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Annual Review

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The Environmental Public Health Service in Wales continues to be an important asset for Public Health Wales and an excellent example of cross-organisation and border working. This report, the fifth of its kind, emphasises the breadth of work the Environmental Public Health Team undertakes, not only providing a response to environmental incidents across Wales, but working at a strategic level to influence and support national policy development and evidence-based action to reduce the environmental burden of disease on health, well-being and public sector service provision in Wales.

I am sure you will find this report an interesting read. I look forward to seeing the Team’s ambitious plans for the future come to fruition as Public Health Wales works with other public bodies and communities across Wales to achieve the intentions of our long-term strategy.
ENVIRONMENTAL PUBLIC HEALTH SERVICE IN WALES
Our Service
Annual Review 2016/17
In Wales, Public Health Wales (PHW) and the Welsh office of Public Health England's Centre for Radiation, Chemicals and Environmental Hazards (CRCE-Wales) work together to provide partners and the public with independent, specialist environmental public health advice and support.  Support is also provided by epidemiology, toxicology and other experts from across both organisations and beyond.  Our Environmental Public Health Service is underpinned by a jointly agreed framework that facilitates reactive work (to address environmental public health concerns) and proactive projects (to understand more about exposure and health relationships, and links with wider determinants).  
Service Aim
Service Objectives
To take appropriate, proportionate action to protect population health
To work in an evidence-based manner to minimise exposures to, and resulting ill-health from, environmental hazards, and support the creation of healthy, fair and sustainable environments and communities
To collaborate and communicate with the wider environmental and public health community and the general public
To audit and act upon learning points to continuously improve service delivery
To undertake research and development work with academic and other partners
To develop data collection and analysis methods to inform actions
Introduction
We know that environmental factors can have a significant influence on our health and well being.  Current estimates suggest the global environmental burden of disease is around 23% of all deaths annually.  Although this estimate relates to the global picture, a similar situation is believed to exist in Wales and the rest of the UK.  Many environmental risks are modifiable and often entirely preventable,  so we have good opportunities to help create healthier, fairer and more sustainable environments to protect health and well-being.

Over the following pages we offer a snapshot of our work and performance this year.  We have been re-orientating our priorities around key policy drivers such as the Well being of Future Generations Act to help us focus on the key public health risks associated with the natural and built environment.  As we work closely with health boards on a broad range of environmental public health issues, we have chosen to reflect our activity by each health board this year.  We will continue to work with them and other partners to help assess, and find solutions to reduce the environmental burden of disease.



Viewpoint...
Environmental Public Health Service in Wales
"The Environmental Public Health Service is an important all-Wales resource.  Working in collaboration with the Public Health England Centre for Radiation, Chemicals and Environmental Hazards (Wales), the service supports the protection and promotion of health and well-being for the population of Wales.  This fifth annual review emphasises the breadth of work undertaken by the team.  This includes contributions to land use planning, advice to minimise and manage health risks associated with acute chemical and environmental incidents and strategic input to influence and guide national policy development to reduce the environmental burden of disease.  Partnership working with stakeholders and the public is key to delivery of the service and this is highlighted throughout the report.  We welcome comment and feedback on the annual review, so that we can continue to improve our services to the people of Wales"
"I am delighted to support this annual review which demonstrates the on-going collaboration between CRCE and Public Health Wales in order to deliver a service that is tailored to the requirements of Wales.  With this in mind, I look forward to my next liaison with Public Health Wales and Welsh Government this spring which I hope will serve to build on the fruitful and productive relationship established.  I am also delighted to note that the WHO Collaborating Centre for Chemical Exposures was re-designated last June which I hope will continue to be a beacon for both Public Health England and Public Health Wales"
Andrew Jones
Deputy Director of Public Health Services / Director of Integrated Health Protection
Public Health Wales
Dr. David Rhodes
Director of Environmental Public Health
Public Health England 
Making a difference
Regular review supports evaluation of service, staff development and training needs. This year, we identified the need for a consistent, standardised approach to service delivery and development and maintenance of skills and knowledge across the service. As a result, two major structural service delivery changes have been implemented.

Day to day service operation is now through a duty desk.  During office hours, Monday to Friday, all primary contacts with the service are dealt with by a duty scientist, supported by a duty manager. The duty scientist will either respond directly, or acknowledge and pass the query to a colleague in the team for response. This approach ensures that the most urgent events are prioritised, that there are clear lines of reporting and responsibility and that all contacts with the service receive a timely and helpful response.

To support this new way of working, operating procedures have been developed. These specify the roles of the scientist and the manager and provide standards for core activities to support auditing.  The duty desk provides the basis for a consistent service regardless of whether CRCE-Wales or PHW staff pick up the enquiry.

This development has taken place in parallel with changes in the delivery of  wider health protection services,  now through the All-Wales Acute Response (AWARe) Service, which uses a similar model.  As a result, there are now clearer lines of reporting and communication internally and externally.

We have also analysed responses to the customer satisfaction surveys. In 2016, 170 customers were sent a survey. While the response rate was around 25% over 85% of those contacted provided positive feedback (as shown below).
Summary of responses to customer satisfaction surveys
Getting in touch with the team was straightforward
+97%
+94%

My incident / enquiry was acknowledged
+91%
The response was easy to understand
Feedback included a request for more training to support environmental public health work locally.  we will develop a series of training events over the next year.  One useful outcome was the need to take more time to explain to users what the service can provide as there was some misunderstanding about our role.

The response was timely
+91%
+88%
Team members were polite and helpful
+88%
The response provided was tailored to my incident / enquiry
+88%
The response fully addressed the public health concerns I raised
+88%
I would use this service again / recommend to others
Environmental Public Health Service in Wales
Air quality update - influencing policy
In last year's annual review we described the public health implications of poor air quality and our planned work in this area. Our progress over the past year has included:






Research that aimed to obtain expert multi-disciplinary opinion and consensus on the approach to public health integration and collaboration in Local Air Quality Management (LAQM). This work redefined the role of public health in LAQM and explored how connecting air pollution management and public health policy and practice can add value to existing arrangements. The study clarified how public health can support LAQM delivery through risk assessment, integrated management, communications, research and evidence appraisal, advocacy and leadership. Stakeholders have now agreed how to implement the findings and the work will inform future policy and practice Wales.
Guidance has been developed to support collective and collaborative air quality management.  Following the Welsh Government’s 2015 consultation on air quality and noise management in Wales we were commissioned to produce guidance for NHS Wales to support local, regional and national air quality management. Suggested actions include:               
There has never been a better time in Wales for partners to work in new ways within and across  organisations to improve air quality and health. However, positive change needs a conscious collective effort to develop innovative solutions. Opportunities now exist to link air quality management with policies such as the  Environment  (Wales) Act 2016, Planning (Wales) Act 2015, Active Travel (Wales) Act 2013, Public Health (Wales) Act 2017 and Climate Change Act 2008. System wide intervention, supported by legislation, can improve health, and reduce air pollution and inequalities.

The most important enabler is the Well-being of Future Generations (Wales) Act 2015 (WFGA). Reducing air pollution, and associated health risks and inequalities, can contribute to most, if not all, of the well-being goals. This makes the Act an excellent opportunity to change policy and practice to enhance air quality management at local, regional and national levels. 
Working together
champion air quality improvement both outside and inside their organisations
We have also contributed to Public Health Wales’ Making a Difference series, focusing on return on investment evidence for reducing public health risks due to transport-related air pollution. This is intended to support collaborative multi-agency action in terms of e.g. speed management, vehicle upgrades, preventing engine idling, active travel, corporate low emission plans and car clubs.
support others to assess and prioritise local air pollution problems
communicate with the public (including patients) about local air pollution
engage senior local decision-makers to take action on air pollution
Environmental Public Health Service in Wales
Land use planning - developing a new way of working
There is now an increasing need for health and well-being to be considered at the early stages of national and local planning policy and developments.  Early engagement and collaboration enables us to maximise public health influence on the process and we continue to explore ways of improving collaboration with our partners both at locally and nationally.

During the year we contributed to the recently published guide 'Planning for better health and well-being in Wales' which provides a basis for public health and planning colleagues to come together in meeting the well-being goals. 

We are currently developing a novel approach in providing wider determinants of health advice in supporting Health Boards and planners.  This includes the following
Engagement and collaboration with heath and well-being specialists to create  a single suggested response to DsPHs

Prioritising  strategic land-use planning and major planning developments

Establishing dialogue with Regulators at pre-planning stages

A series of 'planning and health' seminars, aimed at local authority staff and health specialists

Develop new ways of working to maximise our influence on planning policy and development decision-making
The Public Health (Wales) Act 2017 underlines the importance of Health Impact Assessment (HIA) to assess the likely effects of actions on physical and mental health.  We will continue to work in partnership with colleagues in the Welsh Health Impact Assessment Unit to ensure that we provide effective support to this legislation.
Environmental Public Health Service in Wales
The physical environment - transport and health
We have been looking at the relationship between transport and health to understand how transport policies can influence health and wellbeing.   For example we have exploring the impacts of increasing the use of 20mph speed limits in Wales.  Current evidence suggests the benefits of 20mph speed limits can include decreased particulate matter (PM), a reduction in road traffic noise and road traffic crash casualties, increased active travel, a narrowing of socio-economic inequalities, greater social inclusion and community cohesion, and greater viability of local businesses. While negative effects may include an increase in nitrogen dioxide (NO2).We have recently published a paper looking at the potential benefits of turning all current 30mph roads in Wales to 20mph.  





Our analysis suggests that greater use of the 20mph speed limits may have a range of public health benefits such as a reduction in morbidity and mortality through reduced road traffic and air pollution risks.  As shown below, we also assessed the evidence for 20mph speed limits against the goals of the WFGA and found that this would deliver on all seven goals.  We are continuing to undertake research in transport and health to influence policy and benefit the health of people in Wales .
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Contribution of 20mph limits to Wellbeing goals
Sarah - table cannot be imported unless an image - is there another way of portraying the table?
Environmental Public Health Service in Wales
Private water supplies - improving risk assessment
We are part of a knowledge exchange project with British Geological Survey (BGS) and local authorities.
The project seeks to build understanding of the relationship between Private Water Supplies (PWS) and health and increasing knowledge of the number, location and population coverage of PWS in Wales. Longer term, we aim to create a register of PWS including those serving single domestic dwellings (SDD) which are often not recorded. This will improve understanding of the risks to health and raise awareness of the need for a wholesome water supply for everyone in Wales.

The project also aims to use data such as inorganic water chemistry and water resources to identify future priorities, for example susceptibility to drought due to climate change or presence of geologically derived chemicals.  The aims of the project are provided below.

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Increase access to geological data to support decision making at local, regional and national levels, in relation to PWS

Map chemical properties of water (e.g. plumbosolvency, manganese concentrations) to identify trends in exceedances of drinking water standards e.g. PWS testing data mapped with natural lead concentrations of stream sediments to inform risk assessment 

Consider how to improve understanding of water and health in people using private water supplies (especially SDD sources).
All outputs and data will be freely available to local authorities when the project ends in April 2018. 

Further information is available from the Water Health Partnership  
Private Water supply data (DWI), Stream sediment data reproduced with the permission of the British
Geological Survey ©NERC
Environmental Public Health Service in Wales
Lead - a problem of the present? 
Lead is a persistent environmental toxin which still affects the health of people in Wales many years after bans on lead in paint and petrol. There is no safe level of exposure and children and the developing foetus are particularly susceptible.  Even low level exposure in early life can result in reduced IQ and behavioural problems and these effects can be permanent, can reduce academic and economic achievement and exacerbate socio-economic inequalities.

Establishing the current burden of lead is difficult; there is no systematic surveillance of how many people are affected. Cases reported to us are likely to be the ‘tip of the iceberg’ of exposure. As part of wider multi-agency efforts to reduce the burden of lead on health and health services and achieve a lead free Wales, we are developing surveillance of lead exposure, both to ensure timely public health action for individuals and inform population-level prevention.

In September 2017, we introduced a laboratory notification protocol for whole blood lead levels of ≥5ug/dL in children aged 5 and under and ≥10ug/dL for those aged 6 and over. This level is already being used in the USA, Canada and Australia but it is the first time that it will be used in the UK.

This work will allow us to identify populations and areas at risk of lead exposure. We will aim to increase awareness amongst health care providers of the risks of lead exposure and support them to identify and manage affected patients. It will also support a multi-sectoral, multi-agency strategy to reduce exposure to lead and further our goals of a more equal and healthy Wales that protects current and  future generations.
Wildfires - reducing risk
Operation 'Dawns Glaw', which aims to reduce wildfires, has continued.  This year, actions have included improved intelligence on 'hotspots', use of weather forecasts to inform proactive action and advice, more patrols by front-line services and greater engagement with communities and schools on the dangers of wildfires.

In 2016, there was a 41% reduction (n=1057) in deliberate grass fires attended by Fire and Rescue Services compared with 2015, including a 75% reduction in April, a change that cannot be due to rainfall. The difference that this work is making is widely recognised and the approach seen as the model for future public safety work in Wales.

Welsh Government has endorsed this work and stated:
 "Deliberate grass fires can be devastating. They put human life at risk, endanger property and kill wildlife and livestock. But by working together so closely over the past two years, our fire and rescue services, the police, the Welsh Government and other agencies have achieved a dramatic reduction in the numbers of these fires. I thank them for their work and congratulate them on the success of operation Dawns Glaw so far. There is, however, more work to be done, and it is very pleasing to see the project moving on to work with farmers and landowners to reduce the number of controlled burns getting out of hand".
Environmental Public Health Service in Wales
Working beyond Wales
The WHO Collaborating Centre (WHOCC) (established in 1993) has recently been re-designated for a further 4 years.  It provides advice and support, including guidance on emergency planning and preparedness and response to and recovery from - chemical incidents and events of public health concern.    
An international symposium in London in April 2017 explored likely human behaviour following the declaration of a major incident. Using global examples, delegates considered likely reactions to incidents and the role that the public can play in the  aftermath. It found that most people are unlikely to panic, social cohesion is enhanced and that good communication  between first responders and the public will lead to greater compliance. 

Through the International Training Centre (ITC), a collaboration between the WHOCC and Cardiff Metropolitan University, teaching and training took place in Takoradi, Ghana during May 2017. Based on offshore oil and gas extraction and artisanal gold mining industries and aimed at environmental health officers, public health professionals and clinicians, the training covered emergency planning and preparedness for and response to major chemical incidents.
WHO Collaborating Centre for Chemical Incidents
Teaching and Training
Chemical Incident Surveillance
 A 4-week pilot, from February-March 2017, used a real time news alert system to search and identify global chemical incidents on the internet. Over 2800  media articles were identified, yielding 111 articles of interest. It is hoped that with further development, this approach will improve understanding of chemical incidents, their frequency, nature, location and commonest chemicals involved.
Risk Prioritisation
The WHOCC has continued to work on a risk prioritisation tool for predicting potential human health impact of exposure to airborne chemicals. The approach serves to tailor emergency planning and preparedness to specific hazards.
Teaching in Ghana @ WHO-CC
We continue to lead, on behalf of the rest of the UK, the development of international response to chemical incidents in the marine environment, via Project Mariner, along with partners in Spain, France and Portugal. This two year project will enhance response to hazardous and noxious substances (HNS) through training, collaboration and knowledge sharing.

As part of this project, we have developed and delivered a computer based maritime response training tool and e-learning course around transboundary response.  We have presented at conferences in Portugal and the US, and hosted a workshop attended by local authorities, Natural Resources Wales, the Environment Agency and Welsh Government.
Cardiff Workshop @ CRCE (Wales)
Project Mariner
Environmental Public Health Service in Wales
A spotlight on: waste fires
Abertawe Bro Morgannwg University Health Board
Your Subtitles Goes Here

Notable incidents/enquiries include industrial chemical incidents in Neath Port Talbot, waste fires in Baglan & Bridgend, carbon monoxide incidents in domestic dwellings, and air pollution concerns in Swansea

We have participated in emergency planning chemical incident exercises, alongside Health Board colleagues, testing organisational and local collective emergency plans 

Being already aware of this site, previous risk assessments had identified those who may be affected by a chemical or fire incident.  The MetOffice CHEMET tool was used to map smoke dispersion. The information this generated, along with our experience of public health risk management in other similar incidents, meant that there was no added value through air quality monitoring. A  multi-agency Air Quality Cell was still established to inform actions to assess and manage public health risks.  Local residents were advised to shelter when affected by the smoke and  how they should prepare home-grown produce affected by smoke and ash.

Natural Resources Wales has worked with industry and the Chief Fire Officers Association on guidance to reduce fires associated with recycling. The guidance details control and mitigation mechanisms for waste such as plastics, paper and board, rubber and wood. It aims to reduce the number and duration of fires, reducing the public exposure to smoke, and guide actions to reduce fire risk and protect public health.  Our post-incident review recommended making better use of the Incident Management Team concept and communicating more efficiently through social media.

The Welsh Government targets Wales to be a 100% recycling nation by 2050. Recycling prevents waste going to landfill and recovers value from waste that cannot easily be reused.  Waste wood recycling involves collection, chipping and storage before use in composite wood products or as biomass fuel. Fires occur, and have the potential to adversely affect public health, because of failures in operating procedures, criminal activity and  lack of adequate controls.  

Our Actions

On 19 September 2016, a fire occurred near Heol-y-Cyw, Bridgend, involving 100 tonnes of chipped wood. It generated thick, dark smoke, but initially, plume heat and buoyancy meant plume dispersal was relatively good. As fire-fighting intensity increased, the plume cooled and dispersed less; the result was greater concern amongst local residents and potential for smoke exposure.
Summary of activity data
Breakdown of incidents received 2016/17
Chemical - spill/release
Chemical - water
Chemical - fire/explosion
Biological
Radiation
Environmental Public Health Service in Wales
A spotlight on: minimising impacts from industrial developments
Aneurin Bevan University Health Board

Chemical spills/releases & fires account for the majority of  incidents reported.  Including wildfires in Tredegar, an ammonia release in commercial premises in Pontypool and an industrial fire in Cwmbran

We worked with the Health Board and local authority to manage perceived risks  regarding asbestos exposure at Brynmawr community cinema

We also actively supported Health Board colleagues in local emergency planning, preparedness and resilience exercises
We worked with the Health Board, Natural Resources Wales and community representatives (including the local Assembly Member) to assess likely public health risks from the proposed development's impact on the local environment.  We advised the regulator to exercise caution when considering issuing a permit due to the substantial short-term extra process contributions to local NO2 and the frequency of temperature inversions.  Our advice considered existing air pollution concerns and the vulnerability of the local population in terms of susceptibility to effects of exposure. Mindful of our advice, the regulator required the applicant to reduce the anticipated process contribution.  Our action resulted in process emissions being reduced to concentrations well below the short-term air quality objective for NO2.  If a permit to operate is granted, we have recommended robust air quality monitoring to be undertaken to validate the models.
Our Actions
We routinely review land use development planning and environmental permit consultations to assess public health risks associated with a range of local development types, whether from proposed housing or infrastructure changes to industrial process developments.  We work with the Health Board (who are consultees) to ensure that public health is a key consideration in planning and permit decision-making processes.  

Last year, a permit application for a gas-fired odour treatment system serving a waste transfer station in Cwmfelinfach raised public concerns and generated significant media, political and public interest. Nitrogen dioxide (NO2) emissions were highlighted as a particular cause for concern locally.
Summary of activity data
Breakdown of incidents received 2016/17
Chemical - spill/release
Chemical - water
Chemical - fire/explosion
Biological
Radiation
Environmental Public Health Service in Wales
A spotlight: the 'V Due' incident, Anglesey
Betsi Cadwaladr University Health Board
Your Subtitles Goes Here

We have been advising the Health Board on several large infrastructure projects such as the National Grid North Wales Connection Project, the Flintshire Local Development Plan and Wylfa Newydd Project on Anglesey which includes the proposed new nuclear power station

The area is a mix of rural, urban and industrial regions and provides a wide range of environmental public health challenges
We provided public health advice to the Environment Group (EG) and requested CHEMET modelling from the Met Office. Three ports were shortlisted by SOSREP; Holyhead, Belfast and Liverpool and were assessed by the EG. Key issues were access, available berths, risks to other shipping, facilities to discharge and store cargo, risks to the marine environment and risks to human health. Options were assessed using risk based techniques and Liverpool was chosen.

We advised on the potentially protracted nature of wood chip fires, key pollutants and possible community impacts, particularly for susceptible groups, plume modelling and monitoring, and precautionary public health messages. 
Our Actions
On 1 December 2016, 25000 tonnes of wood pellets on board the cargo ship V Due, self-combusted, causing high temperatures and harmful gas generation. The ship was anchored off Anglesey, all crew were safe and no pollution released. On 2 December salvage experts found carbon monoxide in the engine room and risks of thermal damage to the hull. A 500m exclusion zone was set and the Secretary of State’s Representative (SOSREP) requested a place of refuge.
Summary of activity data
V Due at anchor ©SMIT Salvage
Breakdown of incidents received 2016/17
Chemical - spill/release
Chemical - water
Chemical - fire/explosion
Radiation
Environmental Public Health Service in Wales
Spotlight: Champions League Football Final
Cardiff and Vale University Health Board
Your Subtitles Goes Here

Notable incidents and enquiries include smoke from a prolonged waste fire in the Vale of Glamorgan, cases of carbon monoxide  and lead poisoning and reports of blue green algae in inland waterways  

We have also provided expert advice to the Health Board and Natural Resources Wales on a proposed biomass facility in Barry and are currently advising  Cardiff Council on proposals for a clean air strategy in Cardiff

We contributed to the Public Health Wales UEFA emergency planning group, participated in a series of multi-agency UEFA exercises, supported the Incident Coordination Centre and provided daily intelligence reports to the PHW situation report.  We also supported GOLD and SILVER throughout the UEFA week.  

We assessed and helped plan for a number of risks, including CBRN and hazardous materials incidents, air quality, management of contaminated casualties, severe weather events and decisions around evacuation and shelter.  During the event, we provided a daily risk assessment which covered air quality, on-going incidents and current and forecast weather conditions.
Our Actions
The UEFA Champions League football final at the National Stadium of Wales (Principality Stadium) on Saturday 3 June 2017 was the largest single global sporting event of 2017 and the largest ever to take place in Wales. It took place over a week and included the Women’s Final at Cardiff City Stadium on the 1 June and dedicated mass gathering areas where the public could watch live entertainment, concerts and other football events.
Summary of activity
Breakdown of incidents received 2016/17
Chemical - spill/release
Chemical - water
Chemical - fire/explosion
Biological
Radiation
Environmental Public Health Service in Wales
A spotlight on: local air quality management
Cwm Taf University Health Board
Your Subtitles Goes Here

Notable incidents and enquiries include industrial chemical incidents, carbon monoxide incidents in domestic dwellings, and air pollution concerns

Much of the wildfire activity noted earlier in this report is in the valley communities in Cwm Taf

We have also provided specialist advice to inform planning and permitting consultations, particularly around the quarry Pontypridd 

The local application of this has already been seen in Hirwaun and Rhigos (including Penderyn), where we have supported partners to understand and address community concerns about historic, current and future air pollution concentrations. The area is residential, industrial (mining and energy production) and has a busy road network. Concerns were about emissions from these existing sources and from planned industrial developments, including a large waste processing and gasification plant. We carried out a thorough review and public health interpretation of measured local air quality data. The health board produced a local community health profile that compared rates of ill-health in the area with other parts of the local authority and Health Board.
Our Actions
We have been working with colleagues from the Health Board and local authorities to enhance public health integration and collaboration in the statutory Local Air Quality Management (LAQM) process. Through a formal research project, feedback was invited from local public health and air quality management specialists to specify the role of public health in LAQM and identify barriers and solutions to inform action to bring about policy and practice change. It is intended that this work will not only strengthen links across public bodies, but also reduce air pollution, risks and inequalities.
Summary of activity
Breakdown of incidents received 2016/17
Chemical - spill/release
Chemical - water
Chemical - fire/explosion
Environmental Public Health Service in Wales
A spotlight on: oil spill near Nantycaws
Hywel Dda University Health Board
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The area is notable for the large number of blue-green algae episodes reported to us each summer 

Although much of the area is rural,  there are pockets of industry such as oil refineries around Milford Haven 

Much of the local planning and environmental permitting applications are for intensive farming activties

On the 4 October 2016, over 140 cubic metres of kerosene was released when a main pipeline was damaged during routine maintenance near to the A48 at Nantycaws, Carmarthen. A multi-agency response group was established and the incident gained media attention.  The incident ran for over 5 months
Our Actions
We worked with agencies, including Valero (pipeline operators), the LA, NRW, Welsh Water and the Emergency Services, to minimise the public health impact of the leak.  We were part of the multi-agency Silver and Recovery Groups that met regularly from October 2016 to February 2017 to assess the impact of this spillage and manage the pipeline repair and oil recovery operation.  

A comprehensive programme of environmental monitoring was undertaken and we used this data to inform the risk assessment and subsequent health advice to local residents.  A local property on a private water supply was temporarily connected to the public main supply.  The rapid response to the incident meant that most of the oil was recaptured (over 90%) and that there was only limited and localised contaminated of the area.   
Summary of activity
Copyright: NRW
Breakdown of incidents received 2016/17
Chemical - spill/release
Chemical - water
Chemical - fire/explosion
Environmental Public Health Service in Wales
A spotlight on: Private Water supplies
Powys Teaching Health Board
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The Health Board has a high proportion of private drinking water supplies. Most of the incidents that  we deal with relate to contamination drinking water 

Of the planning and permitting applications that we have responded to in the past year, most have related to large scale farming processes such as intensive poultry farming units which reflect the rural nature of this Health Board

Almost half  (44%) of all PWS in Wales are in Powys (n=6,000). Most serve single homes and cover 18% of the population; more than any other local authority in Wales. This presents a public health challenge since, unlike public water supplies (supplied by a water company) which are of very high quality and tested regularly, the quality of PWS can vary.

PWS in Wales are regulated under the Private Water Supplies (Wales) Regulations (2010). Each local authority must risk assess all PWS in their area, every five years, unless the supply is to a single home with no commercial activities. This regulatory approach is intended to ensure that PWS are of similar quality to public supplies. But, weather and seasons can affect water composition at any time and, potentially, affect health.

The health problems associated with PWS are usually vague and non-specific, such as gastro-intestinal (GI) upset.  If the supply is affected for a prolonged period, people may be making multiple visits to healthcare services, and travelling long distances to do so.
Our Actions
We have recently provided advice on possible contamination by agricultural effluent, domestic heating oil, manganese and iron. Manganese may cause GI problems if consumed in large doses, but tastes very unpleasant, making it unlikely that enough will be drunk to  cause ill health. Iron and heating oil also affect taste and appearance of drinking water at levels typically well below those at which it is a hazard to health.   As discussed earlier in the Review, our knowledge exchange project with BGS will greatly improve our understanding of the risks posed by PWS in Powys and Wales as a whole.

Summary of activity
Breakdown of incidents received 2016/17
Chemical - spill/release
Chemical - water
Biological
Radiation
Environmental Public Health Service in Wales
Looking back, looking forwards
Last year we opened this section with a comment on the implications of the Well-being of Future Generations Act (WFGA) and the importance of it in supporting our aim to reduce the environmental burden of disease on health and health services in Wales. A year on and the importance of the Act has continued to guide public service strategic development, as well as our actions as a service.

As detailed in this report, we aim to do more ‘upstream’ work to advocate and influence, for example by informing local and national planning policies and developments rather than having only limited impact ‘downstream’ by influencing final-stage operational permit decisions. We aim to deliver a service that recognises that the environmental burden of disease can only be reduced by through collaboration across multiple sectors and disciplines.

We are also planning to increase our surveillance capability to improve our understanding of the environmental burden of disease in Wales and, in doing so, guide and support efforts to reduce this.

The Champions League Final in June was an important milestone in our emergency planning, resilience and response processes and marked the first major event to be managed from Public Health Wales’ new Cardiff office. The office move will support improved cross-organisational working and has been notable, in particular, for fostering links with the Policy, Research and International Division (PRID), which includes the Welsh Health Impact Assessment Support Unit (WHIASU). These links will become even more important as we look to influence key policy developments.

There are significant air quality management-related developments on the horizon.   We will be looking to inform and support our partners to take forward ambitious plans to reduce air pollution, health risks and inequalities.  We will also build on this work by developing more research into the links between health and transport policy.

Finally, we will be working with our communications team to modernise the way we communicate during incidents.

We look forward to providing you with an update on our progress with these projects next year.
Public Health Wales - Health Protection Team

Tel: 0300 00 300 32

PHE  - Centre for Radiation, Chemical and Environmental Hazards (Wales)

Tel: 029 2041 6388

Environmental Public Health Service in Wales