Environmental health - 2015 year in review, October 2016

Improve water quality and health through risk management
Drinking water fluoridation
Sydney Water Corporation monitoring improvements
Private water supplies
Supported the appropriate regulation of environmental health issues
Improved the health of Aboriginal people through Housing for Health projects
NSW Aboriginal Communities Water and Sewerage Program
Participated in planning processes to minimise the health impacts from development
Reduce tobacco-related harm by enforcement of smoke free environment and retail regulations
Increasing capacity and planning for an exotic mosquito incursion
Responded to emerging chemicals of concern

Improve water quality and health through risk management

All 96 regional water utilities provided drinking water management systems to public health units. Over the year, NSW Health worked with contractors to help 47 local water utilities implement their risk-based drinking water management systems, including development of annual review templates, critical control point (CCP) performance monitoring templates and incident response guidance. NSW Health is continuing to fund this work in 2016, helping utilities meet the requirement of the Public Health Act 2010.

A management system consists of documents, procedures and other supporting information for the safe supply of drinking water. The process allows water utilities to document current practices that fulfil Australian Drinking Water Guidelines requirements, identify any gaps, monitor critical control points (CCPs, such as filtration and disinfection), and develop and follow operational procedures for CCPs.

This process has brought direct and immediate improvements, including optimising chlorination systems to ensure effective disinfection, optimisation of filtration and other treatment processes, improved record keeping, identification and correction of treatment plant design risks, and introduction of continuous real-time monitoring of plant performance. Annual reviewing of drinking water management systems has commenced.

Drinking water fluoridation

Fluoridation commenced for the first time in areas of Lismore, Ballina and Richmond Valley served by Rous Water County Council (the largest unfluoridated supply system in NSW), Tea Gardens (the last unfluoridated supply in MidCoast Water County Council’s area) and Mulwala (the last unfluoridated supply in Corowa Shire). The program of engaging contractors to inspect aging fluoride plants to ensure ongoing safety and reliability continued. Work continued with Hunter Water to upgrade all their fluoride dosing systems for increased safety and reliability. Approval was given to replace aging fluoride plants in Singleton, Manilla, Nyngan, and Parkes. These will be paid for by NSW Health. The Water Unit contributed to the NHMRC evaluation of the health effects of fluoridation. External researchers were engaged to investigate; the effectiveness of fluoridation in adults, case studies of severe fluorosis, and the effectiveness naturally occurring fluoride in water supplies.

Sydney Water Corporation monitoring improvements

The Water Unit has continued its regulatory activities with Hunter Water, Sydney Water and WaterNSW, the major metropolitan water utilities. A highlight from the past year has been the ongoing work by Sydney Water and WaterNSW to revise their monitoring programs to be better align with the recommendations of the Australian Drinking Water Guidelines. This will see Sydney Water’s website displaying daily information about the performance of their critical control points; filtration, chlorination and fluoridation. At the same time, the testing of treated water for pathogens will be reviewed and the testing effort re-assigned to locations from which more useful information can be collected.

Private water supplies

A Private Water Supplies Steering Committee was formed to make sure that the difficult task of regulating the supply drinking water by organisations other than public water utilities. The steering committee helps the Water Unit provide the public health units with the right support. It is also working to develop a range of tools for public health unit and local government staff to use when inspecting and talking with private suppliers. These are in development with NSW Food Authority.

Supported the appropriate regulation of environmental health issues

A number of publications and educational materials were developed for swimming pools and splash parks including:

• splash park fact sheet,
• requirements for swimming pools
• requirements for skin penetration premises

A swimming pool training day for environmental health officers was facilitated and organised to provide learning and support opportunities.

A systematic review of skin penetration issues was carried out regarding disease and health risks. This review assisted in developing updated requirements for those operators that fall under the definition of a skin penetration procedure. Additionally, a manual was developed to assist environmental health officers with their day to day regulatory activities.

Over the past year, Health Protection has worked very closely with Cemeteries and Crematoria NSW regarding the future direction burials and cremates specifically focussing on how this can be addressed and managed more effectively and efficiently.

An external consultant was engaged to carry out a gap analysis on the Code of Practice for Legionnaires Disease. This resulted in the formation of a legionella working group to reform and improve on the information and templates NSW Health provides.

Work on the accreditation guidelines for on-site sewerage management systems continued in 2015.

Improved the health of Aboriginal people through Housing for Health projects

The Housing for Health program aims to improve the health status of Aboriginal people, in particular children aged 0-5 years, by improving house function and essential health hardware (e.g. fixing a leaking toilet, electrical repairs, having sufficient hot water, having somewhere to wash a young child). The program continued to make significant improvements in the health and safety of tenants across NSW by reducing the risk of disease and injury.

In 2015:

• Four (4) new Housing for Health projects started in Dareton, Nambucca Heads/Bellwood, Qurindi and Western Sydney – Mount Druitt. In these communities, the program surveyed 157 houses and fixed over 1,734 items, benefitting 631 people.
• Eight existing projects were underway in Awabakal, Batemans Bay, Bodalla, Cobar, Malabugilmah/Baryugil, Wallaga Lake, Wanaaring and Yamba. In these communities, the program surveyed 233 houses and fixed over 5,046 items, benefitting 1,087 people.
• Ten projects were completed in Armidale, Balranald, Bellbrook, Broken Hill, Cudjallagong, Cummeragunja, Maclean (Nungera), Maclean (Yaegl), Murrin Bridge, Toomelah/Boggabilla. In these communities, the program surveyed 290 houses and fixed over 7,027 items, approximately 1,133 people.
• In addition to the Housing for Health projects, ‘value adding’ initiatives were implemented in some communities including: a study on the requirements necessary to maintain and renovate rainwater tanks with residents in Malabugilmah and Baryulgil; a Healthy Homes Done Dirt Cheap education session with residents in Nambucca; and removal of asbestos sheeting from houses in Malabugilmah and from a community building in Jabulum.

NSW Aboriginal Communities Water and Sewerage Program

NSW Health continued to be involved in the development and roll-out of the NSW Aboriginal Communities Water and Sewerage Program to ensure adequate operation, maintenance and monitoring of water supplies and sewerage systems in 61 Aboriginal communities. Regional public health units worked with communities, the NSW Office of Water, local water utilities and service providers to implement risk-based water and sewerage management plans and participated in review meetings with communities.

In 2015, 61 Aboriginal communities met the criteria and were eligible for funding under this program. Of those 61 communities:

• 21 were found to have satisfactory services equivalent to neighbouring communities as they were part of a reticulated system prior to commencement of this program.
• 29 now have long term service agreements in place for local water utilities to provide full water and sewerage services equivalent to that in similarly located communities.
• 7 have interim arrangements in place for the local water utilities to support water and sewerage services that are equivalent to that of the wider local community.

Participated in planning processes to minimise the health impacts from development

In 2015 Health Protection NSW staff responded to planning proposals and participated in forums to consider issues around:

• WestConnex road tunnel developments. This included air quality impacts both within the road tunnel and impacts on surrounding air quality. Sydney Public Health Unit and South East Sydney Public Health Unit participated in weekly teleconferences to coordinate a comprehensive response to these developments.
• Western Sydney Airport. Health Protection NSW staff, along with relevant public health units, provided feedback to the NSW Department of Planning and the Environment regarding this proposed development.

Reduce tobacco-related harm by enforcement of smoke free environment and retail regulations

Achievements in 2015 included:

• Regulation of tobacco retailing and smoke-free environments has contributed to the downward trend in tobacco use in NSW. In 2015, the proportion of adults in NSW who were current smokers was 13.5%, representing a decrease of 2.1% from the previous year.
• Authorised officers from public health units and the Ministry of Health worked together to monitor compliance and to enforce smoke-free outdoor public areas under the Smoke-free Environment Act 2000. The rate of compliance from members of the public increased from 98% in 2014 to 99% in 2015.
• On 6 July 2015, the new smoke-free outdoor dining ban came into effect under the Smoke-free Environment Act 2000. Authorised officers from public health units and the Ministry of Health conducted over 1800 inspections from July to December 2015 and observed a compliance rate of over 98%.
• Authorised officers from public health units continued to monitor and enforce sales to minors and point of sale provisions under the Public Health (Tobacco) Act 2000. In 2015, they conducted over 800 inspections of tobacco retailers for sales to minors provisions. Retailer compliance increased from 94% in 2014 to 96% in 2015. For point of sales provisions, over 2000 inspections were conducted and a compliance rate of 88% was observed, representing a 4% increase in compliance from the previous year.

Increasing capacity and planning for an exotic mosquito incursion

In 2015 Health Protection NSW planned to respond to the increasing threat from exotic mosquitos being reintroduced, or introduced, to NSW. This was done through:

• hosting an interagency meeting regarding responsibilities during an event.
• drafting a response plan that continues to be developed.
• running an education session for environmental health officers on mosquitoes with an emphasis on exotic mosquitoes.

Responded to emerging chemicals of concern

In 2015 Health Protection NSW responded to increasing concern regarding contamination of the Williamtown RAAF site with perfluorinated compounds such as PFOS and PFOA. The respond included:

• producing information for public communications regarding this issue
• assisting the Hunter New England public health unit in responding to community concerns
• hosting a national PFOS summit where experts from around the country were invite to produce nationally consisting messaging on behalf of enHealth
• participating in interagency meetings such as the expert panel and risk assessment working group to provide a whole of government response to this issue.