Mr Santo Cannata has been the Senior Environmental Health Officer (SEHO) at South Eastern Sydney Public Health Unit since 1991. As one of the elders of the NSW public health system, we thought we would ask him about some of the more memorable aspects of his job, and some tips on how he maintains his enthusiasm.
I grew up in a small town in Sicily, and immigrated to Australia in 1956 with my mother and siblings. I joined my father in Leichhardt who had immigrated a few years earlier. I did a Meat Inspection Course and, between 1966 and 1976, I worked for the Commonwealth Department of Primary Industry as a meat inspector. I saw how food poisoning could come from meat that was not wholesome. I thought it was interesting to see what happens in the butcher shops and how to prevent transmissible disease and as a result I enrolled to do a Health and Building Inspection certificate course at TAFE.
In 1977, I got a job as a health inspector with the NSW Health Commission Southern Metropolitan Regional Office. I worked for the regional health surveyor in a team of five. The job involved inspecting sanitary depots (where sanitary pans were disposed of in the Little Forest in Sutherland), waste depots, septic tank installations, barber shops, town water supplies, drinking water systems in the Royal National Park, hotels, motels, caravan parks, boarding houses and nursing homes.
In the 1980s, health inspectors began following up patients with notifiable diseases. I remember one outbreak of five typhoid patients who all lived in Sydney’s inner west. They were unrelated. I spoke with patients and families, and established that there was a donner kebab shop that was common to the cases. I inspected the family run shop and all looked fine. Then I discovered the Grandmother out the back making salads. It turned out she was a typhoid carrier.
The most challenging problem was investigating Legionnaires disease cases in the 1980s. It was unclear where the source for cases in Australia was. Was it the water supply? We checked but we didn't find anything in the water pipes at first. Then we thought that it would be a good idea to look at the dead ends of the drinking water reticulation system. We worked with ICPMR and grew some Legionella organisms from the Gladesville Hospital cold water supply.
In 1980, following concerns about the possibility of collusion between doctors and close relatives signing death certificates before cremations, I helped develop the system of medical referees for the Chief Health Officer where a second doctor had to sign off on a death certificate. I developed numerous policies to assist the funeral industry regarding the burial and handling of bodies, single graves, as well as mortuary and cemetery standards.
When I started with the Department, the emphasis for health inspectors was hygiene and sanitation – things like cleanliness and bedbugs. Now the job is more about emerging diseases, emerging environmental risk factors, contaminated land, and understanding risks associated with land contamination or air pollution. There is a need to keep an open mind as to what effects the environment might have on health and remain open to ideas and if possible to research to establish emerging diseases. In public health there is always something new emerging every other day. There is also a need to adapt and research what has been done elsewhere. The internet allows you to look worldwide – we now have tools that were not available when I started. EHOs need to upskill and look ahead, have a proactive approach, analyse and interpret health risks. The challenge is to identify the cause of the problem and prevent recurrence!