Common species include the cluster fly (Pollenia rudis), the autumn fly (Musca autumnalis), the green cluster fly (Dasyphora cyanella), the yellow swarming fly (Thaumatomya notata) and the window fly (Anisopus fenestralis).

Principles of control Control is most easily effected through the removal of organic matter and the maintenance of refuse areas in a clean and tidy condition. Drains and gullies should be free from organic debris. Where Copyright © 1999 Taylor & Francis Group LLC

This is a large group of insects comprising beetles, weevils and moths, which readily attack food during manufacture, processing, storage or transportation. All have a four-stage life-cycle, and most damage is done by the larvae who live in the food, contaminating it with waste products and secretions. Adults further contaminate food through excrement, empty pupae and dead bodies. These pests are not vectors of disease.

Beetles The larder or bacon beetle (Dermestes lardarius) is a member of the hide beetle species. It can be a serious pest in food premises. The adult is about 12 mm in length with a dark body and a distinctive light band across the body (Fig. 12.9). Larvae are dark brown and covered with tufts of hair. The larvae will eat any material of animal origin,

Fig. 12.9 Larder beetle (Dermestes lardarius). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 107, Fig. 13.6.)

including meat, bone, hide, fur and wool. Their presence in food premises is indicative of poor hygiene. The flour beetle (Tribolium confusum) and rustred flour beetle (Tribolium castaneum) are commonly found in flour mills and animal feed mills, but will also feed on other stored foods such as nuts, dried fruit and spices. The larvae of these species are almost identical; adults differ in the shape of their antennae. Both beetles may reach 4 mm in length and under favourable conditions can live for 18 months. Adults produce bitter secretions which taint foods. The saw-toothed grain beetle (Oryzaephilus surinamensis) is commonly found in bulk grain stores, but will also attack rice, dried fruits and nuts. The adult is about 3 mm in length and a dull brown colour, with distinctive serrated ridges on the thorax (Fig. 12.10). Larvae are about 5 mm long and pale yellow. Established infestations can be widespread and difficult to control. Flat grain beetles (Cryptolestes spp.) feed largely on cereals and cereal products. Adults are

1.5–3.5 mm long, shiny mahogany brown and have long antennae. The size and flattened shape of these beetles enables them to survive within machinery. Warm environments are preferred, with optimum temperatures of 30–35°C. Species are often found in conjunction with weevils and sawtoothed grain beetles. The biscuit beetle (Stegobium paniceum) is a pest found in both commercial and domestic food stores. Adults are 2–3 mm in length and mid- to dark brown in colour (Fig. 12.11). Infestation can be widespread because of the ability of adults to fly. The preferred food of larvae is cereal products and dried vegetable material such as that found in packeted soup. Larvae have the ability to chew through most packaging. A related species is the cigarette or tobacco beetle (Lasioderma serricorne). This beetle will survive in a similar habitat to the biscuit beetle, but is less common in the UK. In tropical regions, extensive damage may be caused to tobacco and cigars.

Fig. 12.11 Biscuit beetle (Stegobium paniceum). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 102, Fig. 13.1.)

Fig. 12.10 Saw-toothed grain beetle (Oryzaephilus surinamensis). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.) Copyright © 1999 Taylor & Francis Group LLC

The spider beetle (Ptinus tectus) is common in the food industry, infesting grain, flour, spices, dog biscuits, nuts and dried fruits. In the domestic situation it is associated with old birds’ nests and may cause damage to clothing and fabrics. The adult is 2–4 mm in length, mid-brown in colour, and the rounded body is covered in fine hairs (Fig. 12.12). Yellow mealworm beetles (Tenebrio molitor) are usually associated with birds’ nests; when

Fig. 12.12 Spider beetle (Ptinus tectus). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.)

Fig. 12.13 Yellow mealworm beetle (Tenebrio molitor). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.)

found in food premises they are indicative of neglected hygiene practices. Adults may reach 15 mm, and are a shiny dark brown (Fig. 12.13). The life-cycle may take a year to complete. Preference is for cereals or cereal products, but the beetles will scavenge on dead insects, birds or rodents. The dark mealworm beetle (Tenebrio obscurus) is a similar beetle, but less common in the UK. The lesser mealworm beetle (Alphitobius diaperinus) may be found on imported products such as oilseed, rice bran and cereals. It requires warmth and is more frequently found in piggery and poultry units. The grain weevil (Sitophilus granarius) can be recognized by the presence of a prominent snout at the front of the head (Fig. 12.14). Adults are 3–4 mm in length and dark brown to black. Eggs are laid inside grains of cereal and the larva remains in the grain, feeding and pupating, before the adult emerges through a small exit hole. This activity produces large quantities of dust and faecal material known as ‘frass’ and may cause significant economic loss. Infestation can go undetected for a period of time, and can be introduced into new Copyright © 1999 Taylor & Francis Group LLC

Fig. 12.14 Grain weevil (Sitophilus granarius). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.)

areas when grain is moved. The rice weevil (Sitophilus oryzae) and the maize weevil (Sitophilus zeamais) are similar to each other, but can be distinguished from the grain weevil by being less shiny and having four distinct orange patches on the wing cases. They are imported in grain and cereals.

Moths The larvae of a number of species of moth will readily feed on cereals, dried fruits, spices, chocolates and nuts. The warehouse or cocoa moth (Ephestia elutella) is the foremost moth pest of stored food in the UK. A wide range of foods is attacked, including cocoa beans and chocolate products. The larvae will contaminate food through faecal pellets and from trailing strands of silk produced as they move through the food. The silken threads are difficult to remove and in heavy infestations may hang in festoons from packaging. The larvae are creamy white with dark spots on each segment, and are up to 12 mm long. The moths are 14–16 mm long with pale buff or grey wings (Fig. 12.15). The tropical warehouse moth (Ephestia cautella), also known as the almond or dried currant moth, is frequently imported into the UK. The mill moth or Mediterranean flour moth (Ephestia kuehniella) prefers cereals and may be found in flour mills and bakeries. The larval silk may block chutes and choke sieves and milling machinery. The Indian meal moth (Plodia interpunctella) is imported in foods such as peanuts, cocoa beans and dried fruit. The larvae may be

Fig. 12.15 Warehouse or cocoa moth (Ephestia elutella). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 118, Fig. 14.4.)

yellowish and do not have dark spots on the segments. Adult moths have reddish-brown wing tips.

Controlling insects of stored products

Mites

To reduce the spread of an infestation where insects may be inadvertently introduced into premises, good housekeeping practices are essential:

Mites that infest stored products are pale fawn to brown in colour and are not usually visible as individuals without magnification. They enjoy humid conditions and feed on the moulds that form on food products. The flour mite (Tyroglypus farinae) and the cheese mite (Tyrophagus casei) are the most common species. Heavy infestations may give rise to an allergic dermatitis in people handling infested products.

• inspection of incoming goods and separation of new stock from old • effective stock rotation • regular inspection of goods stored for extended periods • frequent cleaning of storage areas and removal of any spillages • maintenance of the building fabric and suitable ventilation, where appropriate.

Copyright © 1999 Taylor & Francis Group LLC

Where an infestation has arisen, insecticides are usually employed. Badly damaged or heavily infested products may have to be destroyed. A sprayed residual insecticide or an insecticidal dust containing an appropriate active ingredient such as pirimiphos-methyl or fenitrothion can deal with an infestation. However, fumigation by trained operators using methyl bromide may be the only satisfactory treatment for some infestations.

Fig. 12.17 Death watch beetle (Xestobium rufovillosum). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.)

WOOD-BORING INSECTS The term ‘woodworm’ is used generally to describe any beetle whose larval stage attacks timber. In all cases, eggs are laid in cracks and crevices of dead wood, fence posts, seasoned wood, door and window frames, structural timbers and furniture. The larvae hatch and burrow into the wood, tunnelling randomly, excreting a ‘bore dust’ or ‘frass’ characteristic of the species. In the final larval stage, a pupation chamber is constructed close to the surface, where the larva pupates. Adult beetles emerge some weeks later and leave the timber through an exit hole. The size and shape of the exit holes and the presence of ‘bore dust’ close to the infested timber will help to determine the species of beetle. The life-cycle can take between two and 10 years, depending on the species. The common furniture beetle (Anobium punctatum) is 3–5 mm in length with a dull medium-brown coloration and a ‘humped’ thorax (Fig. 12.16). It leaves exit holes of about 2 mm in diameter. This beetle is widespread in the UK and may cause extensive damage, seriously threatening the structural integrity of floors and roof timbers and ruining the appearance of furniture. The death watch beetle (Xestobium rufovillosum) is 5–9 mm long and has a dark brown mottled appearance (Fig. 12.17). The life-cycle

Fig. 12.16 Common furniture beetle (Anobium punctatum). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.) Copyright © 1999 Taylor & Francis Group LLC

may take up to 10 years to complete, and the emerging adult leaves exit holes about 4 mm diameter. This beetle is found in the southern twothirds of the UK, and favours hardwoods such as oak and willow. Serious structural weakening can occur over a period of time. The powder post beetle (Lyctus brunneus) (Fig. 12.18) is about 6 mm long and leaves exit holes about 1 mm in diameter. It commonly feeds on the sapwood of felled hardwoods and produces large quantities of powder from the timber. The house longhorn beetle (Hylotrupes bajalus) (Fig. 12.19) is about 16 mm long and leaves oval-shaped exit holes of about 3 mm by 6 mm. It will infest seasoned softwoods and can cause extensive structural damage during its four to five year lifecycle. Two wood-boring weevils (Pentarthrium huttoni and Euphyrum confine) will also attack timber, particularly that which has been damaged through fungal action. Adult weevils are 2.5–4.5 mm long and dark brown in appearance, with a typical

Fig. 12.18 Powder post beetle (Lyctus brunneus). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 112, Fig. 13.11.)

OTHER PESTS OF PUBLIC HEALTH SIGNIFICANCE Feral birds

weevil ‘snout’. Exit holes are similar in size and shape to those of Anobium punctatum. The lifecycle can take eight months to complete. The adult weevils are commonly found in basements, cellars and other subground floor areas of buildings.

The presence of large numbers of pigeons (Columba livia var) or starlings (Sturnus vulgaris) in urban areas frequently gives rise to complaints of nuisance. Fouling of pavements and buildings where the birds roost and nest, noise and the blockage of gutters and rainwater pipes with feathers, nests and dead birds are common complaints. There is little evidence to substantiate the claim that these birds transmit disease to man, although pigeons have been shown to be infected with ornithosis and salmonellosis. Pigeons, in particular, may gain access to food premises, contaminating food and machinery.

Control principles

Control principles

Infestation can be prevented through the use of timbers that have been impregnated under pressure with a residual insecticide. Surface treatments will discourage females from laying eggs but will have no effect on larvae in the timber. Frequent examination of older, stored furniture will enable early recognition of an infestation and permit remedial and preventive action to be taken. In all cases of infestation by wood-boring insects, treatment should be carried out by specialist personnel. Unsound structural timbers may need to be removed and destroyed, and replaced with sound, seasoned timbers treated with a residual insecticide. Treatment of timber or furniture in situ generally involves the application of a residual insecticide by brushing, spraying or injection. Lindane has routinely been used in the past, but there has been a move towards photostable pyrethroids such as permethrin and cypermethrin. Small infested items can be fumigated using methyl bromide.

Pigeons are attracted to urban areas by the presence of food dropped deliberately or accidentally by the public. Limiting the availability of food through a prohibition on feeding of pigeons and strict regulation over the storage and collection of refuse containing food waste will go some way towards discouraging these birds. Under the Wildlife and Countryside Act 1981, both pigeons and starlings may be taken or killed by authorized persons, provided that approved methods are used. Trapping is effective for pigeons, but less so in the case of starlings. A number of suitable designs are available. All permit birds to enter the trap freely, but deny exit. The traps may be placed on the ground but in urban areas they are more commonly put on the flat roof of low rise buildings. Bait, usually a mixture of maize and wheat or a proprietary mix, is placed inside and outside the trap. Water should also be provided inside the trap. The trap should be left open for a period of about a week to allow the birds to become accustomed to its presence. When the birds are feeding freely, the trap is closed. The trap should be checked daily and all unringed birds humanely destroyed, usually by cervical dislocation. Ringed birds should be returned to their owners.

Fig. 12.19 House longhorn beetle (Hylotrupes bajalus). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.)

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Stupefying or narcotic baits approved for use under the Food and Environment Protection Act 1985 can be used in urban areas, but may present a public reaction if unconscious or dying birds are evident. Pre-baiting is carried out for up to 28 days, after which alpha-chloralose is added. Narcotized bait is usually laid before dawn and left for a few hours before being cleared away. A search must then be made for all affected birds. Ringed birds and non-target species should be allowed to recover; pigeons should be destroyed humanely. Repellents and scaring devices can be employed to prevent roosting and perching on buildings. Netting can be applied to buildings, but will only be viable if the mesh size is suited to the size of the bird. Gels can be applied to ledges and windowsills. Over time, however, their performance is impaired by birds attempting to land and flattening the gel or covering it with droppings. Spring-tensioned wire positioned around ledges is really only suitable for pigeons. Acoustic methods of scaring include sirens, ultrasound and recordings of the distress calls of the target species. Some success has been claimed using birds of prey. Shooting can be used effectively for small numbers of birds, but is likely to give rise to an adverse public reaction.

Control principles Control may be exercised through the cutting out and burning of the overwintering tents of the larvae between November and March. Alternatively, insecticidal sprays can be applied in mid-September or mid-May. Sprays based on permethrin, trichlorophon or diflubenzuron may be approved for control of these moths.

Carpet beetle The carpet beetle (Anthrenus verbasci) is found in domestic premises in carpets, clothing, stuffed specimens, animal furs and skins, and may be associated with birds’ nests. The adult beetles are 1.5–4 mm long, with dark bodies, mottled with patches of lighter coloration, giving rise to distinctive wavy patterns (Fig. 12.20). The larvae are segmented and dark in colour, with tufts of bristles that give them the common name ‘woolly bear’. The larvae cause extensive damage to nonsynthetic fabrics and animal fur and skins. Adults feed on pollen and nectar.

Brown-tail moth The brown-tail moth (Euproctis chrysorrhoea) may give rise to localized concern among the public and tends to be confined to the southern part of the UK. The adult is of no public health significance; the larvae, however, are covered in fine hairs, which can cause severe irritation and skin rash. The caterpillars emerge from the silky tent in which they have hibernated in April/May, and feed on fruit trees, blackthorn, hawthorn and oak. The larvae are covered in thick tufts of brown hair with two white lines of hair tufts on their backs and two orange warts. The hairs are easily detached and can make contact with human skin. Many of the hairs are barbed and resist washing and brushing off. Hairs in the eyes can cause serious discomfort. The larval stage is usually completed by June. Copyright © 1999 Taylor & Francis Group LLC

Fig. 12.20 Carpet beetle (Anthrenus verbasci). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 103, Fig. 13.2.)

Control principles Control involves the removal and destruction of heavily infested materials, together with thorough vacuuming. A residual insecticide containing

fenitrothion, bendiocarb or permethrin, may be applied.

Clothes moths The term ‘clothes moth’ is applied generally to species of moth that commonly damage natural products of animal origin such as wool, fur and feathers. The three common species are the common clothes moth (Tineola bisselliella) (Fig. 12.21), the brown house moth (Hofmannophila pseudospretella) and the white-shouldered house moth (Endrosis sarcitrella). All adult moths are 8–10 mm long, shun light and are not strong flyers. The larvae are white, and through feeding cause holes and damage to blankets, clothing and carpets.

adult beetle is about 5 mm long and black, with distinctive white spots: one on each of the wing cases, and three at the base of the prothorax (Fig. 12.22). The larvae may be up to 12 mm long with a long ‘tail’ of silky hairs. Control is the same as that for carpet beetles.

Fig. 12.22 Fur beetle (Attagenus pellio). (Source: LGMB (1992) Pest Control: a reference manual for pest control staff; invertebrates, LGMB, Luton, p. 68.)

Lice

Fig. 12.21 Common clothes moth (Tineola bisselliella). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.)

All lice have well-developed mandibles for biting and piercing skin, enabling them to suck the blood of their host. Three lice are of public health significance: the head louse (Pediculus humanus capitis), the body louse (Pediculus humanus corporis) and the crab or pubic louse (Phthirus pubis).

Control principles Characteristics Control is achieved through careful storage of articles with naphthalene crystals or mothballs. Dichlorvos strips can be used in enclosed situations. A residual insecticide can be applied to the structure of premises, or to packaging, where approved for use. Where an infestation has occurred, heavily infested articles should be removed and destroyed.

Fur beetle The fur beetle (Attagenus pellio) lives in birds’ nests and is frequently found in the domestic situation. The life-cycle and habits of this beetle are similar to those of the carpet beetle. In appearance, however, there are differences. The Copyright © 1999 Taylor & Francis Group LLC

Head and body lice are 2–4 mm in length and pale grey to light brown in colour. The crab louse is about 2 mm in length and greyish. All lice are darker in colour following a feed. Head lice (Fig. 12.23) are widely found in the UK and primarily affect children. Despite their prevalence, there is still much embarrassment associated with an infestation. Eggs are laid at the base of the hair and hatch, leaving the pale-coloured egg casing, known as a ‘nit’ on the hair. The nymphs feed on blood until sexual maturity. Transmission is through physical contact. Body lice live in the clothing of the host, moving to the host to feed. Survival is reliant on the same clothing being worn at no more than three day

is available on http://ww.wilts-ha.swest.nhs.uk. In the case of body lice, infested clothing should be destroyed or disinfested at a cleansing station.

Mosquitoes About 30 species of mosquito are present in the UK, occupying different aquatic habitats such as coastal salt waters, brackish inland waters, stagnant ponds and water-filled hollows in trees and logs. The two main mosquito groups in the UK are the anophelines and the culicines. In general, all have Fig. 12.23 Human louse (Pediculus humanus capitis). (Source: Burgess, N.R.H. (1990) Public Health Pests, slender bodies, long legs and a well-developed proboscis. The length of the body is dependent Chapman & Hall, London.) on the species, but will range from 7 to 15 mm (Figs 12.25 and 12.26). intervals. Transmission is via infested clothing or physical contact. Body lice may transmit typhus, trench fever and relapsing fever. Crab lice (Fig. 12.24) favour the coarser body hair found in the pubic areas and armpits, and spread through intimate contact. All lice will cause irritation, and scratching may give rise to secondary infection. Fig. 12.25 Anopheline mosquito. (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 71, Fig. 8.4.)

Fig. 12.24 Crab louse (Phthirus pubis). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 92, Fig. 11.2.)

Fig. 12.26 Culicine mosquito. (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London, p. 71, Fig. 8.4.)

Control principles Characteristics Control of head and crab lice can be achieved through application of insecticidal shampoos or lotions containing malathion or carbaryl. In 1998 a working group convened by the Public Health Medicine Environment Group produced a goodpractice document on the control of head lice. It Copyright © 1999 Taylor & Francis Group LLC

Eggs are laid on water, and hatch within a few hours. The larvae will breathe oxygen by moving to the surface of the water. The larvae feed on organic matter and micro-organisms in the water or on the surface. After four larval stages, a larva

pupates, forming a comma-shaped pupa which can propel itself using paddles at the bottom of the abdomen. The adult mosquito emerges from the pupa on to the surface of the water. Only females bite and suck blood; the males feed on the nectar of flowering plants. Females are attracted to a host by heat and exhaled carbon dioxide. A blood meal is required before viable eggs can be laid. During feeding, a small amount of anticoagulant saliva will be injected into the host to prevent the blood from clotting. The irritation, swelling and erythema associated with a mosquito bite is an antibody reaction to this anticoagulant.

of methoprene, the insect growth regulator, and a biological control agent, the bacterium Bacillus thuringiensis israelensis, have been used for larval control in developed countries. Adult mosquitoes can be eliminated using ‘knockdown’ agents or residual insecticides. Handheld aerosols can be used in a domestic environment. Individual protection can be achieved through the application of suitable insect repellents to exposed parts of the body or the use of mosquito coils or candles containing citronella to deter the insects. In tropical areas, sleeping accommodation can be protected by a mosquito net impregnated with a suitable insecticide. Windows and doors can be fitted with mosquito proofing.

Public health significance The mosquito has significant public health importance in tropical and subtropical regions, the female being the vector of malaria, yellow fever, filariasis, dengue fever and forms of viral encephalitis. In temperate regions the effect of a mosquito bite causes discomfort and possible secondary infection as a consequence of scratching. No link has been established between the transmission of the human immunodeficiency virus (HIV) and a mosquito bite.

Plaster beetles Plaster beetles (Lathridiidae spp.) are small dark brown beetles 1.5–2.5 mm long that have a predilection for damp and humid conditions (Fig. 12.27). They can be significant when infestation occurs in food premises. Control over humidity or removal of damp conditions will remove any problems, although a residual insecticide can be applied.

Control principles Effective mosquito control relies on knowledge of the species involved. However, in general, mosquito control should be aimed at both the larval and adult stages of the life-cycle. Breeding sites can be removed through emptying natural or manmade containers of water, draining puddles, ditches and small pools, and channelling water to increase the flow. The larval stages can be eliminated in a number of ways. The application of an agent such as light oil or lecithin will reduce the surface tension of the water, preventing the larvae from obtaining oxygen. These agents spread readily over a large area, and can be applied aerially. Consideration must be given to the ecological effect. Larvicides containing permethrin, pirimiphos-methyl or chlorpyrifos, which are applied to breeding sites, do not have approval for use in the UK. The use Copyright © 1999 Taylor & Francis Group LLC

Fig. 12.27 Plaster beetle (Lathridiidae spp.). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.)

Psocids Psocids or booklice (Psocoptera spp.) are generally found in high humidity situations where they feed on moulds. Damp wallpaper, book bindings and food packets are favoured, and damage may occur where significant numbers are present. These insects are

1–1.5 mm long, wingless and greyish in colour, although the colour may reflect their food. Infestations spread readily through the movement of infested books or foodstuffs. Their presence in domestic situations frequently gives rise to complaints.

Control principles Control can be achieved through improving hygiene and environmental conditions. Infested food packets should be destroyed and storage areas treated with a residual insecticide.

Silverfish Silverfish (Lepisma saccharina) are commonly found in damp situations such as bathrooms, kitchens and pantries. They may be up to 20 mm long, with carrot-shaped wingless bodies and three bristly tails (Fig. 12.28). The colour is a silvery-grey. They feed on protein-rich gums and binding pastes in books and packeted foods, wallpaper paste and fine textiles. The life-cycle may take up to a year to complete. Silverfish are of no public health significance, although severe infestations may be a nuisance. Firebrats (Thermobia domestica) are similar to silverfish, but require a warm, dry environment and have a preference for starchy foods.

Wasps The common wasp (Vespula vulgaris) is frequently found nesting in roof spaces, cavity walls, trees or in the ground. Nests are constructed each year from chewed wood pulp, which is converted into a paper-like substance and formed into many cells within an outer layer. The nest will be expanded during the season to accommodate the growing colony, which may reach many thousands. The wasps seen outside the nest are workers. They are 10–20 mm in length, with a distinctive yellow and black banding and a ‘waspwaist’ (Fig. 12.29). As cold weather approaches, the new queens find a suitable place for overwintering and the rest of the colony dies. The queens emerge from hibernation in spring and form new colonies. Wasps are usually a nuisance in late summer when the workers forage for sweet substances and, if provoked, will sting.

Fig. 12.29 Common wasp (Vespula vulgaris). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.)

Control principles

Fig. 12.28 Silverfish (Lepisma saccharina). (Source: Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.)

Control principles Control of silverfish and firebrats can be achieved through attention to hygiene or the application of residual insecticides based on synthetic pyrethroids, carbamates or organophosphates. Copyright © 1999 Taylor & Francis Group LLC

Control is effected through the application of insecticidal dust at the entrance to the nest. Workers will then carry the insecticide into the nest, spreading it to other wasps in the colony. Pyrethroids tend to excite wasps, and active ingredients such as carbaryl, bendiocarb and iodofenphos are generally used. Operatives should be protected against aggressive behaviour by wasps if the nest should be disturbed. Care must be taken to avoid treatment having an effect on beneficial wasp and bee species. General application of residual insecticides to loft spaces may present a risk to bats.

ACKNOWLEDGEMENTS

FURTHER READING

Many thanks to Dr Burgess and Helen Hadjidimitriadon, the artist, for their kind permission to reproduce some of the drawings from Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London.

Bassett, W.H. (1998) Environmental Health Procedures. 5th edn, E. & F.N.Spon, London. British Standards Institute (1992) BS 5502:1992, Buildings and Structures for Agricultural Use Part 30: Code of Practice for Control of Infestation. Building Research Establishment (1996) Reducing the Risk of Pest Infestations in Buildings, BRE, Aylesbury. Burgess, N.R.H. (1990) Public Health Pests, Chapman & Hall, London. Cornwell, P.B. (1979) Pest Control in Buildings: a guide to the meaning of terms, 2nd edn, Hutchinson, London. Judge, L. (1996) The brown-tailed moth (Euproctis chrysorrhoea). The Safety and Health Practitioner, May, 22–23. Kettle, D.S. (1990) Medical and Veterinary Entomology, CAB International, Wallingford. Local Government Management Training Board (1992) Pest Control: a reference manual for pest control staff, LGMB, Luton. National Britannia Library (1998) Insect Pests of Food Premises, National Britannia Ltd, Caerphilly. Munro, J.W. (1966) Pests of Stored Products, Hutchinson, London. Saul, H. (1996) Year of the rat. New Scientist, 2050, 32–38. Sprenger, R.A. (1991) Hygiene for Management, 5th edn, Highfield Publications, Doncaster. Various information papers and monographs produced by the Building Research Establishment and the Ministry of Agriculture, Fisheries and Food.

REFERENCES 1. Health and Safety Commission (1991) The Safe Use of Pesticides for Non-Agricultural Use: Approved Code of Practice, HMSO, London. 2. Webster, J.P. (1996) Wild brown rats (Rattus norvegicus) as a zoonotic risk on farms in England and Wales. Communicable Disease Report, 6(3), R46–R49. 3. Meyer, A.N., Shankster, A., Langton, S.D. and Jukes, G. (1995) National commensal rodent survey 1993. Environmental Health, 103(6), 127–135. 4. Pond, K. and Battersby, S. (1997) Time for the piper: rat infestations in sewers. Environmental Health, 105(7), 183–185.

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13

The control of dogs Veronica Habgood

INTRODUCTION The UK may be considered to be a nation of animal lovers, but an increased number of dogs, particularly in urban areas (for example, an estimated 700000 dogs live in London [1]), and a heightened public awareness of the health and aesthetic issues arising from a lack of control by owners over their animals has led in recent years to an increasing number of complaints to the police and local authorities. The major issues relate to stray animals, dangerous dogs, fouling in public places, and noise nuisance from barking dogs. During the 1990s, the government has been put under pressure to strengthen the legislative measures in respect of dogs. The resulting law has introduced new powers and responsibilities for local authorities and a need for close co-operation between local authorities, the police and animal welfare organizations. Within local authorities, it is frequently the environmental health service that has responsibility for matters concerning dogs.

CONTROL OF STRAY DOGS It is estimated that on any day in the UK there can be up to 500000 uncontrolled dogs on the streets; at least 200000 are registered each year as strays [2]. These dogs can cause road accidents, kill or maim livestock, bite or attack members of the public, and deposit tonnes of excrement daily. Copyright © 1999 Taylor & Francis Group LLC

The problems associated with stray dogs have been recognized in statute law since 1906, when the Dogs Act 1906 placed a duty on the police to accept and detain any stray dog taken to a police station by a member of the public. Additionally, both the police and local authorities have exercised their discretionary powers in rounding up and dealing with strays. The Local Government Act 1988 offered local authorities discretionary powers to seize and destroy stray dogs. Following this, many local authorities established a dog warden service. The provision of such a service was, however, discretionary and complementary to that provided by the local police. Arrangements for kennelling, and charges for kennelling and, where necessary, destruction, varied among local authorities along with their relationship with the police, voluntary organizations and private kennels. Increasing public concern about issues relating to dogs, together with the perceived success of local authorities operating a discretionary scheme, culminated in new statutory duties for local authorities in respect of stray dogs under the Environmental Protection Act 1990. These provisions became enforceable on 1 April 1992, since when the police have no longer exercised their discretionary powers in rounding up strays. Members of the public are still able to take stray dogs to a police station, pursuant to the Dogs Act 1906, however.

Environmental Protection Act 1990, Sections 149–151 Every local authority is required to appoint an officer whose function is to administer the duties required under the Environmental Protection Act 1990. These duties can be discharged through the appointment of dog wardens, who will be responsible for day to day activities in connection with the seizure and detention of stray dogs. Dog wardens may be local authority employees or contractors. When a dog that is believed to be a stray is found in a public place, the officer has a duty to seize and detain the animal. If the dog is on private land, the officer must receive the consent of the owner or occupier of the land before seizing the dog. The term ‘stray dog’ is not defined, but implies that there is no person in charge of the dog for the time being. A duty is placed on any person who finds a stray dog to return it to the owner or take it to the police or local authority, where particulars of the dog and the name and address of the finder will be taken. The person finding the dog may keep it for at least one month, or hand it over to the local authority or police to be dealt with. Where the owner of the dog can be identified through information on a collar tag or microchip implant, the officer must notify that person by notice that the dog has been seized and where it is being held. The notice must give the person seven days to collect the dog and pay the necessary charges, otherwise the dog is liable to be disposed of or destroyed. A public register containing prescribed particulars of seized dogs is required to be kept by the officer. Such particulars, prescribed in the Environmental Protection (Stray Dogs) Regulations 1992, include a brief description of the dog, including any distinguishing characteristics; information recorded on the collar and tag; the date, time and place of seizure; date and service of any notice; the name and address of any person claiming to be the owner to whom the dog was returned; and the date of return. Where the dog is disposed of, the register must also record: the date of disposal; the method of disposal Copyright © 1999 Taylor & Francis Group LLC

(destruction, gift or sale); the place of sale and the price fetched; and the name and address of the person receiving, purchasing or effecting the destruction of the dog. Seized dogs may be detained in kennels provided by the local authority or a voluntary organization, or private kennels with an arrangement with the local authority. Arrangements must be made for receiving and dealing with dogs found or reported outside usual working hours. The charge to the owner on collection of a stray dog is based on the cost per day of kennelling the dog together with a sum of £25, prescribed by the Environmental Protection (Stray Dogs) Regulations 1992. There is no automatic entitlement to the return of a dog unless the full amount is paid; however, local authorities do have the discretion to determine that a dog be returned to the owner without full payment of the costs. Dogs must be kept for a minimum of seven days following seizure or service of a notice on the owner, whichever is the longer. Dogs that are injured or in poor health can be destroyed before the end of seven days to avoid suffering. In this instance, the advice of a veterinary surgeon should be sought. Following the seven-day detention period, if a stray has not been reclaimed the officer must determine the most appropriate means of disposal. The local authority may make its own arrangements for selling or giving the dog to a person who, in the officer’s opinion, will care for the dog properly, or, commonly, may have an arrangement with a voluntary organization, which will attempt to find a suitable owner. Any person who has purchased or received a dog in good faith has the ownership of that dog vested in him such that the original owner has no rights to reclaim the dog. Alternatively, the dog may be destroyed in a humane manner. The cost to local authorities of exercising their duties in respect of the control of stray dogs will vary, depending on the arrangements made for the appointment of dog wardens and kennelling. Estimates of the direct cost of these functions were made in a Department of the Environment survey in 1991 [3], and ranged from £23000 per annum in a mixed urban-rural district council, to £205000 in a city council area. Guidance to local authorities

on dealing with stray dogs has been produced by the Association of District Councils [4].

Control of Dogs Order 1992 This Order, made under the Animal Health Act 1981, requires every dog on a public highway or in a place of public resort, to wear a collar that has the name and address of the owner inscribed on it or on an attached plate or badge. Some exceptions are provided for, including: dogs registered with the Guide Dogs for the Blind Association, dogs used in emergency rescue work, dogs being used by the armed forces, police or Customs and Excise, and dogs used for sporting purposes. Any dog found on a highway or in a public place without a collar may be seized and treated as a stray pursuant to the provisions of Section 3 of the Dogs Act 1906 or Sections 149– 151 of the Environmental Protection Act 1990.

Identification of stray dogs Traditionally, stray dogs have been identified through information contained on a collar tag, but there is increasing support for the use of microchip implants. Not only does this provide a permanent means of identification, it also helps to overcome breeding fraud. Microchipping has increased significantly in the UK [5], and is also the method preferred in some European countries and for certain ‘dangerous’ breeds worldwide. A standard has been developed by the International Standards Organization (ISO) governing identification marking by microchips (ISO 11784). Both the National Canine Defence League and London’s Battersea Dogs’ Home report an increased number of strays being returned to their owners as microchipping becomes more widespread [1, 5].

DANGEROUS DOGS A number of well-publicized incidents involving attacks by certain breeds of dogs has led in recent years to a tightening in the legal controls in respect Copyright © 1999 Taylor & Francis Group LLC

of ‘dangerous’ or ‘vicious’ dogs. Similar controls have been introduced elsewhere in the world, e.g. in Singapore [6] and Canada [7]. Until 1991, the law concerned with controlling attacks on the public existed within the Dogs Act 1871, which was concerned with dogs that were dangerous and not kept under proper control, and the Town Police Clauses Act 1847, which made it an offence for a ferocious dog to be at large. In 1989, these provisions were extended by the Dangerous Dogs Act 1989. This provided for the making of a court order requiring that a dog be handed over for destruction and the owner disqualified from keeping a dog in the future if a dog was deemed to be dangerous and not being kept under proper control.

Dangerous Dogs Act 1991 This Act provides for even more stringent control. Section 1 applies to certain prescribed breeds of dog bred for fighting or possessing the characteristics of a type of dog bred for fighting. To date, the breeds prescribed are: • • • •

pit bull terrier tosa (Japanese fighting dog) dogo Argentino fila Braziliero.

The provisions of the Act are enforced by the police or an authorized officer of the local authority. Additionally, the local authority role in controlling stray dogs will inevitably bring them into contact with prescribed breeds. The Act prohibits the breeding, sale, exchange, offering as gifts, or importation of prescribed dogs. Furthermore, no one is permitted to have one of these breeds in his possession unless it has been exempted. Exempted dogs are registered and the owners issued with a certificate of exemption. To gain a certificate of exemption, an owner must arrange for the dog to be neutered, permanently implanted with a transponder/microchip implant, tattooed with the dog’s exemption reference number, covered by third party insurance, kept in secure conditions at home and muzzled and

held on a lead by someone aged at least 16 years when in a public place. Additionally, the owner must provide the police with the name, age and gender of the dog, together with the address at which the dog is kept. The transponder is implanted in the scruff of the dog’s neck and an electronic reading device passed within 100–1300 mm of the transponder will produce a digital display that will uniquely identify the dog on the Index of Exempted Dogs. The tattoo is the most simple means of determining whether or not a dog has been exempted, but in circumstances when this is difficult to read, the transponder comes into its own. The difficulty in relying on tattoos has been acknowledged in Sweden, where there is now a move away from tattooing towards microchipping [5]. The Index of Exempted Dogs is administered by a contracted private company that can be contacted by the police or local authority.

Identification of prescribed breeds One of the major difficulties encountered by those concerned with the legislation is the identification of the prescribed breeds, particularly, the pit bull terrier and dogs with pit bull terrier characteristics. In 1992, the then Department of the Environment (DoE) estimated that there were between 5000 and 10000 pit bull terrier types in the UK [8]. The DoE has provided guidance [8], and the Royal Society for the Prevention of Cruelty to Animals (RSPCA) has a small number of qualified expert witnesses. Standards laid down by the American Dog Breeders’ Association includes reference to behavioural characteristics in the identification of dangerous dogs [9]. A High Court ruling in 1993 [10] determined that these behavioural characteristics could be taken into account during any proceedings to confirm whether a dog fell within the prescribed description. The onus of proving that a dog is not a prescribed breed or exhibits characteristics of a prescribed breed rests with the plaintiff. The difficulty in positively identifying a prescribed breed has led to a series of appeals and dogs being kept kennelled at police or local authority expense for periods in excess of 15 months. Copyright © 1999 Taylor & Francis Group LLC

‘Specially dangerous dogs’ Provisions also exist by virtue of the Dangerous Dogs Act 1991 for the Secretary of State to make an order in respect of other ‘specially dangerous dogs’. The order will apply certain requirements in respect of the need for such dogs to be kept on a lead and muzzled in a public place, and prohibit such dogs from being abandoned and being allowed to stray. No orders have yet been made. The Secretary of State can also prescribe the kind of muzzle to be used. In all events it must be sufficient to prevent a dog biting a person. To date, no such muzzles have been prescribed, although reference can be made to British Standard 7659:1994—Dog Muzzles.

Dogs dangerously out of control Any dog that is dangerously out of control in a public place is dealt with under Sections 4 and 4A of the Dangerous Dogs Act 1991. Proceedings may be taken against the owner or person temporarily in charge of the dog. ‘Dangerously out of control’ means that there are grounds for reasonable apprehension that the dog will injure a person, whether or not it actually does so; and ‘public place’ means any street, road or other place (whether or not enclosed) to which the public has or is permitted to have access for payment or otherwise. An aggravated offence is deemed to have been committed where the dog injures any person. Provisions to deal with vicious attacks by dogs exist in the law of many countries, e.g. in British Columbia in Canada [7] and Washington County, Oregon, in the USA [11]. In the case of a dog that is allowed to enter a place that is not a public place and where it is not permitted to be, e.g. a private garden, the owner or person in charge of the dog is guilty of an offence in the case where there are reasonable grounds to suspect that the dog will injure someone, or is guilty of an aggravated offence in the event that the dog causes actual injury. An aggravated offence may be dealt with summarily or on indictment, and carries a more severe penalty than a non-injury offence.

Seizure of dangerous dogs

DOG WARDENS

Powers are available under Sections 4 and 5 of the Dangerous Dogs Act 1991 enabling the police or local authority to seize a prescribed breed that is in a public place and that is not exempt, or, if exempt, is not muzzled and kept on a lead, or is a prescribed ‘specially dangerous dog’, or is a dog that is dangerously out of control. In general, the Dangerous Dogs Act 1991 provides for the destruction of a seized dog. The original provisions were extremely contentious and vigorous campaigning for their amendment took place [12]. This pressure forced some relaxation through the Dangerous Dogs (Amendment) Act 1997, and destruction orders are no longer automatically made following a conviction for an offence. The amendments allow some discretion for exempted breeds where the dog constitutes no danger to public safety and there is good reason why it has not been exempted, such as where there has been some dispute about whether the dog exhibits the characteristics of prescribed breed. A dog falling within this category would not be ordered to be destroyed provided that the dog is exempted within two months of a contingent destruction order being made by the court. In the case of an aggravated offence, a destruction order may not be made where there is no danger to public safety and the dog is kept under proper control in accordance with the requirements of a contingent destruction order. Similar provisions in relation to destruction orders are available to the court where a dog has been seized under the Act but where no person has been or will be prosecuted for an offence. The court may also disqualify the offender from having custody of a dog for whatever period it thinks fit. In cases where an owner is convicted of an offence under the Dangerous Dogs Act 1991, and a court order is made for a dog’s destruction, the dog will not be destroyed until the end of the appeal period, and in the event of an appeal not until the appeal has been withdrawn or determined.

To fulfil the statutory duties under the Environmental Protection Act 1990 and the Dangerous Dogs Act 1991, local authorities have generally provided a dog warden service through the direct employment of dog wardens or through a contractual arrangement. It is reported that some 284 local authorities now provide a dog warden service [13], and many of them are promoting the service in electronic form via the Internet [14, 15]. In most cases, the duties of a dog warden will comprise both statutory and non-statutory functions. These functions include:

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• the seizure and detention of stray dogs, dangerous dogs and associated duties under the Environmental Protection Act 1990 and the Dangerous Dogs Act 1991, as amended • the enforcement of orders and by-laws relating to the fouling of public areas, including ‘poopscoop’ schemes; identification of dogs under the Control of Dogs Order 1992; the control of dogs on highways • the investigation of complaints relating to the keeping of dogs, particularly in relation to general welfare and nuisance from barking or the accumulation of faeces • the provision of advice in respect of the licensing of pet shops, animal boarding establishments and dog breeding premises • health education, through the provision of information to the public promoting the dog warden service; the production and distribution of publicity material concerned with the keeping of dogs; education of the public through talks and presentations. The emotive nature of dog-related issues necessitates the appointment of someone who is sensitive to the sentiments of dog-lovers but is nonetheless capable of acting in an enforcement capacity. The job relies on fostering good public relations and building up a close working relationship with the police and animal welfare agencies. Although no formal qualifications are required, a recently introduced National Vocational Qualification in Animal Welfare and Management

has become available and is suitable for those employed as a dog warden [13].

Dog warden equipment To carry out the duty of seizing stray and dangerous dogs, dog wardens must be properly equipped, not only to protect themselves, but also to ensure that dogs are seized and transported with due regard to their welfare. Generally, a suitably equipped ‘Transit-type’ van is adequate for most local authority use. Desirable features include: • driver separation, with vision panel to rear compartment • aluminium or imperviously lined rear compartment with drainage • wash-hand basin with hot and cold water supply • active ventilation from rear compartment and good interior lighting • side and rear door entry • two to four steel-mesh kennels with opaque dividers • a separate puppy box/kennel • low-loading sill • storage space for dog warden equipment and paperwork • blankets, rubber mats, bowls, food and water for dogs. The dog warden must be provided with protective equipment and means of seizing dogs. This will generally include: a helmet with a heavy duty visor; chest, forearm, groin, leg and foot guards together with heavy duty leather gloves; slip/rope leads; short and long catch-poles; a throw net; and metal guard muzzles. A first aid kit should be readily accessible, and a camera can be useful for identification purposes. Radio contact with the local authority offices will facilitate a quick response to complaints concerning stray dogs and enable the dog warden to call for assistance where necessary.

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DOG CONTROL A miscellany of legal controls is available to local authorities to provide for control in respect of matters such as canine defecation and noise, and these are listed below.

Fouling in public places Complaints concerning dog fouling in public places are commonplace in most local authorities. Although unpleasant aesthetically, the major issue associated with dog fouling is the potential risk to human health. All dogs may carry parasitic worms in their intestines, including the round-worm Toxocara canis. The worms are most commonly found in young dogs. Eggs from the roundworm are disseminated into the environment via the faeces of the dog. These eggs may remain viable for a period of years. Humans become infected through ingestion of viable eggs. Children are most at risk because of the nature of play, which may bring them into contact with contaminated ground. Much attention is therefore focused on the maintenance of dog-free children’s play areas in public parks and on beaches. Each year, a number of children are identified as exhibiting the clinical symptoms of toxocariasis. These symptoms are a form of blindness or eye disease and physical damage to the viscera caused by migrating larvae, which hatch from the eggs. Surveys have shown that asymptomatic infection with Toxocara canis is common, indicating that up to 1 million people in the UK have been infected at some time [16]. Toxocara canis cannot develop into an adult roundworm in the human. Toxocara canis and other worm infestations in dogs can be readily controlled through the administration of anthelmintic (‘worming’) preparations, together with the control of canine defecation. Individuals can reduce the risk of infection by maintaining good standards of hygiene in the home. Such measures include discouraging dogs from licking people; maintaining separate food bowls, utensils, toys and blankets for pets; not allowing dogs to sleep on beds, and washing the hands after handling dogs.

Public Health Act 1875, Section 164; Open Spaces Act 1906, Sections 12 and 15 By-laws can be made under these provisions to control the entry of dogs into prescribed areas of parks, recreation grounds, beaches and promenades and to maintain dogs on leashes in prescribed areas at prescribed days and hours. There is also provision to require owners to clear up faeces within prescribed dog exercise areas. Model bylaws have been produced for local authorities to adopt subject to confirmation by the Home Office. Litter (Animal Droppings) Order 1991 This Order applies the provisions of Part IV of the Environmental Protection Act 1990 in respect of litter and refuse to dog faeces on land that is not heath or woodland or used for grazing animals. The Environmental Protection Act 1990 requires local authorities, certain Crown authorities, designated statutory transport undertakers and occupiers of certain other land, to keep their land clear of litter and refuse. The effect of the order is not to create an offence in respect of dog fouling, merely to ensure that any faeces are removed. Dogs (Fouling of Land) Act 1996 The approach to dealing with fouling in public places has largely concentrated on education of pet owners, supported by provisions under Section 235 of the Local Government Act 1972, which have enabled local authorities to adopt by-laws requiring the removal of canine faeces (‘poop-scoop’ by-laws). These by-laws have been enthusiastically adopted by many local authorities. The Dogs (Fouling of Land) Act 1996 simplifies the law and will gradually replace the ‘poop-scoop’ by-laws. It applies to land open to the air to which the public have access, with some exceptions such as agricultural land and woodland, and includes land adjacent to a carriageway, where the speed limit does not exceed 40 miles per hour. Under the Act, local authorities may, by order, designate land to which the Act applies. The effect of this is to create an offence where a dog defecates and the owner fails to remove the faeces. Powers Copyright © 1999 Taylor & Francis Group LLC

exist to authorized officers of the local authority to issue a fixed penalty notice. The ‘poop-scoop’ bylaws made under the Local Government Act 1972 cease to have effect once land has been designated, and in any case after August 2008. Designation of land under the Dogs (Fouling of Land) Act 1996 requires careful planning and effective publicity, together with capital expenditure for the provision of suitable receptacles, education of the public geared towards toilet training of dogs and high profile enforcement action, although in many cases, the capital investment will have been made when the local authority adopted the ‘poopscoop’ by-laws. Designation under the Dogs (Fouling of Land) Act 1996 may, however, offer some local authorities scope for a renewed publicity and awareness campaign. Many contractors offering dog warden services are able to supply a full range of suitable equipment and publicity material. While many local authorities favour the provision of a dedicated receptacle and suitable cardboard ‘scoops’ or bags for the removal and disposal of dog faeces by owners, some have introduced specially designed ‘dog toilets’ in parks and other open spaces. The design of these dog toilets varies, but essentially most comprise a distinguishable area, normally of sharp sand, which may or may not be partially enclosed by low-level fencing. The sand offers an attractive surface for dogs and encourages defecation. Additionally, one or more vertical timber posts encourage dogs to urinate in the area. The success of dog toilets relies on a high level of maintenance. Firstly, the sand must be regularly cleaned to remove faecal matter (twice-weekly or more often where there is heavy usage); secondly, the sand must be periodically disinfected, perhaps on a monthly basis; and finally, the sand should be replaced at least annually.

Nuisance The noise from barking dogs is a frequent complaint to environmental health departments, and one that is often difficult to resolve. Dogs that are not properly trained or controlled, or that are kept in unsuitable environments may cause noise by barking. Dog

breeding premises and animal boarding establishments have been the focus of well-publicized allegations of noise nuisance, some of which have been the subject of inquiry by the Local Government Ombudsman. Prolonged and persistent barking may constitute a statutory noise nuisance, which can be dealt with under Part III of the Environmental Protection Act 1990 (see Chapter 43). Advice concerning training to reduce the incidence of barking and the use of proprietary anti-barking devices can often be provided by the dog warden. Accumulations of dog faeces on premises may also give rise to a statutory nuisance or risk to public health and can be dealt with similarly under Part III of the Environmental Protection Act 1990. Welfare The welfare of dogs is not of direct concern to environmental health departments, although conditions that give rise to concern may be encountered. In these circumstances, referral should be made to one of the animal welfare agencies such as the RSPCA. CONTROL OF RABIES Rabies, or hydrophobia, is a viral zoonosis transmitted via the saliva of a rabid animal. The saliva is introduced by a bite, or more rarely through a scratch or break in the skin. Rabies occurs worldwide and is endemic in many European countries. Canine and feline animals are the main vectors in Europe, particularly the fox and dog. The spread of rabies across continental Europe, however, has been stalled as a consequence of an aerial vaccination programme. World Health Organization (WHO) figures show a significant reduction in rabies affected animals during the period 1983– 1997 [17]. No cases of indigenous rabies have been reported in England and Wales since 1902; the only reported cases having been contracted abroad. There is much concern at the risk of rabies being introduced into the UK through the accidental or intentional importation of rabid animals aboard ships, aircraft and, more recently, via the Channel Tunnel link. Copyright © 1999 Taylor & Francis Group LLC

The occupations most at risk are animal handlers at quarantine kennels and zoos, port health inspectors, veterinary surgeons, animal health inspectors and dog wardens. Rabies (Importation of Dogs, Cats and Other Mammals) Order 1974 Statutory powers provide both a proactive and reactive approach to dealing with rabies. The Rabies (Importation of Dogs, Cats and Other Mammals) Order 1974, as amended, prohibits the landing in Great Britain of any animal brought from outside Great Britain, except in accordance with the terms of a licence that has been issued in advance. Animals landed within the terms of the order are subject to a quarantine period of six months at the owner’s expense. Certain qualified exceptions do apply to dogs originating in European Union (EU) states that are offered for sale in the UK by virtue of the Rabies (Importation of Dogs, Cats and Other Mammals) (Amendment) Order 1994. The quarantine provisions have recently been reviewed [18] [19], with the key recommendation that the law be relaxed under certain circumstances. More widespread use of microchip implants lends itself to improved record-keeping concerning a dog’s origin, health and vaccination record and may obviate the need for routine quarantine for every imported dog. Rabies (Control) Order 1974 The Rabies (Control) Order 1974 provides for measures to be taken in the event of an outbreak of rabies. Such measures include the declaration of an infected area; the seizure and destruction of the suspect animal; restriction on the movement of animals in to and out of an infected area; action to control dogs, cats and other animals through leashing or muzzling; seizure, detention or destruction of animals not kept under proper control; compulsory vaccination of animals; prohibition on events and activities where animals are brought together; and the destruction of foxes within the infected area.

Rabies outbreak contingency plans have been produced by animal health authorities, i.e. London boroughs, metropolitan authorities, county councils and unitary authorities. These plans set out the action to be taken in the event of an outbreak of rabies in their area, including publicity, liaison with other statutory bodies, manpower, equipment and similar considerations.

Public Health (International Trains) Regulations 1994 With regard to the Channel Tunnel link, the operators introduced various measures during the design and construction of the tunnel to minimize the likelihood of foxes, dogs and rodents gaining access to it. However, there is always the possibility of ‘stowaway animals’ on trains, and the Public Health (International Trains) Regulations 1994 address this situation. A ‘stowaway animal’ is defined as ‘any animal on board an international train, except one which is being lawfully transported through the tunnel, or smuggled through the tunnel’. The effect of this statutory instrument is to require any member of the train crew to report the presence of a stowaway animal to the train manager. The train manager then has a duty to report that sighting to the local authority environmental health service at the next designated stopping place for that service. Where the animal is a rabies suspect, either the train manager or the local authority will advise the Ministry of Agriculture, Fisheries and Food, which will be responsible for any necessary rabies control measures. Where the stowaway animal is not a rabies suspect, the local authority is be able to require the deratting, decontamination or disinfestation of the train. See also p. 293.

REFERENCES 1. Fred’s Fact File, http://www.okima.com/dogs/ facts.html 2. Moore, S.R. and Dhaliwal, P. (1992) Campaign on dogs. Environmental Health, 100(6), 152– 154. Copyright © 1999 Taylor & Francis Group LLC

3. Price Waterhouse (1991) Resource Implications of s. 149–151 Environmental Protection Act 1990 (Dog Control) for the Department of the Environment, Price Waterhouse, London. 4. Association of District Councils (1992) Dealing With Stray Dogs, ADC, London. 5. Brown, C. (1997) Microchip: the high-tech, low-cost solution to strays. Environmental Health, 105(8), 219–220. 6. Primary Production Department, Singapore, Dog Licensing and Control Laws, http:// www.gov.sg/mnd/ppd/cawc/doglaw.htm 7. British Columbia Dial a Law. Noise, Untidy Premises and Dog Control. http:// www.acjnet.org/dialalaw/bc/bc640.html 8. Department of the Environment/Welsh Office/ Home Office (1991) Environmental Protection Act 1990, Part IV. Control of Stray Dogs. Circular 6/1991, DoE, London. 9. UK looks set to adopt US standards on Pit Bull Terriers (1992) Environmental Health News, 8(28), 4. 10. R. v. Knightsbridge Crown Court, ex parte Dunne [1993] Q.B.D. and Brock v. Director of Public Prosecutions [1993] Q.B.D. The Times Law Reports, 23 July 1993. 11. Washington County, Oregon. Laws You Need to Know if You Own a Dog. http:// www.co.washington.or.us/deptmts/at/dog/ dog_laws.htm 12. National Canine Defence League. The Dangerous Dogs Act 1991. http:// www.fido.k9.co.uk/ncdl/index.htm 13. Anon (1997) Taking the Lead on the Isle of Wight. Environmental Health, 105(1), 22. 14. Castlereagh Borough Council. Licensing and Dog Control, http://www.castlereagh.gov.uk/ env/lr.htm. 15. Newark and Sherwood District Council. Dogs and the Law. http://www.nottscc.gov.uk/cc/ s1300370.htm 16. Gillespie, S.H. (1993) Human toxicariasis. CDR Review, 3(10), R140–R143. 17. Boyes, R. (1997) Victory over rabies brings hidden peril. The Times, 26 November. 18. Advisory Group on Quarantine (1998) Quarantine and Rabies: a reappraisal, MAFF, London.

19. Savage C. (1999) Quarantine Wars. Environmental Health, 107(01), 8–10.

FURTHER READING Association of District Councils (1992) Dealing with Stray Dogs, ADC, L ondon. (Through LGA , London.) British Medical Association (1995) The BMA Guide to Rabies, Radcliffe Medical Press, Oxford and New York. Chartered Institute of Environmental Health Officers (1991) Dogs—Control by Local Authorities: Report of Dogs Survey 1991, CIEH, London. Department of the Environment/Welsh Office (1989) Action on Dogs: The Government’s proposals for legislation. A Consultation Paper, HMSO, London. Department of the Environment/Welsh Office/ Home Office (1992) Environmental Protection Act 1990, Part IV. Control of Stray Dogs. Circular 6/1992, DoE, London. Department of the Environment/Welsh Office (1996) The Dogs (Fouling of Land) Act 1996. Circular 18/1996. DoE. London.

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Department of Health and Social Security/Welsh Office (1977) Memorandum on Rabies, HMSO, London. Dog Owner’s Guide (USA). http:// www.canismajor.com/dog/guide.html Health and Safety Executive (1993) The Occupational Zoonoses, HSE, London. Home Office/Department of the Environment/ Welsh Office/Scottish Office (1990) The Control of Dogs: a Consultation Paper, HMSO, London. k9netuk—The Complete UK Dog World. http:// k9netuk.com/contents.html National Canine Defence League. http:// www.k9netuk.com/ncdl/index.html People and Dogs Society, http://www.gurney.co.uk/ pads/index.htm Price Waterhouse (1991) Resource Implications of s. 149–151 Environmental Protection Act 1990 (Dog Control) for the Department of the Environment, Price Waterhouse, London. Tidy Britain Group (1993) Local Authority Survey —Control of Dog Fouling, Tidy Britain Group at the Pier, Wigan.

14

Public safety and health Richard J.Palfrey

INTRODUCTION There is something that is curiously beguiling about most of the attractions that make up the present day leisure industry. They have elements of surprise, excitement and mystery together with their often unique transient nature to be sampled today, or gone tomorrow. They are intended to transport their participants from the familiar to new sensations and excitement. Ensuring the safety of these events is a whole range of environmental health controls that mainly go unnoticed until some serious mishap occurs.

FAIRGROUNDS Fairground apparatus has become increasingly sophisticated in recent years, and the potential for serious personal injury is high if safe working practices are not established and followed rigidly. Fairgrounds have features that are difficult and complex, ensuing from the wide variety of largely non-standard devices, the diversity of sites and the method of operation. In the travelling section of the industry, there are problems of repeated ‘build-up’ and ‘pull-down’. Fairgrounds and amusement parks are generally considered to be relatively safe, although there have been a number of serious incidents involving the public and employees. Guidance on safe practice Useful advice can be found in Fairgrounds and Amusement Parks: Guidance on Safe Practice [1] Copyright © 1999 Taylor & Francis Group LLC

prepared by the Health and Safety Executive (HSE) through the Joint Advisory Committee on Fairground and Amusement Parks. The guidance deals with the principles associated with the overall safety management of attractions and places great emphasis on risk assessment, management of safety and assessment of conformity to design. The guidance gives detailed advice on: • managing health and safety • guidance for designers, manufacturers and installers, importers, suppliers and those who modify and repair attractions • guidance for inspection bodies • guidance for organizers • guidance for controllers • guidance for operators and attendants. Each ride is required to have an operation manual recording operating particulars, together with a record of any modifications or repairs that could affect structural safety. Reports of thorough examinations should be kept for at least 10 years. The guidance requires an initial test, before first use, of all new fairground rides and thorough examination of every ride by an independent, competent, trained person at least once in every 14 months. Any defects must be notified in writing and copied to the HSE, National Interest Groups (NIGs) and also to the appropriate industry trade association if there are implications for similar devices elsewhere. In addition, a daily inspection of each ride is required before the commencement of operation, and a record must be made in the operating manual and be kept for at least three years.

All passenger-carrying amusement devices should have arrangements for the support and retention of passengers either incorporated into the basic design or, where appropriate, additionally provided on the ride. Such devices (seat belts, lap bars, enclosing harnesses, etc.) are required by the guidance to be capable of being positioned or fastened so that they do not inadvertently open during the course of the ride. Where a ride is to be unsuitable for certain categories of passenger, e.g. small children, clear notices or other devices should be displayed prominently to indicate the extent of the exclusion. Detailed objectives are set for operators building up or pulling down rides, a situation that arises more frequently in the travelling sector of the industry. Precautions such as numbering parts, the order or sequence of assembly and dismantling, and the careful handling of components to reduce the risk of damage, are included. Special emphasis is paid to the stability of the ride, consideration being given to the varying ground conditions and the behaviour characteristics of particular rides. Regular checking to ensure that original standards are maintained is also required. Obligations are placed upon ride operators and attendants to ensure that passengers are correctly positioned and that safety equipment is being used and is properly in position and fastened before the ride cycle is commenced. Cautionary notices and pictograms are required to be prominently displayed, clearly indicating reasonable passenger conduct. These can be reinforced by a public address system, if present. The ride operators should be alert in observing passengers during the ride cycle wherever practicable, and should be prepared to slow down and bring to rest any ride if the onset of an emergency becomes apparent. There are, additionally, selection, age and training requirements for operators and attendants. The safe use of electricity, emergency fire arrangements, the safe use of flammable liquids, gas, ammunition and explosives, and other matters, such as the procedures for foreseeable emergencies that may arise or affect the site, are also dealt with.

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Definition and enforcement Fairgrounds are defined in the Health and Safety (Enforcing Authority) Regulations 1998 as meaning ‘such part of premises as is for the time being used wholly or mainly for the operation of any fairground equipment (see below), other than a coin-operated ride, non-powered children’s playground equipment, swimming pool slide, go-kart, or plant designed to be used by members of the public for entertainment purposes for bouncing upon’. Enforcement of the provisions of the Health and Safety at Work, Etc. Act 1974 is the responsibility of the HSE by virtue of schedule 2 of the regulations. Fairgrounds at premises otherwise allocated to local authorities, e.g. in holiday camps, will also fall to the HSE for inspection.

Fairground equipment The definition of fairground equipment is not included in the regulations, but it is to be found in the Health and Safety at Work, Etc. Act 1974 as amended by the Consumer Protection Act 1987. Fairground equipment is here defined as any fairground ride, any similar plant that is designed to be in motion for entertainment purposes with members of the public on or inside it, or any plant that is designed to be used by members of the public for entertainment purposes, either as a slide or for bouncing upon. In this definition, the reference to plant that is designed to be in motion with members of the public on or inside it includes a reference to swings, dodgems and other plant that is designed to be in motion wholly or partly under the control of, or to be put in motion by, a member of the public. Although playground equipment is excluded, the guide does cover the use of amusement devices in other premises, making it of use to local authority inspectors who come across equipment, the use of which may constitute only a minor activity on the premises. A series of guidance notes has also been produced by the HSE in the Plant and Machinery Series. These describe various factors that contribute to accidents on fairground apparatus. The guidelines are based

on HSE reports of incidents, visits to fairgrounds by inspectors and the considerable experience of fairground operators. The range of passenger-carrying amusement devices so far covered by these guidance notes include the waltzer (PM47), the octopus (PM48), the cyclone twist (PM49), the big wheel (PM57), the paratrooper (PM59), the chair-o-plane (PM61), roller coasters (PM68), ark/speedway devices (PM70), water chutes (PM71) and the trabant (PM72). Another source of information is the Fairground User’s Safety Code published by the Royal Society for the Prevention of Accidents (RoSPA) [1a].

Playground equipment Playground equipment and rides may now also be found in hotels and restaurants, where Section 3 of the Health and Safety at Work, Etc. Act 1974 will apply (see p. 463). While the guidance on safe practice is principally aimed at fairground activities, it contains useful guidance on standards that could be required for children’s rides. A useful guide on playground equipment standards is the booklet Playground Management for Local Councils, issued by the National Playing Fields Association [2]. The Entertainment Services National Industry Group (NIG) of the HSE is also prepared to give advice on standards through the HSE Area Enforcement Liaison Officer Service.

HAIRDRESSING Hazards The occupational hazards are numerous. The industry is made up of very small units, usually employing a high proportion of young people, and there is always a large number of trainees and others waiting to enter the industry. The most frequent occupational problems encountered are those of dermatitis of the hands and the ergonomic problems resulting from long periods of standing in tiring postures. There has been a growing awareness of the possible long-term hazards associated with the chemical dyes and sprays that are frequently Copyright © 1999 Taylor & Francis Group LLC

found in these premises, and the risks from customers infected with transmissible blood diseases. However, although there has been concern about the occupational hazards of hairdressing, it is not generally held to be a high-risk activity in respect of the transmission of serious infections. Nevertheless some of the practices employed in hairdressing may result in infection passing from customer to customer if hairdressing implements are not sterilized. Therefore the promotion of hygiene in the salon is important. The two major infections about which there has been most concern, human immunodeficiency virus (HIV) and hepatitis B (see pp. 348 and 358), are both capable of transfer by small amounts of blood and serum (from an infected hairdresser or customer) to breaks in the skin. Although there is no danger if these diseases are not present (it is unlikely that HIV can survive for long periods on equipment anyway), it is poor practice to rely on this being the situation, and so high standards of hygiene and positive methods to ensure the destruction of likely organisms must be employed. Less serious infections, including spots, boils, abcesses, impetigo (both streptococcal and staphylococcal), herpes, ringworm, headlice and warts, may also be passed from person to person if hygienic practices are not employed.

Legislation There is specific legislation covering hairdressing salons. Local authorities may make by-laws that relate to hairdressers and barbers under Section 77 of the Public Health Act 1961 for the purpose of ensuring the cleanliness of the premises, equipment and staff. All hairdressing businesses must also comply with the requirements of the Health and Safety at Work, Etc. Act 1974, and local authorities are the enforcing authorities for these premises. Under the Control of Substances Hazardous to Health Regulations 1999 (COSHH), there is an obligation to carry out an assessment of the risks of substances used at work. Exposure must then be adequately controlled (see Chapter 29). These provisions are important in the hairdressing trade.

Hygiene The main vehicles of bacterial transmission are razors, scissors, clippers and styptic, with brushes, combs, massagers, rollers, towels and hands presenting only an occasional risk. To eliminate risk, it is wise to avoid the use of open razors, replacing them with disposable razors or disposable blade razors, which can be discarded after use. Electric razors can be difficult to sterilize and should also be avoided. The use of scissors cannot be avoided, but if skin is punctured, wounds should be immediately treated, e.g. with a prepacked spirit swab, and left to dry. The scissors should not be used again until they have been sterilized by autoclaving, boiling or soaking them in 70% alcohol chlorhexidine for 30 minutes. Because of the time required for treatment, hairdressers often find it helpful to keep two or more pairs available for use. Scissors should be washed regularly in hot water containing detergent, and then dried or wiped with an alcohol wipe before being allowed to dry. Manual clippers with non-detachable blades should not be used, and care should be taken to ensure that the blades of electrical clippers are correctly aligned to avoid cuts to the skin. When this happens, the blades should be removed and treated as above. Properly adjusted clippers only need a regular wipe over with an alcohol wipe. Styptic, used to stop bleeding, should not be applied directly on to broken skin. It should either be applied on gauze or cotton wool or applied in aerosol form. It is recommended that it is not used at all and that bleeding is controlled by wiping with gauze or cotton wool, or by waiting for the bleeding to stop naturally. Combs, brushes, massagers, etc. may be cleaned by washing with hot water and detergent after each customer, drying and using an alcohol and chlorhexidine wipe. Towels, capes and gowns require no special precautions but should be laundered regularly. Disposable paper items are more hygienic and are especially recommended for customers with skin problems. Apart from alcoholic disinfectants and bleach for blood spills, chemical disinfectants are not generally recommended in hairdressing salons, as they may regularly become contaminated and Copyright © 1999 Taylor & Francis Group LLC

their concentration may vary. They are also often toxic and corrosive. Automatic autoclaves are recommended as being the most effective means of sterilizing hairdressing equipment, and these should be used wherever possible. Glass bead sterilizers use the dry heat method of sterilization. These instruments need time to heat up and may be difficult to use for some items as they can only sterilize the parts in contact with the hot beads. It is also often argued that these instruments may also blunt pieces of equipment with sharp cutting edges. If sterilization is not possible by either of the above methods, disinfection may be acceptable by boiling or steaming for at least 10 minutes in equipment specially designed for hairdressing instruments. The ultraviolet light apparatus often found in hairdressing salons does not sterilize equipment and is therefore not as efficient as the use of autoclaves, etc. Useful guidelines on satisfactory methods of sterilization and disinfection have been produced by the Public Health Laboratory Service [3]. The Department of Health has also produced an HIV/ AIDS (autoimmune deficiency syndrome) information leaflet for hairdressers [3a]. Premises and equipment should be kept clean and staff should follow good standards of personal hygiene. The salon should be kept clean using proprietary cleaners, but alcohol-based disinfectant is specifically recommended for surfaces that need to be wiped three or four times a day. Staff should wash their hands before and after each customer. If staff suffer from dermatitis, disposable gloves should be worn.

Product safety Considerable advice is now available on the composition and safety of products supplied to hairdressing businesses. These products will not present a risk to health and safety if they are used sensibly and in accordance with the instructions supplied by manufacturers. A useful source of information in this respect is the HSE publication How to Use Hair Preparations Safely in the Salon [4]. This booklet gives advice on the storage and sensible use of hair preparations.

Hair preparations are governed by the Cosmetic Products Regulations 1978, which, among other things, requires that cosmetic products shall not be liable to cause damage to human health when applied under normal conditions of use. These regulations lay down safety standards for all cosmetic products, including appropriate labelling requirements.

ACUPUNCTURE, TATTOOING, SKIN-PIERCING AND ELECTROLYSIS During the 1970s, considerable concern was expressed about the possible transmission of blood diseases as a result of skin-piercing activities. Although this concern was initially associated with the spread of the hepatitis virus, the growing awareness of the dangers of HIV and AIDS have since made the control of these potentially dangerous activities essential.

Health and safety aspects General duties are placed on operators of these businesses by the Health and Safety at Work, Etc. Act 1974 to conduct their operations in ways that are, as far as is reasonably practicable, safe and healthy, and do not put staff or customers at risk. Cosmetic and therapeutic skin-piercing, when not carried out under medical control and supervision, is allocated to local authorities for enforcement of the Act. Where a peripatetic practioner carries out work in a client’s private home, this is the responsibility of the HSE.

Adoptive powers Many local authorities, however, feel that the detailed duties in the codes of practice and bylaws made under Part VIII of the Local Government (Miscellaneous Provisions) Act 1982 are more beneficial, and use these specific powers. The powers are adoptive, and district and London borough councils are able to choose the provisions they wish to apply within their areas. Acupuncture and tattooing, skin-piercing and electrolysis are treated separately for the purposes Copyright © 1999 Taylor & Francis Group LLC

of making a resolution to adopt the powers, and local authorities may resolve that any of these activities be controlled, or that different ones be controlled, from different dates. Provision is made for adequate publicity before a resolution takes effect. Acupuncture is not defined in the Act but is generally taken as meaning ‘the insertion of needles into living tissue for remedial purposes’. Tattooing is referred to in the Tattooing of Minors Act 1969 as ‘the insertion into the skin of any colouring material designed to leave a permanent mark’.

Registration The effect of passing a resolution is to require the registration of persons undertaking skin-piercing activities, unless the activities are undertaken by a registered medical practitioner or a dentist. Premises must also be registered. Where a person travels offering skin-piercing services, that person’s home must be registered. There are no transitional periods for the benefit of existing traders. Existing traders must therefore ensure that they register early, and local authorities must ensure that they are able to process these applications before their resolution takes effect. Registration cannot be refused, but where a previous registration has been cancelled by a magistrates’ court as a result of a conviction for an offence under the local authority’s by-laws, the court’s consent must be obtained before a person can be re-registered. The registration certificate issued and a copy of the by-laws must be displayed prominently on the premises, and a reasonable fee is payable to the local authority for registration. Failure to display the registration certificate or bylaws is an offence.

Offences It is an offence punishable by a fine up to level 3 to carry out any skin-piercing activities unregistered. A similar fine is possible for a contravention of by-laws. A court can also suspend or cancel a registration by order instead of, or in addition to, levying a fine.

By-laws

Licences for music and dancing

Model by-laws produced by the then Department of the Environment and the Welsh Office contain provisions to secure the cleanliness of premises, sterilization of instruments and hygiene of the practitioners. Codes of practice are also drawn up by most councils to assist practitioners in complying with their by-laws. Most codes are derived from A Guide to Hygienic Skin Piercing [5]. The British Acupuncture Association, the Traditional Acupuncture Society and the Register of Oriental Medicine have also produced codes of practice. Guidance on the risk of infection from skinpiercing activities has been given to local authorities by the HSE in an advisory circular, Risk of Infection from Skin Piercing Activities [6]. See also: Scottish Centre for Infection and Environmental Health, Body and Skin Piercing— Guidance for Local Authorities, SCIEH, Glasgow, 1998. In 1997, the Department of Health carried out a review of the legislation that gives local authorities the power to register/licence skin-piercing activities. Although the results of the review are not yet available, it is likely that the conclusion will be that on public health grounds there is a continuing need for regulation; but there may be scope for some deregulation where factors such as advances in technology or membership of a professional body provide equivalent protection to public health or where the current regime places unnecessary burdens on business. It is likely that there will be an extension of regulation to include the new fashion of bodypiercing and semi-permanent make-up.

The Local Government (Miscellaneous Provisions) Act 1982 provides that public dancing, music or other public entertainment of a like kind can only be provided under the terms of a licence. Any person providing such an entertainment without a licence is liable to a fine of £20000 and/or imprisonment for up to six months. There are punitive measures for breaches in the terms, conditions and restrictions of a licence of a fine of up to level 5 and/or imprisonment of up to three months (the Entertainments (Increased Penalties) Act 1990). There are exceptions to the licensing requirement in respect of music in places of worship, at religious meetings, at pleasure fairs and at entertainments held in the open air, unless the local authority has adopted the provisions relating to outdoor entertainments. Licences can be granted for one or more occasions and relate to the entertainment, rather than the premises. Licences are required for either live or recorded music (although in the latter case there is no requirement for a licence in premises licensed for the sale of intoxicating liquor), and regardless of whether the entertainment is by the public or by a performer.

PUBLIC ENTERTAINMENT LICENCES Purpose of licensing The objective of this regime is to ensure that such events are adequately controlled, that there is proper hygiene and safety, and that nuisance is avoided.

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Private entertainment Care must be made to distinguish between public entertainment, which requires a licence, and private entertainment which does not under these provisions. It will be a matter of fact and degree in each case as to whether entertainments are private or public, and this is not always an easy distinction to make. There is, however, guidance in Home Office Circular 95/84 and from a number of decided cases. The test set out in Allen v. Emerson [1944] KB 362 [1944] 1 A11 ER 344 DC gives guidance ‘where public entertainment will be provided in a place open to members of the public without discrimination who desire to be entertained and where means of entertainment are provided’. There is no reference to payment, as payment for admission is immaterial to a person’s status as a member of the public. Where a charge is made, the above judgement can be considered in the light

of the test in Gardner v. Morris: ‘it is not whether one or two (or any particular number) members of the public are present but whether, on the evidence, any reputable member of the public, on paying for admission could come in’ (1961 59 LGR 1987 and Frailing v. Messenger 1867 31 JP 423). Bona fide guests of members of clubs are not regarded as members of the public (Severn View Social Club and Institute Ltd v. Ckepstow Licensing JJ (1968) 1 WLR 1512). However, the device of becoming a member of a ‘club’ merely on the immediate payment of a fee and completion of an application form has been discredited (see Panama (Picadilly) Ltd v. Newberry (1962) 1.WLR. 610). The Home Office view is that it is likely that events will be required to be licensed if large numbers of people are able to gain admission simply upon payment of the required fee. This view was upheld in the High Court in the case of Lunn v. Colston-Hayter (Times Law Reports 28 Feb. 1991). Premises available to the general public, such as a function room in a public house, do not need to be licensed when used for a private purpose, e.g. a wedding reception. For information on the licensing of private places of entertainment see the note on p. 259.

Licences for sporting events The second category of entertainment for which a licence is required consists of, or includes, any public contest, exhibition or display of boxing, wrestling, judo, karate or similar sport. There are exceptions to this requirement for these entertainments when held at pleasure fairs, and when taking place wholly or mainly in the open air. The Fire Safety and Safety at Places of Sport Act 1987 requires a licence for indoor sporting events that the public attends. Sports entertainment at sports complexes also requires a licence.

Musical entertainment in the open air The third category applies to any public musical entertainment held wholly, or mainly, in the open Copyright © 1999 Taylor & Francis Group LLC

air and on private land. There are exemptions for events such as fêtes etc. This requirement relates to open-air pop festivals (see below) and other openair entertainments in which music is a substantial ingredient. This control is adoptive and the procedure requires publicity following the appropriate resolution, with the provisions becoming effective from the date specified in the council resolution.

Application for licences Schedule 1 of the 1982 Act contains detailed provisions on the procedure for applying for licences and the powers of local authorities to impose conditions. The procedure for making an application is found in paragraph 6 of schedule 1 of the Act. Applications for the grant, renewal or transfer require the applicant to give 28 days’ notice to the local authority, chief police officer and fire authority. Where the required notice has not been given, the local authority has some discretion to consider it, but a prerequisite to this is that consultation takes place with the fire authority and chief officer of police. Applicants must furnish such particulars and give notice as the local authority may prescribe by regulations. Subject to limited exceptions, a reasonable fee must be paid and the amount is at the discretion of the local authority. However, the fee must not be arbitrary, unreasonable and improper and should not exceed the cost of administration of the licensing system. The exceptions relate to licences for buildings occupied in connection with places of worship and for village, parish or community halls and similar buildings. The local authority may also remit the fee where the entertainment is of an educational, charitable or similar purpose.

Licence conditions Licences are issued subject to standard conditions prescribed by regulations made by the licensing authority. Every licence then granted, renewed or transferred is presumed to have been issued subject to these conditions unless it has been expressly excluded or varied. It is open to the holder of a

licence to apply for conditions to be varied. When attaching conditions, it should be borne in mind that these must relate to safety, health and the prevention of nuisance. One way of ensuring that licence conditions are adhered to is to attach a licence condition requiring door supervisors to be registered and trained. Many local authorities do this as a means of raising the quality of door staff and reducing criminal activity in clubs. It is claimed that community safety in and around late night venues is enhanced by such schemes. Guidance on establishing a scheme is contained in the Home Office circular 60/1995, Registration Scheme for Door Supervisors. The hours of opening are best controlled by special conditions as hours of opening are linked closely with liquor laws. There is a limit on the conditions that may be attached to a licence for an outdoor entertainment. These relate to the safety of those present, provision of access for emergency vehicles, the provision of adequate sanitary appliances and the prevention of noise nuisance. (HSE Guidance Notes GS50 and IND(G)102L.) Provisional licences A good feature of the 1982 Act is that it permits the issue of provisional licences, subject to confirmation, for premises about to be constructed, or under construction or alteration. This is useful for those engaged in elaborate or costly proposals, as it gives an early indication of whether the project is likely to receive a licence. Consultation When considering an application, the licensing authority is required to consider the observations submitted by the chief officer of police and the fire authority. Conditions adopted by many local authorities also require public notice of application to be given. It appears, however, that no other person has a right of objection, although any observations made would be considered. Although no guidance is given in the 1982 Act about the hearing of objections when they are made, Copyright © 1999 Taylor & Francis Group LLC

the applicant should be informed of the nature of the objections so that he or she can respond. In these situations, procedures for dealing with applications must be considered carefully or they will lead to appeals against licensing authority decisions. All applications must be dealt with in accordance with the terms of natural justice, though in many cases an oral hearing will not be necessary and can be dealt with by written representation only. If an oral hearing is arranged it is wise for objectors to state their case first.

Offences Where entertainments are provided without the necessary licence or in contravention to the terms, conditions or restrictions of a licence, an offence is committed. The only statutory defences are to prove that due diligence had been exercised, that all reasonable precautions had been taken or that a special order of exemption is in force under Section 74(4) of the Licensing Act 1964. These orders automatically override any conditions on permitted hours. An investigation of a breach of hours in licensed premises should therefore include a check on whether a special order of exemption is in force.

Public conveniences at places of entertainment Certain local authorities are empowered to require sanitary facilities to be made available for public use in ‘relevant’ places (see below) by Section 20 of the Local Government (Miscellaneous Provisions) Act 1976. The requirement by written notice can be occasional—for such occasion specified in the notice—or provided for continuing use. There is only a right of appeal against the latter, although unreasonable requirements under the former may be challenged in any prosecution for non-compliance. ‘Relevant place’ means any of the following: 1. A place that is normally used or is proposed to be normally used for any of the following purposes, namely:

(a) the holding of any entertainment, exhibition or sporting event to which members of the public are admitted, either as spectators or otherwise. (b) the sale of food or drink to members of the public for consumption at the place. 2. A place that is used on some occasion or occasions or proposed to be used on some occasion or occasions for any of the purposes aforesaid. 3. A betting office. A duty is imposed to have regard to the needs of disabled persons when complying with a notice. There may be some overlap with the requirements of some licensing procedures.

at which amplified music is played at night and which is likely to cause serious distress to inhabitants). These powers include the removal of people attending and seizure of sound equipment. Powers of entry There is a provision in the 1982 Act for the entry of places of entertainment by the police, or by authorized officers of the licensing authority and the fire authority, for enforcement of the licence. Proceedings for alleged breaches of the schedule may be instituted by any person and there is no limitation in the Act. Revocation

Pay parties In view of the dangers to the public and the nuisance caused by so called ‘pay parties’, the Entertainments (Increased Penalties) Act 1990 raised the penalties for the use of premises for which no licence was in force, or for contravention of the terms and conditions of a licence imposing a limit on the number of people who may be present at the entertainment to a £20000 fine or six months’ imprisonment. The Criminal Justices Act 1988 (Confiscation Orders) Order 1990 gives magistrates the power to order the confiscation of the proceeds, where these exceed £10000, made by people convicted of these offences. ‘Pay parties’ is the most commonly used generic name given to these events, the different names given to the various types of pay party reflecting both the size and venue of the event: • acid house party, dance parties, raves and warehouse parties • the smallest pay parties often held in domestic premises are called ‘blues parties or ‘she-beens’. (See Joint Home Office and Department of the Environment Guidance booklet Control of Noisy Parties, September 1992.) Sections 63–67 of the Criminal Justice and Public Order Act 1994 give the police powers to deal with ‘raves’ (a gathering of 100 or more people Copyright © 1999 Taylor & Francis Group LLC

If convicted of an offence under the Act, the licence may be revoked. The principles of natural justice apply, and the holder of a licence should, even though convicted of an offence, have an opportunity to state his or her case. There is a right of appeal against any adverse decision of a licensing authority, but the holder of a licence is not bound to implement the decision until either the 21 day appeal period has passed or the appeal has been determined. The appeal period cannot be extended. The procedure for an appeal is given in Section 34 of the Magistrates’ Courts Rules of 1981. Appeals are by way of re-hearing and the appellate court is entitled to substitute its own opinion about the facts or merits of the case. (It would no doubt give some consideration to the fact that the original decision has been made by an elected representative body.) As the magistrates’ court can only summons those against whom it can make an order, only the licensing authority can be summoned to appear. If observations or objections were considered in arriving at a decision, it would be for the licensing authority to bring evidence of these before the magistrates’ court. An appeal against the decision of the magistrates’ court may be brought to the crown court with 21 days, but in this case there is provision to extend this time for giving notice of appeal. The Public Entertainment Licences (Drugs Misuse) Act 1997, which came into force on 1 May 1998,

will make it easier for local authorities to close night clubs where there is a serious drugs problem. Under the Act, an authority is able to revoke a public entertainment licence if informed by the police of serious problems relating to the supply or use of controlled drugs at or near the licensed premises and if it is satisfied that such action will assist in dealing with the problem. Apart from refusing to renew or transfer a licence, local authorities may be able to impose conditions on a licence. Where there is an appeal against a decision to revoke or not renew a licence the licence is suspended until after the appeal.

The Private Places of Entertainment (Licensing) Act 1967

When licences are refused, appeals to a magistrates’ court are available, and the appeal is in the form of a re-hearing of the application. Private parties not for gain In the case of private parties that are not held for gain and do not come within the scope of licensing legislation, the powers available to local authorities are restricted solely to the noise nuisance abatement powers of Part III of the Environmental Protection Act 1990. This includes the power under Section 81 [5] to seek a High Court injunction if the authority considers that summary proceedings would provide an inadequate remedy. POP FESTIVALS

In areas where this Act has been adopted, private dancing, music or other entertainments of a like kind, which are promoted for private gain, must also be licensed. A definition of ‘private gain’ is found in the London Authorities Act 1991. The Act is an adoptive one and therefore only applies if the appropriate authority—district councils, the London boroughs or the council for the Isles of Scilly—so resolves. The procedure for adopting the Act, together with the requirements for publicity, etc., are laid down in Part II of the schedule to the Act, and the powers available enable control of events involving music and dancing including pay parties. When licences are granted, they can be made subject to terms, conditions or restrictions imposed by the licensing authority. This may include conditions providing power of entry to private premises for which generally there is no right of entry. Those also applicable to public entertainments will usually be equally relevant. Enforcement provisions are identical to the provisions found in the Local Government (Miscellaneous Provisions) Act 1982, in respect of public entertainment and, as with that Act, any person may prosecute for the breaches defined in Section 4. Inve stigations into alleged contraventions of this Act need care and the procedures of the Police and Criminal Evidence Act 1984 must be followed. Copyright © 1999 Taylor & Francis Group LLC

Background These often accommodate in excess of 100000 people and employ many hundreds of staff. They comprise a major sector of the leisure industry. Guide to Health, Safety and Welfare at Pop Festivals and Similar Events [7] This 1993 guide, currently under review, indicates the key points in the planning and arrangement of a pop concert. Advice is given on health and safety, fire and emergency planning and venue facilities. Legislative controls Under the Local Government (Miscellaneous Provisions) Act 1982, local authorities may adopt the controls for public musical entertainments taking place wholly, or mainly, in the open air and on private land. These were included specifically to control pop festivals. Whether the particular festival has the requisite degree of music, giving rise to a need for a licence, and whether it is a public or private entertainment, must be determined for these controls to be relevant. Licence conditions can be imposed in the interest of health and safety and is limited to securing:

• the safety of performers and other persons present • adequate access for emergency vehicles • the provision of adequate sanitary accommodation • preventing neighbourhood disturbance by noise. The law of nuisance (see Chapter 7) also provides a broad and powerful restriction on any kind of potentially intrusive activity. With the approval of the attorney general, local authorities or individuals who have reason to feel unhappy at the prospect of a pop festival (or indeed of any large gathering) can take the matter to the High Court and, if they can prove a likelihood of substantial and unreasonable interference to the community, they will obtain an injunction. This will effectively put the promoter at risk of proceedings for contempt of court if a nuisance is caused as a result of the pop festival. (Such action has been taken successfully by Windsor and Maidenhead borough council and Newbury district council in relation to pay parties.) Although the law of nuisance is not a very flexible means of control, it can give local authorities a very effective negotiating weapon. The essence of a nuisance is a condition or activity that unduly interferes with the use or enjoyment of land. This has been applied to a number of cases involving the congregation of crowds, and in the case of A.G. v. Great Western Festivals Ltd (unreported) to pop festivals in particular. The features of a pop festival that might amount to a nuisance include noise, trespass and damage to adjoining property, traffic congestion and pollution by litter. The normal remedy for a nuisance is an action for an injunction. For temporary events, such as pop festivals, it will usually have to be a quia timet injunction—one granted before an event on the basis of evidence showing a strong possibility that a nuisance will occur. The Noise at Work Regulations 1989 will also apply to persons at work at the pop festival. The general duties of the Health and Safety at Work, Etc. Act 1974 will also apply, including the management of Health and Safety at Work Regulations 1992, and these powers may prove useful in dealing with the many other hazards, such as laser equipment, disco lighting and pyrotechnics encountered on the site. Copyright © 1999 Taylor & Francis Group LLC

Other legislation such as the Theatres Act 1968, the Cinemas Act 1985 and the Building Regulations may also be relevant. Forward planning To ensure the success of any large pop festival, it is essential that planning starts at least six months before the event, that sufficient funds are available to invest in the event, and that an efficient back-up organization and management policy is established. It will, therefore, be necessary to set up a working party composed of the promoters, local authority, police and fire officers and representatives of voluntary organizations at an early stage. Many of the faults and failures of festivals in relation to matters that are the concern of the local authorities have arisen not only through a lack of co-operation between promoters and local authorities, but also through not allowing the time for such co-operation to be really effective. The prime responsibility rests with the promoters. It remains, however, a major responsibility of a local authority to create conditions under which such co-operation is possible. In the initial stages, the local authority should be concerned with the location and suitability of the site, estimated attendance figures, legal and financial implications, and all of the possible public health problems. Standards must be identified and met and the necessary safeguards observed. If local legislation requires an application to be made for a public entertainment licence, this should be made clear to the promoters, who may then take the appropriate action in good time. Sites vary from fields to theatres to sports stadiums—and even on occasions lakes and rivers. The choice of site therefore has a direct bearing on the standards that will need to be applied. Prediction of numbers It is not possible to plan for a pop festival without a reasonable idea of the numbers expected to attend. Prediction of numbers is undeniably a difficult task, particularly for those with little experience of pop festivals.

Standards Attention needs to be paid to the following issues, all of which are dealt with in the guide: • • • • • • • • • •

• • • • • •

crowd safety structural stability of stages etc. protection of water sources refuse and litter food safety washing facilities (one for every five sanitary conveniences) drainage pest control noise sanitary accommodation (one closet per 100 females and three closets for every 500 males plus 1.5 m run of urinal per 500 males) access and signs for disabled people fire prevention and fighting (also see [8]) power supply medical services security management of site and stage.

Other outdoor events A Code of Practice for Outdoor Events [9] provides guidance on safety management at outdoor shows and meetings. It indicates standards for crowd control and site operations at events ranging from national athletic meetings to agricultural festivals and car boot sales. Managing Crowd Safety (IND(6)1426) published by the HSE gives guidance on management responsibilities for such events. SAFETY AT SPORTS GROUNDS A sports ground is any place where sports or other competitive activities take place in the open air, and where accommodation has been provided for spectators, consisting of artificial structures or of natural structures artificially modified for the purpose (Safety at Sports Grounds Act 1975). The Wheatly Report, commissioned in 1972 as a result of the Ibrox Park disaster, resulted in Copyright © 1999 Taylor & Francis Group LLC

the passing of the Safety at Sports Grounds Act 1975. The Act requires all designated sports grounds (those in respect of which a designation order is in operation) with a capacity of over 10000 people to be issued with safety certificates by the local authority. This capacity may be changed by order, and can be different for different classes of sports grounds. The Act was considerably extended by provisions contained in the Fire Safety and Safety of Places of Sports Act 1987 giving certifying authorities similar powers in respect of regulated stands, i.e. covered stands with a capacity of 500 or more spectators. The 1975 and 1987 Acts are administered in London and conurbations by the London borough councils and metropolitan authorities, respectively, and in the rest of England and Wales by unitary and county councils. In Scotland, the work is carried out by unitary councils. It is the duty of every local authority to enforce the Act and its regulations, and arrange for periodic inspections of designated sports grounds. Powers of entry to, and inspections of, any sports ground for this purpose are provided by Section 11 of the 1975 Act. The Football Spectators Act 1989 was introduced to control admission to designated matches by a membership scheme. It also provides for the safety of spectators by means of licences and safety certificates.

Safety certificates Safety certificates may only contain conditions to secure safety at the sports ground, and may include a requirement to keep records of attendance and maintenance of safety measures. Before a certificate is issued, the local authority is required to consult the building authority and the chief officer of police. When determining an application for a safety certificate, it is the local authority’s duty to determine whether the applicant is a qualified person, that is, one who is likely to be in a position to prevent contravention of the terms and conditions of any certificate issued. The form of application is contained in the Safety of Sports Grounds Regulations 1987, which, among other things, lay down the procedure

for making an application under the Act. Safety certificates may be amended either with or without the application of the holder, but amendments must be limited to safety measures. Transfers of certificates are provided for, but the local authority’s duty to determine whether the person is a qualified person remains. In both cases, consultation must take place between the chief officer of police, the fire authority and the building authority before the local authority amends or transfers the certificate. Any alteration to a sports ground that may affect safety must be notified to the local authority in advance. If a person is judged by a local authority not to be a qualified person, there is a right of appeal to the magistrates’ court as there is against the inclusion or omission of anything from a certificate or a refusal to amend it. Where a general safety certificate is in force, its provisions take precedence over certain other pieces of legislation that may impose terms and conditions. This may well affect the licence conditions issued in respect of any public entertainments licence.

Guidance

Prohibition notices

In 1994, the Sports Council in association with the Football Trust published a guide [11] that offers advice on evaluating existing toilet facilities, improving standards, and choice of equipment for new installations. It applies to rugby and hockey stadiums as well as to football grounds. Specific guidance is given on planning, location and access, design of toilet areas, fittings and materials, provision of toilets for family areas, disabled spectators, non-spectator use, and portable toilets. The section on design recommends that before finalizing any designs that omit doors or lobbies to toilet areas, the local environmental health officers should be consulted. A chapter is devoted to the subject of the ratio of toilets to the number of male and female spectators. Tables 14.1 shows minimum recommendations made by the guide for newly constructed or refurbished stadiums and stands, per accessible area.

A special procedure is detailed in the Act for dealing with situations where serious risk is posed to spectators. In that situation, local authorities have power to serve prohibition notices that specify the matters giving rise for concern, and restrict or prohibit admission to, or to parts of, a sports ground until matters have been remedied. These notices take effect immediately. A person aggrieved by a prohibition notice may appeal to the magistrates’ court against the notice, but in view of the overriding requirement for safety, the bringing of an appeal does not have the effect of suspending it. Offences Various offences are detailed in the Act, including contravention of the certificates, and its terms or conditions, etc. These are punishable by fine or summary conviction, or fine and/or imprisonment for not more than two years on indictment. Copyright © 1999 Taylor & Francis Group LLC

Useful guidance on sports ground safety is included in the voluntary code, Guide to Safety at Sports Grounds, issued jointly by the Home Office and the Scottish Home Office and Health Department [10]. Advice is given in this document (which is known as the ‘Green Guide’) on the construction and layout of grounds, including details of access and egress and ground capacity estimation, terracing, barriers, stands, etc., as well as for other matters covered by a certificate. The third edition in 1990 incorporated lessons from the Hillsborough, Sheffield tragedy in 1989 and the Bradford City fire in 1985. Its recommendations may be put into statutory form by inclusion in safety certificates. The information contained in the guide is especially applicable to football grounds, but the advice is also of use in dealing with a variety of sporting events at grounds where the gathering of crowds may present a safety problem. Toilet facilities at stadiums

Indoor sporting events Safety at indoor sporting events is controlled by the public entertainments licence procedure detailed

Table 14.1 Minimum number of toilets and washing facilities for newly constructed or refurbished stadiums and stands

Source: [11].

in Schedule 1 of the Local Government (Miscellaneous Provisions) Act 1982 (see p. 255). These are not covered by the Safety at Sports Ground Act 1975.

Health and safety enforcement Responsibility for enforcing the Health and Safety at Work, Etc. Act 1974 in sports grounds falls to local authorities (unless they are sports grounds under the control of local authorities). However, because there are overlapping responsibilities relating to safety of sporting events at sports grounds, there is a need for liaison between the various authorities involved. It is the Health and Safety Commission’s (HSC) policy that the provisions of the 1974 Act should not generally be enforced if public safety is adequately covered by enforcement of the specific legislation in the 1975 Act. In cases of an urgent threat to life or injury, however, the use of the Act’s powers would not be precluded if they could eliminate the risk or reduce it.

CINEMAS

and related enactments. This Act made no change to the previous law except that, on the recommendation of the Law Commission, it amended provisions derived from the Sunday Entertainments Act 1937 so as to extend the exemption from the Sunday Observance Act 1780 to cover exhibitions produced by means of videos. Licences Subject to certain exemptions, film exhibitions may only be given in premises that have been licensed by the local authority in which they are situated. Before the consolidating legislation was passed, licensing control related to exhibitions of ‘moving pictures’ produced on a screen by means that included the projection of light. This definition was not flexible enough to encompass changes in modern technology, and did not include video exhibitions, which are transmitted by signal. While control now extends to videos shown in clubs and pubs, it does not extend to exhibitions of moving pictures arising out of the playing of video games, and places such as amusement arcades and public houses therefore do not require to be licensed under this legislation.

Legislation

Licence conditions

The main piece of legislation concerning the exhibition of films is the Cinemas Act 1985, which consolidates the Cinematograph Acts of 1905 and 1952, the Cinematographic (Amendment) Act 1982

The granting of a licence is discretionary and, subject to regulations made under the Act, licensing authorities may impose terms and conditions on the licence. The terms and conditions that may

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be imposed are not limited to those for securing safety but, when imposed, the test to be applied is that they should be reasonable and in the public interest. Subject to these restrictions, there is no fetter upon the power of the licensing authority. Model licensing conditions are detailed in Home Office Circulars No. 150/1955 and 63/1990. The London Inter-borough Entertainments Working Party has produced its own set of rules relating to the showing of films for inclusion in licences issued under the Cinemas Act 1985.

Film exhibitions for children When granting a licence, the licensing authority has a duty to impose conditions or restrictions prohibiting the admission of children to film exhibitions involving the showing of works designated unsuitable for them. The familiar classification of films is not based on statute, but is undertaken by a body known as the British Board of Film Classification (BBFC). Its system of classification, the object of which is principally to indicate which films are considered suitable for viewing by children, has been adopted by local authorities. For the classification of films by the BBFC see Home Office Circular No. 98/1982 and 63/1990. Any film exhibition organized wholly or mainly for children requires the consent of the licensing authority, and in these circumstances they can impose special conditions or restrictions. A statutory obligation to provide for the safety of children’s entertainments is contained in the Children and Young Person’s Act 1933.

Applications for licences When applying for a licence, or for its renewal or transfer, the applicant must give 28 days’ clear notice of intention to the licensing authority, the fire authority, and the chief officer of police. When the requisite notice has not been given, the licensing authority can still grant a licence, but only after consultation with the other two authorities. (The mere sending of a letter does not constitute consultation). Licences are granted for periods of up to 12 months. Fees for licences may be fixed by Copyright © 1999 Taylor & Francis Group LLC

the licensing authority, but they must not exceed the sum stipulated in the Fees for Cinema Licences (Variation) Order 1986. These are currently set at £173 in the case of a grant or renewal for one year; in the case of a grant or renewal for any lesser period the fee is £58 for each month for which a licence is granted or renewed, but in this case the aggregate of the fees paid in any year is not permitted to exceed £173. The maximum fee for a transfer of licence is £35. These figures can be amended by order of the Secretary of State. (Useful advice on fees is contained in Association of District Councils’ Circular 1986/ 119. The Association of District Councils is now part of the Local Government Association.)

Regulations Section 4 of the Act requires film exhibitions to comply with regulations made by the Secretary of State. To date no new regulations have been made but, by virtue of the Interpretation Act 1978, the Cinematograph (Safety) Regulations 1955 as amended and the Cinematograph (Children) No. 2 Regulations 1955 have effect.

Exemptions Certain exhibitions are exempted from the requirement to obtain a licence. These include exhibitions in private dwellinghouses where the public are not admitted and where there is no private gain, or where the sole or main purpose is to demonstrate or advertise products, goods or services or to provide information, education or instruction. Where the public are not admitted, or admitted without payment, or the exhibitions are given by an exempted organization and conditions regarding private gain etc., as above, are fulfilled, no licence is required. Exempted organizations are defined in relation to a certificate given by the Secretary of State. This exemption does not apply to certain exhibitions for children as members of a club, the principal object of which is attendance at film exhibitions, unless in a private house or as part of the activities of an educational or religious institution, or to exempted organizations in cases where the

premises were used for an exhibition for more than three days out of the previous seven days. It is not necessary to obtain a licence when premises are not used for more than six days in a year, and where film exhibitions are held occasionally and exceptionally, and the occupier has given at least seven days’ notice in writing to the fire authority and the chief officer of police, and he or she complies with any regulations of conditions imposed by the licensing authority and notified to him or her in writing. Strictly speaking, licences are required where film exhibitions take place in premises on a regular basis, even if fewer than six times per year, as the use would not be exceptional, but many authorities do not require a licence in these circumstances. Film exhibitions that take place in buildings or structures of a movable character only need to be licensed (by the licensing authority where the owner normally resides) where the owner has given at least two days’ notice to the fire authority and the chief officer of police, and he or she complies with any conditions imposed by the authority in writing.

Sunday opening The Sunday Observance Act 1780 is not contravened by staging film exhibitions on a Sunday, but a licensing authority is entitled to impose conditions, including those aimed at preventing employment, where a person has been employed for the previous six days. There are exceptions to this restriction in cases of emergency notified to the licensing authority where a rest day is given in lieu and where an employer has, on making due enquiry, reasonable grounds for believing that a person has not been employed for the earlier six days.

operating without a licence and in other cases level 5 on the standard scale. In addition, a court can order the forfeiture of anything produced to the court relating to the offence, as long as the owner has been given an opportunity of appearing to show cause why it should not be. If the owner of a licence is convicted of an offence as stipulated in Section 10 of the Act, or failed to provide for the safety of children, the licensing authority may revoke his or her licence.

Power of entry Right of entry to inspect premises to see whether the relevant provisions are being complied with is given to police constables and authorized officers of licensing and fire authorities. Inspections by the fire authority to check on fire precautions, however, require 24 hours’ notice. When authorized by warrant, constables or authorized officers of the licensing authority can enter and search premises when they have cause to believe that an offence has been, is being, or is about to be committed. This power is subject to the restrictions of Section 9 of the Police and Criminal Evidence Act 1984, and authorized officers must produce authority when requested. Any person who intentionally obstructs an officer is liable on summary conviction to a fine not exceeding level 3 of the standard scale. A constable or authorized officer who enters and searches any premises under the authority of a warrant issued under Section 13 above, may seize and remove apparatus or equipment, etc. which he or she believes may be forfeited under Section 11.

Appeals Offences Where premises are used without a licence or consent (in respect of children) or where terms, conditions or restrictions are contravened, those responsible for the organization or management, as well as the licence holder, are guilty of an offence. A maximum fine of £20000 is stipulated for Copyright © 1999 Taylor & Francis Group LLC

A person may appeal to the crown court against a refusal or revocation of a licence or terms, conditions or restrictions subject to which a licence is granted as he or she may against the refusal to renew or transfer a licence. Appeals in Scotland are to the sheriff’s court. Refusals in England and Wales in relation to Sunday opening and any conditions in that respect are to the crown court.

Commercial premises that promote cinematographic exhibitions (video juke boxes) as a means of attracting custom come within the Act’s control. It is not necessary for a charge to be made for admission for a licence to be required if the exhibitions were advertised and the sums paid for the facilities or services are for private gain. Additional requirements in respect of television exhibitions in Part 4 of the Cinematographic (Safety) Regulations 1955 have to be complied with.

or in buildings known as ‘patent theatres’ where the performance may take place by virtue of ‘letters patent’. The licensing authorities are the London boroughs, unitary authorities and district councils. The law relating to theatres was formerly embodied in the Theatres Act 1843, which at the time gave the Lord Chamberlain powers of absolute censorship over the presentation of any stage play. To assist in this measure, copies of every new stage play were required to be submitted to him. In these early days, theatre-going was something of a hazardous affair and the records show that in 1884 alone it was calculated that, worldwide, 41 theatres were burned down involving the death of over 1200 people. From these tragedies, lessons were learned and there followed important decisions and action regarding public safety, fire precautions and fire-fighting. The Public Health (Amendment) Act of 1890 enforced stricter fire regulations, but within a few years there followed demands that all theatre planning should be subject to municipal or state control. It was not until the Theatres Act 1968, however, that this legislation was repealed and the role of the Lord Chamberlain in respect of censorship was abolished. Copies of scripts of all new plays are now sent to the British Library. The censorship measures were replaced by provisions for the prevention of obscene performances vested in the courts, rather than by administrative or executive action.

Health and safety enforcement

Licences

Responsibility for enforcement of the provisions of the Health and Safety at Work, Etc. Act 1974 in cinemas lies with local authorities. However, where the main purpose of a cinema premises is for educational or vocational training, similar to that provided in the mainstream education system, such premises will be the responsibility of the HSE.

When considering the need for a licence, the term ‘play’ is usually taken to mean any dramatic piece —whether improvized or not—by one or more persons who are actually present and performing. What the performers do, whether it consists of speech, singing or action, must constitute the whole or a major part of a performance and involve the playing of a role. For example, a dialogue between persons in costume or action without words may constitute a dramatic piece. Ballets, whether they fall within the above definitions or not, do require a theatre licence, but theatre licences do not cover public music or dancing events. Where, however, the music is incidental to a play, or it takes place in the interval, or the music and dancing forms

Where a licence has been revoked, it remains in force until the determination or the abandonment of the appeal or, if successful, it is renewed or transferred. Local authorities in Greater London have powers to vary licences and grant provisional licences, but other authorities have no power to grant a licence except in respect of premises actually in existence. Where introductory music is played at any premises, or is featured in an interval or at the conclusion of a show, it is considered to be part of the exhibition provided that the total time taken amounts to less than one-quarter of the time taken by the film exhibition. A public entertainment licence is therefore not required.

Video juke boxes

THEATRES Generally speaking, any premises used for the public performance of plays is required to be licensed. The only exceptions to this arise in respect of buildings under the control of the armed forces Copyright © 1999 Taylor & Francis Group LLC

part of a musical comedy, a public entertainment licence is not required. It is not unusual for a building to hold both licences. Full licences are granted for periods of up to one year, but there is also provision to grant a licence in respect of one or more occasions (an occasional stage play licence). When a full licence is applied for, the licensing authority and chief officer of police in whose area the premises are situated, must be given at least 21 days’ notice of intention to make application. The information to be given with an application must be in accordance with regulations prescribed by a licensing authority. An application for a renewal of a licence must give at least 28 days’ notice of intention. Where, however, the application is for one or more particular occasions, only 14 days’ notice is required to be given, and there is, in this instance, no obligation to inform the chief officer of police.

Appeals Where a licensing authority refuses a licence, there is a right of appeal to a magistrates’ court by way of complaint for an order, and the licensing authority will be a defendant. Although the chief officer of police has to be notified of an application, he or she is not party to appeal proceedings, even if the decision to refuse a licence was made after considering his or her recommendations to do so. There is no right of appeal against a licensing authority decision to issue a licence. Persons aggrieved by the decision of a magistrates’ court may appeal to the crown court. When granting a licence, a licensing authority may impose conditions and restrictions, but they must act judicially in doing so, and the restrictions that the licensing authority is empowered to make are strictly controlled. They relate in the main to matters of health and safety, and do not extend to restrictions on the nature of plays or the manner of the performance.

Licence conditions It is worth emphasizing that the conditions that can be imposed by a licensing authority when Copyright © 1999 Taylor & Francis Group LLC

granting, renewing or transferring a licence are strictly limited to protecting physical safety and health. This is usually achieved by adopting local conditions that are principally aimed at providing a safe means of escape. This is achieved by providing an escape route that allows normal people to get out from a theatre after an outbreak of fire to a place of safety by their own efforts, without being placed in jeopardy while doing so. In addition, the conditions will require a sufficient number of well located exits with adequate lighting and direction signs throughout. Equipment and areas of potential hazard are required to be protected and there must be an efficient exit drill procedure to ensure orderly exit. In addition to these physical requirements, control of psychological factors conducive to panic need to be addressed and alarm procedures should reflect this. Fire escape drills are helpful, but it should be borne in mind that in a building whose occupants are transient they may be of limited value unless permanent staff are trained to help the temporary occupants. This is usually reflected in a requirement for the provision of adequate stewards or attendants. These requirements are even more vital in situations when an audience consists mainly of children, and it is not unusual for theatrical performances to which Section 12 of the Children and Young Persons Act 1933 applies to provide an increased number of stewards. It is essential to liaise with the fire and rescue services when considering these aspects of a theatre licence. As to the provision of exits, entrances, etc., see also the Public Health Act 1936, Section 59 for further powers. Conditions related to health include the provision of adequate ventilation, the prevention of over-crowding and the provision of adequate sanitary accommodation and washing facilities, including facilities for the use of disabled people. Guidance on this may be found in the British Standard 6465: Part 1:1984 Sanitary Installations, and powers for requiring it are contained in Section 20 of the Local Government (Miscellaneous Provisions) Act 1976. In older, purpose-built theatres it is not unusual to find large spans of unsupported ceilings, often decorated with ornate plaster mouldings. In these

circumstances, conditions often require the regular inspection of these features and the provision of certificates of safety. For further advice on the safety of ceilings and the responsibility of licensing authorities, see Home Office Circular No. 264/1947.

provisional licence may be issued if the licensing authority is satisfied that the completed premises would be in accordance with its requirements. A licence will be granted subject to the condition that it will be of no effect until confirmed.

Relationship to liquor licences

Sunday performances

When a theatre licence is granted, the licensee acquires the right to sell intoxicating liquor if he or she notifies the clerk to the licensing justices of his or her intention to do so, unless the licensing authority has issued the licence subject to restrictions prohibiting the sale of liquor. When imposing such restrictions it is important that the local authority considers each application on its merits, for it is not permitted to attach a restriction in pursuance of a general rule. Where liquor is permitted to be sold by virtue of a theatre licence, the provisions of the Licensing Act 1964 apply, and it is therefore only permitted to be sold during the ordinary permitted hours applicable to licensed premises. A condition can be imposed by the licensing authority, however, limiting the sale of liquor to the times when the premises are used as a theatre. If such a condition is not imposed, the theatre can also sell liquor when it is not in use as a theatre, including days such as Sundays, Christmas Day and Good Friday, when no performances take place. As in other licensed premises, extension of the permitted hours is not permitted.

By virtue of Section 1 of the Sunday Theatre Act 1972, licensed theatres are permitted to open on Sundays despite the prohibition contained in the Sunday Observance Act 1780. Theatres are, however, required to be closed by 2 am (3 am in Inner London) after Saturday night performances and must remain closed until 2 pm.

Fees The person applying for the grant, renewal or transfer of a licence must pay the licensing authority a reasonable fee. This requirement is waived in respect of occasional licences if the performance is of an educational or like character, or is to be performed for a charitable or other like purpose.

Offences It is an offence to use unlicensed premises and any person concerned in the organization or management of a performance is liable, on summary conviction, to a fine of up to level 4 on the standard scale, or imprisonment for three months, or both. A similar penalty is available for the breach of the licence conditions, and in this instance a licence can be revoked. Fines of up to £1000 and up to six months’ imprisonment can be imposed for presenting or directing obscene plays and those that incite racial hatred or provoke a breach of the peace by the use of threatening, abusive or insulting words. In the case of the latter offence, proceedings can only be authorized with the consent of the attorney general. Authorized officers of licensing authorities have certain powers of entry, and wilful obstruction of an officer is an offence. It should be noted that, in many instances, the law concerning the licensing of theatres is also contained in local Acts that may supplement, modify or supersede the general law.

Health and safety enforcement Provisional licences As with many other forms of licensing, it is possible to grant a provisional licence where premises are under construction or alteration. In such circumstances, a Copyright © 1999 Taylor & Francis Group LLC

Enforcement of the provisions of the Health and Safety at Work, Etc. Act 1974 in theatre premises is allocated to local authorities under the Health and Safety (Enforcing Authority) Regulations 1998.

DEALING WITH LICENSING APPLICATIONS Although most routine matters relating to licensing administration are delegated to officers of a council, decisions on whether or not to grant licences are usually dealt with by a committee. It is important that sound administrative procedures in accordance with the rules of ‘natural justice’ are followed to avoid procedural difficulties at later stages. Committee hearings of licensing applications are generally more informal than court hearings as the rules on evidence do not apply and it is not given under oath. Nonetheless, the committee must endeavour to ensure that fair and orderly hearings take place and that applicants are given the opportunity of being heard before applications are refused, even if not expressly required by the law. Applicants should be permitted to be accompanied by a legal or other representative if desired, and as much notice of the hearing as is practicable should be given in order to enable them to prepare their case adequately. Similarly, any body or person wishing to make representations in respect of an application should also be given the opportunity of appearing before the committee. It is important that committee members are given copies of every document. It is also desirable for applicants to be informed of the nature of any objections to their application so that they can respond to them. While local variations to procedure will exist, there are certain elements that should always be followed. 1. Those present should identify themselves and the chairman of the meeting should ascertain whether the applicant, if unaccompanied, was aware that he could be represented. 2. The chairman or appropriate officer of the council should open the hearing with an outline of the relevant details of the application. 3. The applicant should be invited to present his case, following which he may be questioned by members of the committee. Persons who have made representations may also be afforded this opportunity.

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4. Comments are then invited from the technical officers, including the police and fire authority where present, following which the applicant should be permitted to ask questions of the officers. 5. The applicant should then to allowed to make a final statement. It is vital that the case of any party is prosecuted in the presence of the other, and it is essential that all the committee members remain present throughout the hearing. 6. Committee members should confine themselves to asking questions and must not indulge in any discussion of the merits of the case. 7. Any request for adjournment should be granted if refusal would prejudice a fair hearing and deny the applicant natural justice. 8. The applicant, third parties and officers of the council may be asked to withdraw at the end of the hearing to allow the committee to consider the matter. The committee’s legal adviser and minutes secretary will remain, and if it is necessary to seek clarification and further advice parties may be recalled. 9. When a decision is reached the parties will be recalled and the decision announced to the applicant, together with an explanation of any conditions that are to be attached or reasons for a refusal. The information is then given in writing as soon as practicable together with details of any rights of appeal.

LIAISON WITH THE LICENSING JUSTICES Although the administration of liquor licensing legislation in England and Wales is undertaken by the licensing justices, environmental health departments should play a significant part in the process. The formal system of notification of applications includes the requirement for the proper officer of the district council to be notified. The proper officer is responsible for returning comment on behalf of the council, and directors of environmental health, when designated as proper officers, are in an excellent position to co-ordinate the response and achieve improvements relating to food hygiene and health and safety.

A procedure must be set up to consult each relevant department of the council and coordinate the replies directly to the licensing justices. Where matters are raised it is often the case that an applicant will deal promptly with any deficiencies, or at least give a written undertaking to deal with them within a reasonable timescale, in order to ensure that a liquor licence is granted. If facilities are lacking or substandard and no informal agreement can be obtained, it is open to the proper officer to object to the issue of the licence. This will entail a personal appearance at the hearing, and so a system of early notification of this course of action to the council’s legal representatives should be in place in the internal administrative procedures. In order to keep the licensing justices informed of environmental health officers’ continuing interest in premises that they license, it is useful to send them copies of any notices of requirements served. It is also useful to keep the licensing justices informed of public entertainment licence decisions, as these often also relate to premises having liquor licences in some shape or form.

SWIMMING AND LEISURE POOLS To obtain the benefits and pleasure that swimming can give, the water of a swimming pool must be

fresh and crystal clear, attractive in appearance, and free from harmful and unpleasant bacteria. To achieve these characteristics, the water must be in a state of chemical balance. Only minimum amounts of chemicals should be used if they are not to cause discomfort to the delicate membranes of the bathers’ eyes, nose, throat and skin. The water supplied to pools will often be of varying quality, and therefore it can be seen that, apart from knowledge of the delicate adjustments necessary to maintain the correct balance, some knowledge of the quality of water making up each pool is necessary. Pool pollution may arise from a variety of sources: dust, hair, body grease and excretions from the nose and throat, for example, collect on the surface of the water (the top 16 cm of water contains 75% of the bacterial pollution). Many of the insoluble pollutants, such as dirt, sand from filters, and precipitated chemicals, may find their way to the bottom of the pool. In addition, there may be forms of dissolved pollution, such as urine, perspiration and cosmetics, and chemical pollution produced by reaction in the water treatment. While many of these factors are unpleasant and merely a nuisance rather than a risk to health, they must all be considered when designing a pool and selecting a water treatment plant. However, the most serious pollution comes from the living organisms introduced by the bathers themselves,

Fig. 14.1 Physical, chemical and biological pollution of swimming pools. Copyright © 1999 Taylor & Francis Group LLC

and it is this form of pollution that gives rise to a number of unpleasant conditions and diseases, and poses the most serious risk unless the pool is properly controlled and facilities such as showers and footbaths are provided to reduce pollution loads (see Fig. 14.1).

4.

5. Standards of operation Primary responsibility for pool water quality obviously lies with the pool operator, although environmental health officers have a key role through their enforcement of public health and safety legislation to ensure pools are maintained in a clean and safe condition. It is therefore essential that operators receive adequate training and knowledge to ensure the correct balance between treatment and pool usage.

6.

7. Sampling techniques The use of correct sampling techniques is essential to provide reliable information to determine whether disinfection is being carried out properly or not: 1. Although many pools will now have automatic monitoring equipment, these are not a substitute for routine testing by the operator, although they may allow a reduced programme of tests. 2. Training of pool operators should include advice on how to act effectively on the results and, as many of the tests require matching of colours, operators should be examined to ensure that they have no difficulty in reading results correctly. 3. While almost any sample of water from the distribution system may be typical of the whole this is not the case with swimming pools where pollution and disinfectant levels vary. The bottom at the deep end may receive little or no pollution over a period of time while continuing to be disinfected, and yet the shallow end could contain pollution added only a short time before the sample was taken. The state of the water therefore depends a great Copyright © 1999 Taylor & Francis Group LLC

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deal on the concentration of disinfectant and its speed of action. Sampling normally is done at the shallow end of a pool when bathers are present and active, but instructions on the proper place and time of sampling cannot be rigidly stipulated. Frequent residual determinations of deep end samples should be taken, but samples for bacteriological analysis at the deep end need not be done so frequently. For special pools (paddling, diving and remedial pools) variations on sampling technique are a matter of common sense. A record should always be kept of the place, time, and use of the pool, the pH and the amount of chlorine (residual and free) in the water. These do not need to be kept permanently, but are useful evidence of the state of a pool over the previous few weeks. The frequency of tests depends upon the use of the pool, its equipment and past performance, and heavy use, changes in disinfectant and recent failures will require more frequent bacteriological checks. No pool, however, should go without its occasional bacteriological check, with the samples being taken unannounced on a day and time when the pool is in use. Particular care must be taken to avoid contamination of samples and to neutralize the disinfectant in samples taken for bacteriological examination. When samples are taken for bacteriological analysis a chlorine determination should be made on another sample at the same time and place as the first. As results of bacteriological examinations are not immediately available, regular and frequent determinations of free residual (if chlorine is used) are an important check on the condition of the water and a guide to any action required. For no pool should this be less frequent than two to three times a day. Pool attendants should be trained to do the tests, but officers should also do a test when they visit. Test kits must be properly maintained and kept clean at all times with any glassware being thoroughly washed in clean water to remove test reagents before making subsequent tests.

12. Reagents have a ‘shelf life’ and require replacing at regular intervals. They should be properly stored when not in use.

Purification All swimming pools should be equipped with adequate purification plants to remove sources of pollution. The most usual method is to recirculate pool water after chlorination, filtration and aeration. By maintaining sufficient levels of a chosen disinfectant, usually chlorine, in the water, the rapid and immediate destruction of bacteria is assured. In any pool, water is also constantly being discharged, as part of the filtration process, and being replaced with fresh water. Pollution can also be progressively diluted. However, although a significant amount of pollution may be removed at the first turnover, the proportion falls with successive turnovers; even after the water has been through the filter system several times, a small proportion of pollution remains. The turnover rate of a pool is determined by the number of hours it takes to pass the total pool water volume through the filter. This influences the choice of filter and its operation during each 24-hour period. However, when choosing a filter it should be borne in mind that not all pool water will actually pass through a filter in a single turnover due to remixing of the filtered water when it is returned to the pool. It has been estimated that even in a pool with good circulation, something like seven ‘turnovers’ are required in order to filter 99% of the pool water. The following rates of turnover are suggested as being minimum requirements: 1. Private outdoor pools with a small bathing load would normally need a filter with an eight-hour turnover period. 2. Private indoor heated pools would require a six-hour turnover period. 3. School pools, which are often heavily used, require a turnover of less than two hours. (These figures will only be relevant if plant is well maintained and operated in good condition.) Copyright © 1999 Taylor & Francis Group LLC

Filtration From the foregoing, it will be seen that the selection of a filter should be undertaken with great care as it has an important bearing on the ultimate clarity, appearance and safety of the pool water. The filter is the heart of any pool installation, and without an effective one problems will arise in maintaining pool water in an acceptable condition for bathing. It is the correct use of a filter, in association with correct chemical disinfection, that maintains pool water bright and clear. For organisms such as Cryptosporidium, good filtration is the only means of protection against infection because it is resistant to the residual disinfectants in normal use. Filters are generally of the pressure type using sand, diatomaceous earth, or cartridges as the filtering medium.

Sand filters These are basically of three categories, depending on the rate of flow of water through the sand bed. The system employed by each type is similar. Water, under pressure, flows through a bed of graded sand enclosed in a container. These filters ultimately reach a point when they are unable to deal with further particulate matter, and they are then cleaned by ‘back washing’: the reversal of the water flow disturbing the sand particles and allowing the filtered-out debris to be backwashed to waste. Such filters, although expensive to install, are simple to operate and can be inexpensive in use, as the filter medium is reused time and time again.

Diatomaceous earth filters Although of varying designs, these filters tend to work on the same filtration principle as sand filters. This involves the use of a fine fabric supported within the filter vessel through which the water flows. Diatomaceous earth is introduced to the vessel as a filter powder, and forms a fine coating over the fabric. This layer removes the dirt from the water until, when fully loaded as shown by a

rise in pressure, the water flow is reversed, and the filter powder and dirt are discharged to waste. These filters can be very efficient and give good quality water when operated correctly. They do tend to be more expensive to use, however, as the diatomaceous earth has to be discharged to waste.

Cartridge filters These filters are normally used in small pools, and rely on the passage of water through pads of bonded fibre and/or foam. The dirt-coated pads are removed and replaced at intervals because it is uneconomic to try to clean dirty pads. This system can be relatively inexpensive to purchase and operate, but the efficiency of filtration, while adequate, may not be as high as for those types described above.

Sterilization While filters are an essential part of the water treatment process, a sterilant or disinfecting chemical has to be used to ensure that water is kept free from harmful bacteria and other organisms. While many disinfectants, such as ozone, brominel and iodine, are available, to date only chlorine has satisfied all the major requirements. Its effectiveness, low cost, speed of kill, and relative ease of control, makes it the most likely disinfectant to be encountered.

Chlorine In many pools, chlorine is injected automatically in controlled quantities. In most large pools, this method of sterilization is very sophisticated, and samples of water are tested and dosed to maintain continuous control of the levels of free and combined chlorine. As a result, many of the problems associated with high combined chlorine levels —chlorinous odours, stinging eyes and skin irritation—can be eliminated. Usually, the dose of chlorine is maintained at a sufficiently high level to produce a free residual of 1.5–3 ppm, but where there is heavy use, levels of Copyright © 1999 Taylor & Francis Group LLC

up to 5 ppm free chlorine should not give rise to complaint, provided the pH is carefully controlled (pH 7.4–7.6 being considered ideal). There are, at present, four main chlorine donors used for swimming pool water treatment, and the chlorine content varies according to the donor chosen. Sodium hypochlorite This form of chlorine liquid is widely used, and is an accepted method of chlorination. It is marketed commercially under a number of different names, and contains 10–15% chlorine. Because this product is very caustic and has a very high pH (pH 12), great care must be taken in its handling. In use it can cause the pH of the pool water to increase, will tend to increase total dissolved solids, and can cause scale and corrosion of metal pipes and valves. As this material can decompose quickly if stored incorrectly—in heat, light or in metal containers—it is inadvisable to order more than one month’s supply at a time. Fig. 14.2 shows a full sodium hypochlorite treatment system. Isocyanurates These materials offer the advantage of being stable in sunlight, making them suitable for use in outdoor pools. They are available in powder or granule form, are safe to handle and have a long shelf life. The granules are added directly to the pool water or in solution through a feeder. They dissolve to leave no sedimentation and, being slightly acid, have little effect on pH levels. Depending upon their form, they have relatively high levels of available chlorine: sodium dichloroisocyanurate 56%, and trichloroisocyanuric acid 91%. When using these materials, cyanuric acid levels should be maintained at between 25 ppm and 50 ppm; if it rises above 150 ppm, ‘chlorinelock’ can occur.

Calcium hypochlorite This is available in tablet or granular form, and is usually made into a 6% solution to be pumped

Fig. 14.2 Pool water treatment system using hypochlorite. (Courtesy of Wallace & Tiernan, Tonbridge, Kent.)

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into the circulation. The material contains 65% minimum of available chlorine that is stable if stored in cool, dark conditions prior to dilution. In use, this material has the advantage over sodium hypochlorite of not causing the pH level to rise by as much, and it does not add nearly as much total dissolved solids (TDS). A disadvantage is that a much larger dosing pump is required, and it needs constant agitation to keep it soluble when made up in solution.

Determination of residual chlorine For low concentrations of chlorine in pool waters, use is made of the Palin-DPD (diethylphenylenediamine) test for chlorine, and phenol red tablets (containing a reagent to counter chlorine bleaching) for the pH test. Reliable and simple to use, these kits use tablets and comparator discs to monitor chlorine and pH levels.

Chemistry of chlorine in pool water When chlorine and water are mixed, the free chlorine killing agent hypochlorous acid is formed, together with hypochlorite ion and hydrochloric acid. The hypochlorous acid combines with organic pollutants (body fluids, dead skin and ammonium compounds) to form chloramines— combined chlorine. The hypochlorous acid (free chlorine) is rapid acting, whereas hypochlorite ion is slow acting, and the percentage of these constituents is influenced by the pH, e.g. the efficiency of free chlorine is approximately 100% higher at pH 7.5 than it is at pH 8.0, and the former figure should be aimed for. However, in addition to adding bacteria to a pool, bathers constantly add nitrogenous matter, and chlorine is also needed to deal with these pollutants and remove chloramines in the pool water. Both hydrochloric acid, which reduces the pH of the water, and nitrogen trichloride can be formed unless adequate hypochlorous acid is added. Control of the amount of chlorine added is therefore essential to ensure a satisfactory free chlorine level, and that the proportion of combined chlorine is maintained at about one-third of the total chlorine present. Copyright © 1999 Taylor & Francis Group LLC

Breakpoint chlorination If insufficient chlorine is available in a pool, the combined chlorine level will rise, the water may lose colour and clarity, and nitrogen trichloride may be produced resulting in complaints of smarting eyes and skin irritation among bathers. If sufficient chlorine is added, it will combine with the pollutants and break them down to harmless substances. Further additions of chlorine will then be present in the water as free chlorine, available to deal with further pollution as it arises. A ‘breakpoint’ occurs and the residual falls, and from this point free chlorine can exist together with combined chlorine. This is the system adopted in most pools in the UK.

Ozone The use of ozone in the purification of swimming pool waters is practised extensively throughout mainland Europe, and appears to be finding some favour in the UK. The initial cost of an ozone installation is high, but it is claimed that if used in a new pool complex, the cost difference may be largely offset by capital savings in heating and ventilation plant. It is also claimed that ozone has several advantages over chlorine in that it is an effective bactericide, and is also effective against viruses. It oxidizes organic matter and the resultant pool water has excellent clarity. However, it has a short life in solution, and is toxic and aggressive. As ozone does not remain in water as ‘residual’ ozone, it is necessary to chlorinate to provide residual protection in the water. The amount of chlorine necessary is, however, greatly reduced, and the process still results in an improved atmosphere in the pool hall, with a noticeable lack of characteristic monochloramine odour. Fig. 14.3 shows a diagrammatic layout of an ozonization plant. The dose of ozone should be about 2 mg/l. ‘Slipstream’ ozonation is now available. This treats only 10% of the water with ozone, the rest being treated by a normal filter and chlorine dosing system.

Fig. 14.3 Ozonization of swimming pool water.

Bromide

Other disinfectants

Treatment of swimming pool water with bromide is sometimes encountered as it is claimed to counteract some of the disadvantages of using chlorine as a disinfectant. It has been widely used in the USA since the 1940s, and is commonly used in its solid form under the name Dihalo, which combines bromine (66%) and chlorine (28%). It has been predicted that the use of this disinfectant may increase in the future, although its relatively high cost may restrict this. In France, liquid bromine has been used in swimming pool water treatment, and its innocuousness to bathers has been confirmed in a number of toxicological studies. Its bactericidal, viricidal and algicidal properties are comparable with chlorine, and it is claimed that because the connection between its bactericidal activity and the pH is slight, this factor can be kept at a level where the risk of irritation is minimal. The bromine content of water can be readily measured by chemical methods using colorimetry or by electrochemical methods. Reagents used are orthotolidine or DPD, the former being the most sensitive.

Iodine chlorine dioxide, ultraviolet light and metal ions (electro katadyn system) have been used, mainly outside the UK, but their use is rare as all have disadvantages.

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The determination of pH values pH is the expression used to indicate the degree of acidity or alkalinity of water. Pure neutral distilled water has a pH of 7.0; a figure below 7.0 will indicate that the water is acidic, above 7.0 that the water is alkaline. Normal waters contain a variety of substances in solution. Calcium and magnesium salts give the water its characteristic hardness, for example, and traces of many other compounds are naturally present and are affected by changes in pH. Alkaline conditions can give rise to irritation if the pH rises much in excess of pH 8.0, and the effectiveness of chlorine as a sterilant is also greatly reduced. In ‘hard’ water areas, another problem can arise with a high pH: the precipitation of calcium salts, which results in a cloudy pool and blocked filters. Should this occur, the filter must be thoroughly

backwashed as the accumulation of the deposit may set hard and possibly ruin the filter. If the pool water is allowed to go acidic, even very slightly, two major difficulties arise. Firstly, corrosive conditions will exist, and any metal parts of filter systems etc. in the pool will be attacked, and any alkaline floor and wall finishes, such as the proprietary ‘Marbelite’, may also suffer. Secondly, in acidic conditions, unpleasant compounds are formed by the interaction of chlorine and polluting substances, which cause irritation to mucous membranes and eyes, and give rise to the so-called ‘pungent odour of chlorine’. This is the reason for most of the complaints of ‘over-chlorination’, and the cause is not an excess of chlorine, but the formation of these irritant and smelly compounds due to the presence of too little chlorine in an acid water. This is the reason for maintaining pool water at around pH 7.4 to 7.6, i.e. slightly alkaline. It will give some protection against the accidental production of acid conditions, while still allowing effective performance by the chlorine. In measuring pH values, advantage is taken of the fact that certain dyes, known as indicators, change their colour in a definite and reproducible manner and degree, according to the pH value of the solution with which they are mixed. Phenol red or diphenol purple are the most suitable for pool water, their ranges being pH 6.8 to 8.4 and 7.0 to 8.6, respectively. Both are available in tablet form. For very accurate measurement of pH, a meter should be used.

excessive foaming or the formation of a foam layer on the surface of the pool.

Total dissolved solids (TDS) The addition of water treatment chemicals to pool water results in an increase in the amount of solids dissolved in the pool water. When these increase to undesirable levels the colour, clarity, appearance and taste of the water can be adversely affected, to the discomfort of bathers. A maximum of 1500 ppm should not be exceeded. The choice of disinfectant can have a significant effect on the TDS content of pool water, and control can be obtained by accurate control of pH value (7.3– 7.5), the use of minimum quantities of chemicals, regular backwashing of filters and dilution of pool water with fresh water. Alkalinity Alkalinity is the quantitative analysis of the amount of alkali present in the water as bicarbonate, which will act as a ‘buffer’ and be readily available to react with fluctuating pH conditions and maintain the clarity and comfort conditions in the pool. A level of around 100 mg/l is desirable. It must not be allowed to rise above 220 mg/l, otherwise corrosion can result. High levels of alkalinity can be lowered by the addition of hydrochloric acid to the pool water. Water quality guidelines

Algal control Algae are tiny aquatic plants that often first appear in pools as brown or green slimes on steps, walls and floors. If they are allowed to establish themselves, they can be a considerable nuisance. They grow rapidly, increase chlorine demand, block filters and are the main cause of discoloured water. In correctly maintained pools, algal problems are rare. Weekly additions of algicide will establish a buffer against temporary or inadvertent loss of chlorine, which may create the conditions that favour rapid algal growth. Care must be taken when using algicides of the quaternary type, as over dosing may lead to Copyright © 1999 Taylor & Francis Group LLC

It is recommended that where water quality values are set, they are seen as objectives for operators to follow rather than as rigid or inflexible standards. Colony counts and the test for Escherichia coli and other coliform organisms provide simple tests for checking the bacteriological quality of swimming pool water. If coliform organisms are absent and pH and disinfectant residual levels are maintained at correct levels, the risk to bathers will be minimal. Colony count tests, which determine the number of organisms capable of living in the pool water, although regularly carried out, are not essential for assessing

bacteriological safety. They are, however, useful as indicators of the general quality of the water and that filtration and disinfection processes are operating correctly. A range of values can be established for each pool, depending on the local circumstances and disinfectant used. These will, after a time, establish a norm for the pool, and this can be used to identify significant changes in water quality. This is more useful to the enforcement officer than the actual numerical results themselves. Guidelines on appropriate bacteriological standards are to be found in the Department of the Environment’s booklet The Treatment and Quality of Swimming Pool Water [12]. The absence of coliform organisms with colony counts not greater than 10 (and always fewer than 100 organisms per ml) at 24 hours gives a good indication that the quality of the pool water is satisfactory. Counts above 100 organisms per ml require investigation. Occasional counts of up to 10 coliform organisms, in the absence of E.coli, are acceptable provided that they do not occur in consecutive samples, that pH and disinfectant levels are satisfactory, and that the colony count levels are within the established norm for the pool. Where there are persistently poor results, which may indicate disinfection and filtration failures, a full investigation and sampling programme must be implemented. In these circumstances, it may also be necessary to look for the presence of Pseudomonas aeruginosa and possibly Staphylococcus aureus, as extra indicators of water quality. Procedures for taking samples are described in detail in The Bacteriological Examination of Drinking Water Supplies [13].

Whirlpool spas These have become very popular forms of water recreation, and are now to be found in many hotels, clubs and leisure centres, etc. In theory, their disinfection should be relatively simple, but their very popularity and the heavy loading they are subjected to make this a difficult task unless a strict regime is utilized. Spa pools are commonly disinfected with Dihalo (bromine), although more are changing to Copyright © 1999 Taylor & Francis Group LLC

hypochlorite disinfection for easier and more efficient control. Most pools run at a temperature of around body heat (37°C), and this may induce bathers to sweat heavily. In leisure and fitness centres, pools are often used after heavy exercise often without showering before immersion, and because the pool volume is small, pollution levels will be high. The combination of pollution, temperature and bathers being close together in a confined space, coupled with inadequate surface water removal, insufficient filtration and unbalanced water can lead to discomfort and danger. The water temperature is ideal for skin rash inducement and respiratory infection, unless disinfection is efficient. Pseudomonas aeruginosa folliculitis has been the most commonly identified infection associated with whirlpool spas, with the characteristic rash developing anywhere between eight hours and five days after bathing (mean incubation period 48 hours). When investigating complaints, it is important to differentiate this rash from others of an eczematous nature, sometimes associated with solid bromine treated pools. The folliculitis may, on occasions, be associated with mastitis and otitis externa in the bathers. Circumstantial evidence has also linked whirlpool spas to occasional urinary tract infections, and they may serve as sources of other infections including legionellosis and Pontiac fever. Defective maintenance or operation are usually common in reports of outbreaks. The Swimming Pools and Allied Trades Association (SPATA) has produced standards for the installation and operation of commercial spa pools, and there is mention of SPATA in the Department of the Environment’s booklet The Treatment and Quality of Swimming Pool Water [12]. These guidelines should be followed to ensure trouble-free operation. It is also recommended that, in addition to emptying and refilling pools at least weekly, the pH value, disinfectant concentration and temperature be tested regularly during the day, and records be kept in a log book. From time to time, tests for alkalinity, total dissolved solids and surface and calcium hardness should be undertaken. Control of bathing load and enforced intervals between bathing sessions can assist in maintaining water quality.

Biological standards may be found in SPATA’s Standards for Spa Pools [14], which states that the biological conditions of the water shall be at the judgement of the environmental health officer for the area. Notwithstanding this, the standards recommended for spa water are: • total plate count at 37°C should not exceed 100 colonies for 1 ml of sample water • no E.coli in 100 ml of sample water. See also Hygiene for Spa Pools [15]. The health and safety guidelines for public spas and hot tubs issued by the US Department of Health and Human Services suggests. ‘The presence of organisms of the coliform group, or a standard plate count of more than 200 bacteria per millilitre or both in two consecutive samples or in more than 10% of the samples in a series shall be deemed as unacceptable water quality.’

operators, and these responsibilities extend to protecting the public that may use the pool and any contractor working at pool premises. The HSE is the enforcing authority at local authority-run pools, including school pools. At pools that form part of residential accommodation (hotels, holiday camps, etc.) and leisure complexes, enforcement is the responsibility of the local authority. The Public Health Act 1936 contains powers for local authorities to make by-laws for the regulation of swimming pools under their management. Model by-laws are available from the Department of the Environment, Transport and the Regions (DETR), and cover aspects such as water purity, hygiene, behaviour and the prevention of accidents. Even though the above legislation exists, effective safety relies on the general acceptance and adoption of recognized standards, such as the following.

The health and safety aspects of pools

Safe design of the pool structure, systems and equipment

Guidance on safety in swimming pools, the risks associated with their operation, and the precautions to be taken to achieve a safe environment for the public that uses them and the employees who work in them, is to be found in the HSE/ Sports Council Publication Safety in Swimming Pools [16]. This booklet outlines the standards of good practice as a basis for decision-making by managers on what arrangements are best for their pools. The risk of drowning in a swimming pool is not high in comparison with the overall national drowning problem, with only 3–5 % of drownings occurring in pools. Considering the estimated 150 million visits to swimming pools each year, the figures are small. However, any death that can be avoided, especially in such a controlled environment where all risk should be removed, is inexcusable. The problem is therefore primarily one of management. Existing legislation, which controls safety in swimming pools, is to be found in the Health and Safety at Work, Etc. Act 1974 and the Public Health Act 1936. The Health and Safety at Work, Etc. Act 1974 places certain general obligations on all pool

Good design is essential for a safe pool environment, and safety is one of the important factors looked at by the Sports Council when considering schemes submitted for grant aid. Designers and sponsoring authorities are encouraged to meet the standards recommended in the booklet [16]. Details on the structure and finishes of the pools and buildings are outlined to avoid dangerous situations, such as abrupt changes in floor level in wet areas, being built into a pool. Precautions to prevent people, particularly young children, having accidents or falling through open ledges of stairways and landings are included. Good planning and circulation layout ease management problems and enhance safety. Floor and wall surfaces and features next to wet circulation areas should not present a hazard to bathers, and slipresistant flooring and well-designed walls that avoid sharp edges, projections or abrasive finishes are recommended to minimize these hazards. Suitably toughened glazing, as specified in BS6206, should be used in areas adjacent to wet circulation routes to reduce the risk of injury and damage.

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Entry to and exit from a pool should not only be safe but easy, and the design and sighting of these facilities must be suitable for the pool. Pool edges should be clearly visible—colour contrasted—so that bathers can avoid hitting the edges when diving or jumping in. This may not be feasible where the pool takes the form of a gently sloping ‘beach’, but in such leisure pools this is not so critical. The profile of the pool bottom should not be a hazard to swimmers in the pool or those jumping in, and for rectangular pools the Sports Council has recommended a number of possible pool profiles, with water depths ranging from 2 m deep water to 90 cm shallow water with gradients of not more than 1:15. In irregular-shaped leisure pools, profiles will depend on pool layout and any features present. Wave machine openings, sumps, and inlets or outlets of the pool water circulation system should have suitable protective grilles or covers designed to prevent trapping. Undue suction should not be created at openings, which could otherwise result in a body being held against the grilles. Any safety signs used should comply with the Safety Signs Regulations 1980, and the content and location of signs needs careful consideration as part of the overall safe pool environment. Clear signs, slowing depths of water, areas where it is safe to swim or dive, and those giving instruction on the safe use of diving or other equipment are particularly important. Examples are given in Safety in Swimming Pools [16]. The installation of heating, ventilation and air conditioning systems in pools needs careful consideration, as these factors can indirectly affect pool safety. They also promote rapid corrosion of pool-side structures if out of balance by permitting excess humidity. A comfortable temperature should be maintained in the swimming pool hall and changing areas. A maximum temperature of around 27°C in the water with the air temperature about 1°C higher, to avoid excess condensation, is suitable. Effective, draught-free ventilation should be provided, and humidity and air movement should be balanced to achieve comfortable conditions. Adequate lighting, either natural or artificial, should be provided to avoid excessive glare or Copyright © 1999 Taylor & Francis Group LLC

reflections from the pool water, to avoid solar gain, and to ensure that the whole of the pool and its base are easily visible to lifeguards and bathers. Wet and corrosive conditions in pools can compound the risks from electricity. Designers should be aware of the various risks of shock, burns, fire or explosion, and take these dangers into account.

Maintenance requirements and safe working practices The correct planned maintenance of buildings and plant is essential in ensuring the health and safety of pool users and employees. Arrangements should therefore be made for their thorough inspection and examination, either by utilizing manufacturers’ instructions or by pool operators devising them as part of the pool operating procedure. Maintenance should take place at the specified intervals and records should be kept of any remedial work carried out. Buildings should generally be inspected annually, but where high humidity levels increase the risk of corrosion, and chemicals in the atmosphere may increase the risk, some structures may require more frequent inspection, e.g. every six months. Any steam boilers and plant should be maintained to the standards required by sections 32–35 of the Factories Act 1961, including a regular, thorough examination by a competent person. After each examination, a certificate should be obtained and kept available for inspection. Staff should be adequately trained for their pool duties and useful courses to provide this training are organized by the Institute of Baths and Recreation Management (IBRM). These include courses for supervisors, attendants and plant operators. Courses designed for the latter include technical aspects of pool water treatment. Asbestos may be found in swimming pool premises since at one time it was widely used for insulation and fire protection. All work with asbestos is now subject to the Control of Asbestos at Work Regulations 1987 as amended and its associated codes of practice. Generally speaking, only persons licensed by the HSE under the

Asbestos (Licensing) Regulations 1983 as amended may work on asbestos. Access to exterior windows for cleaning can pose special problems in swimming pools. Suitable guidance on this aspect of maintenance can be found in Prevention of Falls to Window Cleaners [17]. Fixed electrical installations should be inspected and tested to the standards in the current edition of Regulations for Electrical Installations published by the Institution of Electrical Engineers [18]. Because of the adverse conditions of a pool environment, tests should be done at least annually.

The pool water treatment system Whichever system of disinfection, filtration and circulation is used, it must be operated safely. The main risks associated with treatment systems include risks to bathers from unclear water, and risks to bathers and employees from the chemicals used in disinfection systems. There is often the added danger to employees of having to work in confined spaces on these items of plant. Written health and safety policy statements should include an assessment of all of the hazards associated with all aspects of the plant and the precautions to control the risks. Adequate staff training should be provided. Advice on delivery, storage and handling of chemicals is given in a series of Department of the Environment booklets (see Further reading) giving guidelines for the design and operation of plant using different disinfectants. All chemical containers should be clearly labelled with their contents, and the packaging and labelling should comply with the Chemicals (Hazard Information and Packaging) Regulations 1993. Storage facilities should be secure, dry, well ventilated, clearly marked and sited well away from public entrances and ventilation intakes. Safe systems of work should always be followed to safeguard employees from harmful materials; these may include the provision of protective clothing and, in some cases, respiratory protection. Firstaid provision should be adequate to deal with the consequences of chemical splashes etc. Copyright © 1999 Taylor & Francis Group LLC

Where any major, uncontrolled release of toxic gas is possible, written emergency procedures for dealing with such an incident should be prepared, and should include evacuation procedures and the notification and co-ordination of emergency services. While the Department of the Environment booklets give good advice on the safe design and operation of the common disinfection systems, the more important hazards associated with these systems are listed below. SODIUM HYPOCHLORITE AND ACID SYSTEMS Used with automatic dosing systems these have been known to release chlorine gas when water pumps have failed. Correct siting of pumps to avoid them losing their prime and the provision of interlocks to prevent incorrect dosing, as well as additional sampling points and correct maintenance procedures, are measures to be adopted to eliminate this hazard. ELECTROLYTIC GENERATION OF SODIUM HYPOCHLORITE This can sometimes produce hydrogen and, occasionally, chlorine gas. In view of the flammable nature of hydrogen the selection, siting and maintenance of electrical equipment is likely to be a specialist job. OZONE SYSTEMS These present hazards from the chemicals used and from the electrical ozone generating process. Guidance on the health hazards associated with ozone is to be found in Ozone Health Hazards and Precautionary Measures [19]. Ozonators should be provided with automatic shut-down devices to cope with any abnormal operation. Where ozone devices are installed to remove ambient odours in changing rooms, ozone levels must not be allowed to exceed the recommended occupation health limits set out in the HSE guidance note Occupational Exposure Limits [20]. CHLORINE GAS SYSTEMS Chlorine gas is particularly hazardous and, in view of the advice contained in the statement on the use of chlorine gas in the treatment of water of swimming pools

issued by Department of the Environment Circular 72/78 recommending that this use should cease by 1985, it will only rarely be found. Where it is found, the advice contained in the HSE booklet Chlorine from Drums and Cylinders [21] and the Department of the Environment booklet Swimming Pool Disinfection Systems Using Chlorine Gas—Guidelines for Design and Operation [22] should be followed. ELEMENTAL LIQUID BROMINE SYSTEMS Being less hazardous than other pressurized gas systems, the main problems of these systems relate to spillage. Adequate supplies of neutralizing material should be provided to deal with such emergencies. CALCIUM HYPOCHLORITE, CHLOROISOCYANURATE, HALOGENATED DIMETHYLHYDANTOIN AND SOLID ANCILLARY SYSTEMS The main risks relate to general chemical handling and the generation of chlorine gas if chemicals are mixed or stored incorrectly. pH ADJUSTMENT BY THE USE OF CARBON DIOXIDE The system of metering carbon dioxide gas into the water circulation system is becoming more popular as it eliminates the risk of chlorine gas generation—unlike acid and hypochlorite systems. However, because of the risk of asphyxiation, carbon dioxide should be stored outside of buildings. SAND FILTERS When it is necessary to enter filter vessels the advice published by the HSE in Confined Spaces [23] should be followed.

Supervision arrangements to safeguard pool users All pools require supervision if they are to be operated safely. Pool operators should therefore consider carefully the main hazards associated with their pool, and make detailed arrangements to deal with them. The precautions taken by the pool operator must include a written operating procedure, which sets out the organization and arrangements for user safety, including details of staff training requirements. This is particularly important when a pool may be used without constant poolside supervision. These should Copyright © 1999 Taylor & Francis Group LLC

be constantly reviewed and updated so as to take account of incidents experienced at the pool, thus keeping the procedures relevant. By displaying suitable signs and posters such as those based on the Swimming Pool User’s Safety Code published by RoSPA [24], bathers can be made aware of potential hazards and encouraged to act responsibly. Generally, the DETR recommends that a minimum water area of 2 m2 per bather be allowed for physical safety, but this is only a guideline and operators must assess the maximum number that can be safely admitted to their pool, taking account of bathers’ behaviour and also the capacity of the pool water treatment system. Where it is deemed necessary to provide constant poolside supervision, sufficient adequately trained lifeguards should be provided and effectively organized and supervised. Because of the variety of pool facilities and users, it is not feasible to make specific recommendations for lifeguard numbers. These must be arrived at by taking account of all relevant local factors, although as a starting point some advice on minimum numbers is set out in the Department of the Environment publication The Treatment and Quality of Swimming Pool Water [12].

REFERENCES 1. Health and Safety Executive (1997) Fairgrounds and Amusement Parks: Guidance on Safe Practice, HSG 175, HSE/Joint Advisory Committee on Fairground and Amusement Parks, HSE Books, Sudbury, Suffolk. 1a. Royal Society for the Prevention of Accidents (undated) Fairground User’s Safety Code, WS 53, RoSPA, Birmingham. 2. National Playing Fields Association (1983) Playground Management for Local Councils, NPFA, London. 3. Noah, N.D. (1987) Guidelines for Hygienic Hairdressing, Public Health Laboratory Service, Colindale. 3a. Department of Health and Social Security (1987) AIDS: Guidance for Hairdressers and Barbers, HMSO, London.

4. Health and Safety Executive (1986) How to Use Hair Preparations Safely in the Salon, HSE Books, Sudbury, Suffolk. 5. Noah, N.D. (1983) A Guide to Hygienic Skin Piercing, PHLS Communicable Disease Surveillance Centre, Colindale. 6. Health and Safety Executive (1985) Risk of Infection from Skin Piercing Activities, LAC(T) 5.6.1, HSE Books, Sudbury, Suffolk. 7. Health and Safety Executive/Home Office/ Scottish Office (1993) Guide to Health, Safety and Welfare at Pop festivals and Similar Events, HMSO, London. 8. Home Office (1990) Guide to Fire Precautions in Existing Places of Entertainment and Like Premises, HMSO, London. 9. National Outdoor Events Association (1997) Code of Practice for Outdoor Events, NOEA, Wallington, Surrey. 10. Home Office/Scottish Home Office and Health Department (1990) Guide to Safety at Sports Grounds, HMSO, London. 11. Sports Council/Football Trust (1994) The Guide to Safety at Sports Grounds, Sports Council, London. 12. Department of the Environment (1984) The Treatment and Quality of Swimming Pool Water, HMSO, London. 13. Department of the Environment/Department of Health/Public Health Laboratory Service (1983) The Bacteriological Examination of Drinking Water Supplies, Report 71, HMSO, London. 14. Swimming Pools and Allied Trades Association (1983) Standards for Spa Pools, SPATA, Croydon. 15. Public Health Laboratory Service (1994) Hygiene for Spa Pools, PHLS, Colindale. 16. Health and Safety Executive/Sports Council (1988) Safety in Swimming Pools, Sports Council, London. 17. Health and Safety Executive (1983) Prevention of Falls to Window Cleaners, Guidance Note GS25, HSE Books, Sudbury, Suffolk. 18. Institution of Electrical Engineers (1997) Requirements for Electrical Installations, IEE, Stevenage. 19. Health and Safety Executive (1983) Ozone Health Hazards and Precautionary Measures, Copyright © 1999 Taylor & Francis Group LLC

20.

21.

22.

23.

24.

Guidance Note EH38, HSE Books, Sudbury, Suffolk. Health and Safety Executive (1998) Occupational Exposure Limits, Guidance Note EH40, HSE Books, Sudbury, Suffolk. Health and Safety Executive (1987) Chlorine from Drums and Cylinders, Guidance Booklet HS(G)40, HMSO, London. Department of the Environment (1980) Swimming Pool Disinfection Systems Using Chlorine Gas—Guidelines for Design and Operation, HMSO, London. Health and Safety Executive (1998) Entry into Confined Spaces, 101, HSE Books, Sudbury, Suffolk. Royal Society for the Prevention of Accidents (1992) Swimming Pool User’s Safety Code, RoSPA, Birmingham.

FURTHER READING Anon (1993) Pool Manager’s Handbook, Olin (UK), Droitwich. Association of Professional Piercers (1994) Procedure Manual, APP, San Francisco. Chamberlain, M. (1985) Swimming pools— established safety standards. The Safety Practitioner, March. Department of the Environment (1975, reprinted 1980) The Purification of Swimming Pool Water, HMSO, London. Department of the Environment (1981) Swimming Pool Disinfection Systems Using Calcium Hypochlorite, Chloroisocyanurates, Halogenated Dimethylhydantoins and Solid Ancillary Chemicals—Guidelines for Design and Operation, HMSO, London. Department of the Environment (1982) Swimming Pool Disinfection Systems Using Chloroisocyanurates—A Survey of the Efficacy of Disinfection, HMSO, London. Department of the Environment (1982) Swimming Pool Disinfection Systems Using Ozone with Residual Chlorination—Monitoring the Efficacy of Disinfection, HMSO, London. Department of the Environment (1982) Swimming Pool Disinfection Systems Using Ozone with

Residual Free Chlorine and Electrolytic Generation of Hypochlorite—Guidelines for Design and Operation, HMSO, London. Department of the Environment (1982) Swimming Pool Disinfection Systems Using Sodium Hypochlorite and Calcium Hypochlorite—A Survey of the Efficacy of Disinfection, HMSO, London. Department of the Environment (1982) Swimming Pool Disinfection Systems Using Sodium Hypochlorite—Guidelines for Design and Operation, HMSO, London. Department of the Environment (1983) Swimming Pool Disinfection Systems Using Electrolytically Generated Sodium

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Hypochlorite —Monitoring the Efficacy of Disinfection, HMSO, London. Noise Council (1995) Code of Practice for the Control of Noise from Outdoor Pop Concerts, Noise Council, London. Pool Water Treatment Advisory Group (1995) Pool Water Guide, PWTAG, Diss, Norfolk. Swimming Pools and Allied Trades Association (1980) Standards for Swimming Pools—Water and Chemical, SPATA, Croydon.

15

Port health Peter Rotheram

DEVELOPMENT OF PORT HEALTH Systematic quarantining of ships arriving from Levantine Turkey was adopted by Venice in the aftermath of the Black Death when it became apparent that the Levant had become a permanent reservoir of plague. The Venetian ships collected valuable cargoes of silk and spices that had been transported overland to the Levant, and they were isolated in quarantine for 40 days on returning to Venice to establish that they were not infected. When plague spread to the Baltic and the Low Countries, ships arriving in England from infected areas were detained by an Order of Council, but it became increasingly difficult to restrict the illicit landing of people [1]. English common law did not oblige townspeople to maintain a watch between sunrise and sunset or to detain people unless they had committed a felony. The first Quarantine Act of 1710 removed these impediments to enforcing quarantine, but it was only after the Levant Company lost its monopoly of trade with Turkey in 1753 that legislation was introduced—an Act for Enlarging and Regulating Trade into the Levant Sea 1753 and an Act to Oblige Ships to Perform Quarantine 1753 [1] — requiring all ships loading in the Levant to undergo quarantine in the Mediterranean. But the Dutch did not apply such rigorous quarantine [2], and with more than half the cotton used in England transhipped through Holland, British shipping was at a disadvantage. As a consequence, the law was subsequently amended. The Act to Encourage Trade into the Levant Sea Copyright © 1999 Taylor & Francis Group LLC

1799 provided a more convenient mode of performing quarantine. Ships from the Levant were permitted to perform their quarantine in the Medway at Stangate Creek, hulks were provided for cargoes to be aired, and Parliament voted funds for the building of a lazaret at Chetney Hill. The relaxation of quarantine was achieved amid controversy about whether plague was ‘epidemic’ or ‘contagious’. Charles Maclean, a ship’s surgeon who had served with the East India Company, propounded an elegant hypothesis suggesting that diseases that were seasonal and could infect people more than once were ‘epidemic’, while those that occurred independently of season or the state of the air and only infected a person once were ‘contagious’. His hypothesis [3] was based on the observations of ships’ surgeons that fevers such as typhus and yellow fever were dependent on the season and the state of the air. The experience of Southwood Smith at the London Fever Hospitals brought him to the same conclusions as Maclean, and he developed his theme on the high economic costs of disease that was later adopted by Edwin Chadwick [4]. The spread of cholera to Great Britain prompted the General Board of Health to produce a report on quarantine [5]. Largely the work of Southwood Smith, it was decidedly anticontagionist and led to the first International Sanitary Conference in 1851. The resulting convention was ratified by only France and Sardinia, however. The British view was that the enforced detention of ships in quarantine was only necessary when the disease was actually on board, and that if the

ship was in a foul condition it should be cleansed and disinfected before pratique was granted. Orders assigning to the Poor Law Authorities at endangered ports the power to deal with shipping arrivals suspected of having cholera on board were issued by the General Board of Health in 1849. Section 32 of the Sanitary Act 1866 subsequently made ships subject to the jurisdiction of the Nuisance Authority of the district in which they were moored. Regulations were introduced requiring ships to be inspected and dealt with as if they were a house. This arrangement was not entirely satisfactory when there was more than one Nuisance Authority in a port, and Section 20 of the Public Health Act 1872 empowered the Local Government Board to constitute one Port Sanitary Authority with jurisdiction over the district on any port established by the commissioner of customs. These statutory powers were consolidated in 1875 and re-enacted in the Public Health Act 1936, which changed the designation Port Sanitary Authorities to Port Health Authorities. The statutory provisions relating to port health were subsequently incorporated into the Public Health (Control of Disease) Act 1984. In Scotland, port health functions are exercised by port local authorities, designated under the Public Health (Scotland) Act 1897. A Joint Board constituted as a port health authority precepts the constituent local authorities for its expenditure.

JURISDICTION The functions of a port health authority are assigned directly by statute or in a statutory instrument. The area of jurisdiction of a port health authority is specified in a statutory order. It may comprise the whole or part of a customs port, including the whole of any wharf and the area within the dock gates. A port health authority may, within its district, exercise any of the functions of a local authority relating to public health, waste disposal or the control of pollution assigned to them in the order. The Prevention of Damage by Pests Act 1949 provides that the local authority for any port health Copyright © 1999 Taylor & Francis Group LLC

district is the port health authority. It is also designated as a local authority under Parts I and III of the Environmental Protection Act 1990 and as a food authority under the Food Safety Act 1990. Any local authority having jurisdiction in any part of a port health district is excluded from exercising any functions assigned to the port health authority.

ORGANIZATION Most of the work of a port health authority is undertaken by environmental health officers; where a district council is the port health authority, the work may devolve on a few specialists. The whole environmental health department may be involved, particularly where the port or airport is handling traffic outside normal business hours. When the port health authority is constituted as a joint board, it will employ its own environmental health officers and administration staff and precept the constituent local authorities for any expenditure incurred. In either case, the port health authority will appoint one or more port medical officers; district health authorities have a statutory obligation to provide these services free of charge to the port health authorities. The port medical officer may also be appointed as a medical inspector of aliens, to undertake medical examinations on behalf of the immigration service. Where a port or airport is approved by the European Union (EU) for the importation of produce of animal origin from third countries, an official veterinary surgeon (OVS) has to be appointed by the competent authority. At any port or airport the port health officers liaise with customs officers and traffic controllers to maintain surveillance of shipping and aircraft arrivals. Customs officers alert the port health officer whenever they become aware of any apparent contravention of the Public Health (Ships) Regulations 1979 and Public Health (Aircraft) Regulations 1979, or the Imported Food Regulations 1997. When the port health authority is not an enforcing authority under the Animal Health Act 1981 the port health officer will advise the responsible authority of

any animals that are imported contrary to the rabies control legislation. Details of the cargo imported on a ship or aircraft can be cleared from a manifest, which can be obtained from the carrier. This information may be stored as computerized inventory control, which involves the importer entering details of each consignment on the computer system to obtain clearance from customs and port health.

INTERNATIONAL HEALTH CONTROL Successive International Sanitary Conferences eventually led to the elimination of quarantine [6], and under the auspices of the World Health Organization (WHO) the International Health Regulations 1969 specified the maximum restrictions that could be applied to ships and aircraft involved in international commerce. They are based on the assumption that the only effective protection against the spread of epidemics is the provision of wholesome supplies of food and water, the effective disposal of waste, and the elimination of vectors of disease on ships and aircraft. Following the increasing emphasis on epidemiological surveillance for communicable disease recognition and control, the WHO agreed to strengthen the use of epidemiological principles as applied internationally, to detect, reduce or eliminate the sources from which infection spreads, to improve sanitation in and around ports and airports, to prevent the dissemination of vectors and, in general, to encourage epidemiological activities on the national level so that there is little risk of outside infection establishing itself. As a result of a worldwide campaign by the WHO, smallpox was eradicated and vaccination against the disease is no longer required. Efforts to control cholera by vaccination failed to prevent the spread of the disease, and people arriving from infected areas are no longer required to have cholera vaccinations. Yellow fever and plague are controlled by measures to control the vectors of the disease. A yellow fever vaccination is required for people arriving in countries where the mosquito vector of the disease is prevalent, but this does not include the UK. Copyright © 1999 Taylor & Francis Group LLC

Following the change in the approach to dealing with cholera and the elimination of smallpox, the International Health Regulations were amended in 1973 and 1981. The diseases subject to the Regulations are plague, yellow fever and cholera, and provision is made in the UK for implementing the government’s obligations under these regulations in the Public Health (Ships) Regulations 1979 and Public Health (Aircraft) Regulations 1979. The effect of global warming is causing concern, as warmer weather in the British Isles will facilitate the spread of species of mosquito that would otherwise not breed there, increasing the risk of the introduction of exotic disease, particularly by aircraft. It is hoped that the WHO will address this problem when it brings forward its proposals to review the international health regulations.

THE PUBLIC HEALTH (SHIPS) AND (AIRCRAFT) REGULATIONS 1979 These provide for people arriving on infected or suspected ships or aircraft to be placed under surveillance; the periods are calculated from the time of leaving the infected area. Measures to control the spread of Lassa fever, rabies, viral haemorrhagic fever and Marburg disease are also specified. Requirements for the notification and prevention of the spread of other infectious diseases from arrivals at ports and airports are included in the Public Health (Infectious Disease) Regulations 1984 and 1988. An infected ship or aircraft is: 1. A ship or aircraft that on arrival has on board a case of a disease subject to the International Health Regulations, or a case of Lassa fever, rabies, viral haemorrhagic fever or Marburg disease. 2. A ship or aircraft on which a plague infected rodent is found on arrival. 3. A ship or aircraft which has had on board during its journey: (a) a case of human plague developed by the person more than six days after his or her embarkation

(b) a case of cholera within five days of arrival (c) a case of yellow fever or smallpox. A suspected ship or aircraft is: 1. A ship or aircraft which, not having on arrival a case of human plague, has had on board during the journey a case of that disease developed by a person within six days of his or her embarkation. 2. A ship or aircraft on which there is evidence of abnormal mortality among rodents, the cause of which is unknown on arrival. 3. A ship or aircraft that has had on board during its journey a case of cholera more than five days before arrival. 4. A ship that left an area infected with yellow fever within six days of arrival. 5. A ship that on arrival has on board a person who the medical officer considers may have been exposed to infection from Lassa fever, rabies, viral haemorrhagic fever or Marburg disease.

HEALTH CLEARANCE OF ARRIVALS The master of a ship or the commander of an aircraft arriving from a foreign country must report to the port health authority not more than 12 hours and not less than four hours before arrival: 1. The occurrence on board during the passage (or the last four weeks if longer) of: (a) death other than by accident (b) illness where the person concerned has or had a temperature of 38°C or greater that was accompanied by a rash, glandular swelling or jaundice, or persisted for more than 48 hours; or has or had diarrhoea severe enough to interfere with work or normal activities. 2. The presence on board of: (a) a person suffering from an infectious disease or who has symptoms which may indicate the presence of infectious disease; (b) any animal or captive bird of any species including rodents and poultry, or mortality or illness among such animals or birds. Copyright © 1999 Taylor & Francis Group LLC

3. Any other circumstances that are likely to cause the spread of infectious disease. If none of these circumstances prevails, the ship or aircraft does not require health clearance (free pratique) unless otherwise directed by an authorized officer of the port or airport health authority. Otherwise the specified signals (Table 15.1) should be shown on arrival and no person may board or leave the ship or aircraft other than a customs officer, immigration officer, the pilot of a ship or an authorized officer until health clearance has been granted. These restrictions on boarding or disembarking do not apply when only the presence on board of any animal or captive bird requires reporting, unless plague has occurred or is suspected among rats and mice or there has been abnormal mortality among them. When health clearance is required, a maritime or aircraft declaration of health has to be completed by the master or commander, except in the case of arrivals from Belgium, France, Greece, Italy, The Netherlands, Spain or the Irish Republic. Control measures to prevent the spread of infectious disease from ships and aircraft that are ‘suspected’ or ‘infected’, or which have arrived from an infected area, may include medical examination, or the disinfecting of any person suffering

Table 15.1 International code of signals health clearance messages

*By night, a red light over a white light may be shown, where it can best be seen, by ships requiring health clearance. These lights should only be about 2m (6 ft) apart, should be exhibited within the precincts of a port, and should be visible all round the horizon as nearly as possible.

from or exposed to infectious disease, disinfection or disinsectation of ships, aircraft or clothing, measures to prevent the escape of plague-infected rodents and the removal of any contaminated food or water other than the cargo.

AIRCRAFT DISINFESTATION In order to minimize the risk of aircraft spreading vectors of disease, the commander of an aircraft that has landed in a risk area may be required to produce details of the application of residual insecticides or in flight disinsectation. The International Maritime Organization (IMO) has recommended [7] an initial treatment with permethrin to produce an even deposit of 0.5 g/m2 on carpets and 0.2 g/m2 on other surfaces (these rates may be halved for subsequent treatments). For the purposes of in flight disinsectation, an approved aerosol formulation is required to be dispensed uniformly in the enclosed space at the rate of 35 g/100 m3. The serial numbers of the aerosol dispensers used in the treatment should be entered on the aircraft’s declaration of health. In no circumstances should insecticide be used on an aircraft, unless it has been specifically approved for that purpose.

SHIP DISINFESTATION A ship arriving from a foreign port must have a deratting certificate issued in a designated approved port showing that the ship has been deratted within the previous six months, or a deratting exemption certificate issued in either an approved port or a designated approved port showing that the ship was inspected and found free from rodents and the plague vector. The list of approved and designated approved ports is published by the WHO, and amendments are notified in the Weekly Epidemiological Record [8]. If the certificate was issued more than six months previously, the ship must be inspected at an approved port and, if necessary, be deratted at a designated approved port. Where the ship is proceeding immediately to a designated/approved port, the validity of the certificate may be extended Copyright © 1999 Taylor & Francis Group LLC

by one month. This provision would be applied where the amount of cargo remaining on board prevents the inspection of all the spaces for the issue of a deratting exemption certificate. If evidence of rodents is found during the inspection of a ship, the port health officer is authorized to require the master to apply the appropriate control measures. These may be either trapping, poisoning or fumigation of the infested spaces, together with the elimination of any harbourage.

Disinfestation methods on ships The various types of ship construction (Fig. 15.1) together with the limited time available to disinfest ships limit the options for treatment. Consequently, acute poisons such as sodium fluoracetate, or fumigation with hydrogen cyanide or methyl bromide may be required. These will usually be undertaken by a contractor, but it is the responsibility of the port health officer in charge to specify the treatment required and to have regard to the safety aspects. Acute rodenticides should only be used in spaces that can be secured to prevent access. While fumigation is taking place, the crew must be accommodated ashore. Care is required if it is intended to fumigate food with hydrogen cyanide or leave food exposed to hydrogen cyanide during fumigation. If a ship, aircraft or cargo infested with rats arrives from an area in which plague is present, or if there is undue mortality among them, then fumigation should always be required. As methyl bromide is three times heavier than air, its use is particularly appropriate for the fumigation of foodstuffs, or a fully laden ship. Methyl bromide and hydrogen phosphide are also used for the elimination of arthropod infestations of cereals, nuts, dried fruit and herbs and spices. Such fumigation may take place prior to shipment or after loading on board the ship. With regard to in-transit fumigation, the IMO recommends that the ship’s master should obtain approval from his national administration. At least two members of the crew, including one officer, should be trained with particular reference to the behaviour and hazardous properties of the

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Fig. 15.1 Profiles illustrating decks, superstructures, spaces and tanks in different types of ships. (Reprodusing by kind permission of Lloyds Register of shipping, London.)

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Fig. 15.1 continued.

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fumigant in air, the symptoms of poisoning and emergency medical treatment. They should brief the crew before the fumigation takes place and the ship should carry gas detection equipment, at least four sets of protective breathing apparatus, and appropriate medicine and first-aid equipment. It is the responsibility of the fumigator to ensure that all spaces treated are gas tight and that warning notices have been posted at the entrances to any spaces considered unsafe. Adjacent spaces, accommodation and working spaces should be checked for the level of gas concentration at least at eight-hour intervals, and the readings recorded in the ship’s log book [7].

SHIPBOARD SANITATION The provisions of the Public Health Acts relating to filthy, unwholesome and verminous premises or articles and verminous persons (see Chapter 16) apply to ships as if the vessel were a house, building or premises within the district, and the master or other officer in charge the occupier. With regard to statutory nuisances (see Chapter 7), the Environmental Protection Act 1990 defines ‘premises’ to include any vessel. An abatement notice may be served on the master of a vessel as if he or she were the occupier of premises on which a statutory nuisance exists or is likely to occur. Except for a ship belonging to the Queen or visiting forces, the person in charge of a ship may be ordered to remedy any conditions on board that are prejudicial to health, and statutory nuisances may be dealt with summarily. The standardization of sanitary measures to be taken on ships is specified by the WHO in the Guide to Ship Sanitation [9]. It provides practical recommendations for protecting food and potable water, the disposal of waste and elimination of pests, all of which are necessary to prevent the spread of disease.

INTERNATIONAL TRAINS An international train is a shuttle train or through train operating through the Channel Tunnel, and the person designated as the train manager on Copyright © 1999 Taylor & Francis Group LLC

a journey terminating in the UK is responsible for advising the enforcement authority of the presence of any animal or sick person aboard the train. The Public Health (International Trains) Regulations 1994 define the enforcing authority as the port health or local authority at any place designated as a control area, freight depot or terminal control point. In relation to the records to be kept by an international train operator and in the event of a health alert, the Secretary of State is designated as the enforcing authority. Where a stowaway animal that is, or was at the time of its death, capable of carrying rabies, plague or viral haemorrhagic fever is suspected aboard an international train, the enforcement authority at a stopping place may require the train and its contents to be deratted, disinfected or decontaminated. There are also powers for the disinfection or decontamination of any rolling stock or any article on board where a sick person has been identified on the train. Sick traveller means a person who has a serious epidemic, endemic or infectious disease, or whom there are reasonable grounds to suspect has such a disease. It does not mean venereal disease or infection with human immunodeficiency virus (HIV). See also p. 248.

WATER SUPPLIES Every port and airport is required by the international health regulations to have a supply of pure drinking water. Potable water for ships and water boats must be obtained only from those water points approved by the port health authority. Water boats should have independent tanks and pumping systems for potable water. Hydrants for the supply of water from ashore should be located so as to prevent contamination. Supply pipes should be above the high water level of the port, and drainage openings for pipes need to be above any water surge from passing ships. Water supply hoses require a smooth, impervious lining and should be used exclusively for the delivery of potable water. When not in use the ends should be capped.

potable water before the system is used to supply potable water. Automatic chlorinators on an ultraviolet sterilization system should be fitted where low pressure evaporators are used for desalination. Sea water obtained when within 32 km of the land should never be used to produce potable water.

IMPORTED FOOD CONTROL

Fig. 15.2 Acceptable location of potable water in relation to bilge space of innder-bottom tank. (Source: [9], reprinted with amendments in 1987.)

Ships’ storage tanks for potable water should be independent of the hull (Fig. 15.2) unless the tank bottom is at least 45 cm above the deepest load line. The bottom of the tank should not be in contact with the top of any double bottom tank. Pipe lines carrying non-potable liquids should be routed so they cannot contaminate the potable water supply. A manhole on the tank top should have a coaming to keep the opening clear of the deck, and overflow pipes should have the open end pointing downwards. Where tanks do not meet these recommendations, the water may be used only for domestic purposes aboard ship, or should be chlorinated before use as potable water. Chlorine should preferably be applied as a hypochlorite solution with equipment that will produce a free chlorine residue of 0.2 mg/l. Whenever any potable water tanks or any part of the supply system has been contaminated, serviced or repaired, they should be cleansed, disinfected and flushed before being put back into operation. The chlorine solution for disinfection should be 50 mg/l for 24 hours, or in an emergency 100 mg/l for one hour. The heavily chlorinated water should be discharged and the system flushed with Copyright © 1999 Taylor & Francis Group LLC

The Imported Food Regulations 1997 (IFRs) apply to all food not of animal origin imported into the British Isles from third countries, unless it is in free circulation within the EU at the time of landing in Great Britain. (The British Isles include Northern Ireland, the Isle of Man and the Channel Islands, but Great Britain refers to England, Scotland and Wales only; Northern Ireland has its own IFRs.) It is an offence under the IFRs to import any food into Great Britain or Northern Ireland (other than an exempt product of animal origin, Schedule 1) (Table 15.2) that is intended for sale for human consumption but which has been rendered injurious to health, is unfit for human consumption, or is unsound or unwholesome, or is so contaminated as to render it not suitable for human consumption in that state. The food authority responsible within a port health district for enforcing the IFRs is the port health authority or port local authority, otherwise it is the food authority for a district (other than a county council in England). An authorized officer of a food authority may examine any food subject to the IFRs, and the importer shall provide all such facilities as may reasonably be required for such examination. If the authorized officer considers that the food should be sampled, he may require that once he has obtained his sample the food shall not be removed from the place specified for six days, excluding Saturdays, Sundays and public holidays. If the food is not clear of customs charge, an officer of Customs and Excise may give written permission to a person to remove the food, but he shall notify the authorized officer of the food authority of his intention to do so. If, after inspection or examination, it is found that any consignment, lot or batch of food has

Table 15.2 Schedule 1 of the Imported Food Regulations 1997, exempt products of animal origin

been imported contrary to the 1997 IFRs, the authorized officer may permit its use for purposes other than human consumption, order its re-export outside the EU or seize the food and have it dealt with by a justice of the peace, or in Scotland a sheriff or magistrate, who may condemn the food and order its destruction. Where food from a third country enters Great Britain or Northern Ireland and an authorized Copyright © 1999 Taylor & Francis Group LLC

officer considers it reasonable that examination should be deferred to the place of destination within the UK, the food authority at the place of destination shall enforce and execute the IFRs when it arrives at the specified destination. The importer must give the authorized officer at the place of entry into the UK an undertaking in writing that the container containing the food has been sealed and will not be opened until it reaches its specified place of destination. The receiving authority must be notified expeditiously that the food has not been examined, and whether customs examination has been deferred. A copy of the importer’s undertaking must also be sent to the receiving authority. These provisions are extensively abused at airports where food is frequently removed to custom’s enhanced remote transit sheds (ERTS) without the importer giving the requisite undertaking. As no offence is committed by importers contravening the deferred examination requirements, there is a serious problem enforcing food safety requirements at airports as food may reach its destination before the receiving authority can be notified. The IFRs 1997 amend the Food Safety (General Food Hygiene) Regulations 1995 in regard to the carriage in bulk of liquid oils and fats in sea-going vessels. They allow the transport of such products that are intended for processing in tanks that are