Environmental health in Australia: overlooked and underrated

An Investigation into the Prevalence of Methamphetamine Related Enquiries to Local Government Environmental Health Officers

Methamphetamine contamination of residential properties remains a serious public health concern for members of the public. External stakeholders including Environmental Health Officers (EHOs) and testing and remediation technicians are engaged on investigating whether contamination has occurred from manufacturing or smoking processes. More specifically, local council EHOs are responsible for managing clandestine drug laboratories when notified by police and also for responding to public enquiries. However, the full scope of these contaminated properties is not seen by any single stakeholder, making it very challenging to quantify these situations. To evaluate the prevalence of methamphetamine related enquiries from the general public to EHOs, this study surveyed and interviewed officers from around Australia. It was found that public enquiries were infrequent with only 6% of respondents having received enquiries in the last month, which indicates that people are seeking information from other sources. Interestingly, there were case study scenarios that also mentioned issues with awareness and the flow of information. Concerns regarding difficult cases, police notifications, and site visits were also highlighted. The results of this study provide a benchmark of how methamphetamine related cases are managed and highlight the need for trustworthy information that is available to EHOs, governments, industry members, and the public in a unified location.

Locally acquired strongyloidiasis in remote Australia: why are there still cases?

In Australia, strongyloidiasis primarily affects returned travellers, Vietnam veterans and refugees or asylum seekers, and First Nations people. Non-overseas acquired cases are seen almost exclusively in Australian First Nations remote communities. Australian First Nations communities have one of the highest rates of strongyloidiasis in the world. Our work has shown that strongyloidiasis is a disease of poverty. Acknowledging this is important-we need to shift the lens to socioeconomic factors, particularly environmental health hardware such as working toilets and sewerage systems, showers and laundries, and effective wastewater and rubbish removal. The rates of strongyloidiasis in First Nations communities is a result of decades of inadequate, poorly constructed and/or poorly maintained housing, and poor environmental health hardware (hereafter hardware). The solution lies in adequate funding, resulting in well designed and maintained housing and appropriate hardware. Governments need to allow First Nations communities themselves to take the lead role in funding allocation, and design, construction and maintenance of their housing and hardware. This will ensure housing and hardware fulfils cultural and physical needs and desires, and protects health. Improving housing and hardware will also improve other health outcomes. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'.

Mental health impacts of climate change and extreme weather events on mothers

Background: The perinatal period is a time of increased vulnerability for perinatal mood and anxiety disorders (PMADs). Emotional trauma is a risk factor for PMAD development and is common among survivors of extreme weather events (EWEs), which are becoming more frequent and intense as the climate crisis progresses. EWE-related stress and anxiety have not been extensively studied in the perinatal population. However, the limited available data suggest a negative impact of EWE exposure on perinatal mental health, warranting further investigation and investment.Objective: To address this knowledge gap, we interviewed new Australian mothers to understand how EWEs affect the mental health of the perinatal population.Method: Australian mothers (18 years of age or older) with a baby under 12 months of age were recruited to participate in a single virtual focus group session (seven group sessions were run in total) and complete an anonymous survey. Participants were asked questions regarding their concerns about extreme weather and its impact, as well as their general maternal functioning. Maternal functioning, depression, and climate distress were measured via the survey.Results: The study sample comprised 31 Australian mothers (Mage = 31.74, SD = 4.86), predominantly located in Queensland. Findings from the focus groups suggested six key themes; however, of focus to this study are three themes related to maternal mental health: health and well-being, helplessness and avoidant coping, and resilience and adaptation. Predominant subthemes focused on trauma resulting from EWE exposure, economic and heat concerns, social isolation, hopelessness about the future, and feelings of resilience.Conclusions: The evidence linking adverse perinatal mental health outcomes with climate change and EWEs highlights the urgent need for interventions in this context to protect perinatal mental health and well-being. By acknowledging the traumatic impact of these experiences on mothers, this study supports advocacy for policies that specifically address this issue.

Identifying occupational health and safety risks among environmental health officers in Australia and New Zealand through an online survey

To identify the occupational health and safety (OHS) risks among environmental health officers (EHOs) in Australia and New Zealand. The objectives were to profile and compare OHS experiences from different countries and regions to gain a regional perspective on OHS hazards that impact EHOs. An online hazard exposure survey was conducted among 339 EHOs (Australia: n = 301, 88.8%; New Zealand: n = 38, 11.2%). The Mann-Whitney U test was used to compare 2 ordinal data groups, the Kruskal-Wallis H test was used for more than 2 ordinal groups, and the independent samples t test was used to compare the means of 2 independent groups where the dependent variables were normally distributed. Multiple regression techniques were used to analyze workplace incidents and age groups. A high degree of similarity in the types of workplace exposures and risk perceptions as well as concerns with organizational OHS management commitment were observed among EHOs from the 2 countries. Workplace violence and physical and psychosocial demands were the most commonly reported OHS hazards. Employer type, sex, and age group were significantly related to workplace exposure and OHS experience among EHOs in both countries. This study provides a profile of workplace exposure in the environmental health profession in the 2 countries and offers recommendations for the implementation of preventive action.

Climate Change and Health: Local Government Capacity for Health Protection in Australia

Climate change is the greatest global health threat of the 21st century, with numerous direct and indirect human health consequences. Local governments play a critical role in communities' response to climate change, both through strategies to reduce emissions and adaption plans to respond to changing climate and extreme weather events. Australian local government environmental health officers (EHOs) have the relevant skills and expertise to inform and develop adaptation plans for health protection in the context of climate change. This study used an online survey followed by phone interviews of local government management to determine the extent to which EHOs are involved in adaptation planning in health protection climate change plans. Questions were also asked to determine whether local councils are aware of EHOs' capability to contribute and to gauge the willingness of management to provide EHOs with the workload capacity to do so. The findings demonstrated that although climate adaptation and mitigation planning is occurring in local government, it is not including or considering the public health impacts on the community. Primarily, it was found that this oversight was due to a lack of awareness of the health impacts of climate change outside of a disaster or emergency scenario. Currently, EHOs are an untapped source of knowledge and skills that can contribute to climate change adaption planning. To support this, a framework of local environmental health practice was developed to assist the reconceptualization of the scope of practice required for the planning and response to climate change.

A SWOT analysis of contemporary gaps and a possible diagnostic tool for environmental health in an upper-middle income country: a case study of South Africa

This study evaluated the state of environmental health in the Republic of South Africa using the strengths, weaknesses, opportunities, and threats (SWOT) analysis framework. The internal and external factor evaluations were conducted by reviewing existing literature searched using a combination of keywords and boolean functions. The weighted score for the strengths and weaknesses was 0.79 and 1.04, respectively. The external factor evaluations findings revealed that environmental health has an equal amount of threats and opportunities, however, the threats outweigh the opportunities. The total weighted score for the internal and external factor evaluations was 1.83 and 2.25, respectively, which were below the average value of 2.5. The internal-external factors matrix indicated that environmental health in the Republic of South Africa needs to be refocused and re-aligned to public health protection. Failure to address the weaknesses and threats and optimise the strengths and opportunities may further weaken the provision of environmental health services.

Environmental Health Responses to COVID 19 in Western Australia: Lessons for the Future

The COVID-19 pandemic tested the health system of Western Australia (WA) and the relatively new overarching legislative framework that guided the state-wide public health response to the pandemic. This study aimed to evaluate the experiences and roles of environmental health officers (EHOs) in WA during the management of COVID-19 and to identify any policy changes that are needed to facilitate the rapid deployment of EHOs during a future public health crisis. An online survey with 78 respondents was administered and analysis was both qualitative and quantitative. It was found that participants believed there was inadequate resourcing, workforce shortages, increased workloads, and a lack of recognition and integration of the profession within the COVID-19 response. Notably, more than 65% of the respondents believed they could have been better utilised during the pandemic. This research has demonstrated that the COVID-19 pandemic in WA had clear gaps in its processes for managing responses and resilience to pandemics. Policy recommendations outlining a more efficient and integrated delivery of environmental health services throughout the state during emergencies are discussed.

Tuberculosis care designed with barramarrany (family): Participatory action research that prioritised partnership, healthy housing and nutrition

Issue addressed.

Ongoing tuberculosis (TB) transmission in Aboriginal communities in Australia is unfair and unacceptable. Redressing the inequity in TB affecting Aboriginal peoples is a priority in Australia's Strategic Plan for Tuberculosis Control. Improving TB care needs not to just identify barriers but do something about them. Privileging the voices of Aboriginal people affected by TB is essential to identify effective and enabling strategies.

University Staff and Students' Attitudes towards a Completely Smoke-Free Campus: Shifting Social Norms and Organisational Culture for Health Promotion

A large university in Queensland, Australia with a diverse staff and student community introduced a campus wide smoke-free policy in 2016. The purpose of this enquiry was to understand attitudes about a new smoke-free policy, its potential impact and the shift in social norms and organizational culture to inform the next phase of implementation. An electronic survey was distributed to all staff and students approximately 12 weeks after the smoke-free policy was implemented. The survey consisted of multiple-choice questions about demographics, smoking behaviour, attitudes towards smoking and tobacco control, awareness of the smoke-free policy, and attitudes towards the effect of a completely smoke-free campus on quality of life, learning and enrolment. The survey was completed by 641 university staff and students. Respondents reported seeking out (80.4%) and socialising in smoke-free environments (86.6%) and supported smoke-free buildings (96.1%), indoor areas (91.6%), and outdoor areas (79%). The results revealed overwhelming support for a completely smoke-free campus (83%) and minority support for designated smoking areas (31%). Overall, respondents reflected positively towards a campus wide smoke-free policy. These findings suggest Queensland’s early adoption of tobacco control laws influenced the social environment, de-normalised smoking, changed behaviour, preference for smoke-free environments and shifted social norms. These findings provide convincing evidence for organisational change and suggest health promotion policy makers should progress the implementation of smoke-free policies nationally across the higher education sector.

The New Environmental Health in Australia: Failure to Launch?

BACKGROUND

The New Environmental Health is an approach to environmental health adopted in 1999. The new approach was in response to emerging health risks from the pressures that development placed on the environment, climate change, and increasing vulnerabilities of local communities. The new approach heralded a change in perception and roles within environmental health. Twenty years on, it seems these changes have not been embraced by local government.

METHODS

To determine whether this was the case, we assessed the use of the term "environmental health" in local government annual reports, and where environmental health functions sit within the organisational structure of councils.

RESULTS

We found that the New Environmental Health has not been adopted by councils and environmental health relates solely to the delivery of statutory services and legislative compliance.

CONCLUSIONS

One result of this is local environmental health practitioners, who constitute the major health protection capability of councils, are defined by the narrow legislative obligations imposed on councils. This represents a significant lost opportunity as public health is not protected in the way that was envisaged with the adoption of the New Environmental Health.

Environmental Health Practice Challenges and Research Needs for U.S. Health Departments

BACKGROUND

Environmental health (EH) professionals, one of the largest segments of the public health workforce, are responsible for delivery of essential environmental public health services. The challenges facing these professionals and research needs to improve EH practice are not fully understood, but 26% of EH professionals working in health departments of the United States plan to retire in 5 y, while only 6% of public health students are currently pursuing EH concentrations.

OBJECTIVES

A groundbreaking initiative was recently launched to understand EH practice in health departments of the United States. This commentary article aims to identify priority EH practice challenges and related research needs for health departments.

METHODS

A horizon scanning approach was conducted in which challenges facing EH professionals were provided by 1,736 respondents working at health departments who responded to a web-based survey fielded in November 2017. Thematic analyses of the responses and determining the frequency at which respondents reported specific issues and opportunities identified primary EH topic areas. These topic areas and related issues informed focus group discussions at an in-person workshop held in Anaheim, California. The purpose of the in-person workshop was to engage each of the topic areas and issues, through facilitated focus groups, leading to the formation of four to five related problem statements for each EH topic.

DISCUSSION

EH professionals are strategically positioned to diagnose, intervene, and prevent public health threats. Focus group engagement resulted in 29 priority problem statements partitioned among 6 EH topic areas: a) drinking water quality, b) wastewater management, c) healthy homes, d) food safety, e) vectors and public health pests, and f) emerging issues. This commentary article identifies priority challenges and related research needs to catalyze effective delivery of essential environmental public health services for common EH program areas in health departments. An unprecedented initiative to revitalize EH practice with timely and strategic recommendations for student and professional training, nontraditional partnerships, and basic and translational research activities is recommended. https://doi.org/10.1289/EHP5161.