enHealth Council

Session Reports

Report of 1^st Session of the enHealth Council
14-15 December 1999, Canberra

Opening of First Session of enHealth Council

enHealth Council Mission and Role of Members

Administrative Matters

Communication and Corporate Identity

Implementation Framework

New Items for enHealth Council

Carry-over items from the National Environmental Health Forum

Opening of First Session of enHealth Council

The first session of the enHealth Council was held in Canberra on 14-15 December 1999. The following Members were in attendance:

Professor C. Ewan – Chair
Mr O. Ashby – National President, Australian Institute of Environmental Health
Ms J. Bowman – Department of Human Services, Victoria
Dr K. Buckett – Commonwealth Department of Health & Aged Care
Dr S. Corbett – NSW Health Department
Mr J. Dodds – Queensland Health
Ms P. Harris (for Mr M. Hyman) – Environment Australia
Mr M. Jackson – Health Department of WA
Dr A. Langley – Department of Human Services, South Australia
Mr C. McCarthy – Aboriginal and Torres Strait Islander Health Commission
Ms S. Moir (for Dr M. Jacobs) – Department of Health & Human Services, Tasmania
Dr A. Neller – Public Health Association of Australia and the Australian Consumers Association
Mr P. Prendergast – Public Health Policy & Regulatory, Ministry of Health, NZ
Mr X. Schobben – Territory Health Services, Northern Territory
Mr J. Woollard – Department of Health & Community Care, ACT
Ms S. Tuffin – Secretary to Council (Commonwealth Department of Health & Aged Care)

Apologies

Mr M. Hyman – Environment Australia
Dr M. Jacobs – Department of Health & Human Services, Tasmania

Observers

Environmental Health Section (Commonwealth Department of Health & Aged Care)

enHealth Council Mission and Role of Members

Terms of Reference

Council acknowledged the Terms of Reference, as spelt out in the National Environmental Health Strategy. While the Terms of Reference are in essence the role of the enHealth Council, it was agreed that a mission statement be developed that reflects the vision and values of the Council.

In addition to considering the Terms of Reference as part of ongoing priority setting and workprogram development, the Council requested that a paper be prepared on the possible role of the enHealth Council in the region and internationally. This will be discussed at the 2^nd session.

Membership and role

The inaugural meeting of the enHealth Council addressed a range of administrative matters in order to set the ground rules for operating. Under this item, Members discussed the arrangements and processes for communicating with their respective jurisdiction, organisation or sector.

The preparation of session reports, this being the first, was endorsed to provide transparency of Council discussions and decisions to relevant sectors and the general community.

Administrative Matters

Internal structure of Council

Council agreed to the establishment of an Executive Committee to assist with the operational aspects of the Council workprogram. The Terms of Reference for the Executive Committee will be refined and endorsed at the 2^nd Session.

Environmental Health Section and Secretariat

The enHealth Council is supported by staff in the Environmental Health Section of the Commonwealth Australian Department of Health and Ageing.

Schedule of meetings for 2000

The enHealth Council will meet four times per year. The meeting dates for 2000 were endorsed and are:

2^nd session 8-9 February, Canberra

3^rd session 4-5 April

4^th session 25-26 July

5^th session 24-25 October

Alternate meetings will rotate around States and Territories.

Operating Procedures

Council endorsed operating procedures for managing agenda and meetings, action arising, out of session arrangements and decisions and representation issues.

Interaction with, and reporting to, other bodies

The importance of partnerships and collaboration in environmental health was acknowledged. Identifying those partners, and the methods of interaction and engagement, needs considerable thought. A paper, being prepared by the Secretariat, will be considered at the 2^nd Session of Council.

Strategic frameworks, such as the many National Strategies, along with other "entities", such as Cooperative Research Centres, should be considered in the development of the paper.

The Council reaffirmed the importance of Local Government involvement in environmental health management and the desire for representation in enHealth Council business. A letter is being prepared to the National Public Health Partnership Group expressing this view

Communication and Corporate Identity

Marketing and Communication

The Marketing and Communication Strategy was noted as an important tool for reference when planning and managing projects. Council reinforced that marketing and communication is not simply the production of booklets, pamphlets and posters. There are many other options for communicating messages and promoting the existence of the enHealth Council and the advice it prepares and the work it does.

Corporate identity

Council noted the enHealth logo and proposed design of publications and associated material.

Implementation Framework

Background on development and consultation processes

Council noted the process for developing the draft Implementation Framework, the document which operationalises the National Environmental Health Strategy. The draft Framework was released for targeted consultation in October and received general support from respondents.

Council considers the Framework to be an evolving document that captures the environmental health activities across Australia, led by a range of agencies. As an evolving document, it is expected that issues will be included, removed or modified over time.

A subset of the Framework will be the responsibility of the enHealth Council specifically. Business plans will be developed for these areas and will identify the need or outcome sought, action or activity, partners, timeframe and indicators for evaluation. These will be reviewed annually.

There was also general support for the creation of a directory of demonstration projects around the country as a reference document. The Council will consider this further.

In considering the sections of the Framework, Council identified which were strategic in nature or required action at a national level. It is in these areas that enHealth Council will take on the role of lead agency and business plans will be developed.

Indigenous Environmental Health

Council identified this area as a priority to progress at a national level. As a result the Council will take the lead agency role and will facilitate collaboration and the establishment of partnerships.

The establishment of an Indigenous Environmental Health Worker Forum, as a standing committee of the enHealth Council, was supported. Jurisdictions will be asked to nominate individuals as interim members of the Forum, pending the next National Indigenous Environmental Health Worker Conference in 2000.

Information

Information underpins all aspects of environmental health practice. As a result, the enHealth Council must set parameters or clear boundaries for the aspects of "information" they will address. For example, the collection of information could be undertaken on an issue-specific basis (air, water, mosquito-borne disease etc) or more broadly. As a first step, the enHealth Council will identify what data is routinely collected by jurisdictions. Next steps will be considered at the 2^nd Session of Council.

Workforce

The skills and training needs of the environmental health workforce are paramount to the successful management of current and emerging environmental health hazards. The enHealth Council agreed to work in this area in two ways: the identification of core skills for environmental health practitioners and the delivery of such courses, and continuing professional development programs. A Task Group will be established with representation from a wide range of sectors to progress this work.

Council also recognised the importance of integrating training and other needs of Indigenous Environmental Health Workers into the broader consideration of the environmental health workforce.

Economics

The need for a methodology(s) for the economic evaluation of environmental health incidents was supported as a national issue for the enHealth Council to take a lead role in developing. Council noted the work already underway, by the Commonwealth, to develop a draft guide for economic evaluation in environmental health and established a Steering Committee to oversee this project.

Research

Council agreed that research is fundamental in guiding best environmental health management practice in Australia. The enHealth Council, while not having funds to commission research or provide research grants itself, does have a role in identifying national research priorities, facilitating the consideration of environmental health research needs and integration of those needs into existing frameworks such as the National Health and Medical Research Council, the Public Health Research Education Program and Cooperative Research Collaborations.

A Research Task Group is to be established to provide advice to the enHealth Council on a range of activities. It will provide advice on environmental health research priorities and inform policy decision making and develop a priority setting framework that sets out criteria to identify priorities for research in environmental health. The Task Group will also provide advice on the most appropriate mechanisms for progressing environmental health research

Health Impact Assessment

Council confirmed the importance of health impact assessment as a strategic national issue. While the need for caution was expressed in relation to some existing systems in jurisdictions for health impact assessment, the enHealth Council agreed to advocate for the uptake of this tool by jurisdictions and agencies.

Draft guidelines were tabled at the meeting and will be released widely for consultation before referral to Council for endorsement. It was recognised that the Marketing and Communication Strategy would provide advice on how to publish, market and advocate for the uptake of the guidelines when endorsed.

Council acknowledged the remit of the Legislative Reform Working Group, of the National Public Health Partnership Group, and its potential role in the inclusion of health impact assessment into legislation or regulation.

Standards and Guidelines

The development of standards and guidelines is a high priority for enHealth Council and is one of the formal Terms of Reference. The conduct of an audit of Australian environmental health information, standards and guidelines was reported. The outcomes of the audit will be used by the enHealth Council to set priorities for the development of new standards and guidelines or the revision of existing standards and guidelines. The audit report is expected in May 2000.

Health Risk Assessment

Health Risk Assessment was considered a strategic issue of national import. Council noted the project to develop a health risk assessment methodology and will consider the document for publication following a three-month consultation period in 2000.

Drinking Water

Action in this area is primarily the responsibility of a range of other agencies, with the National Health and Medical Research Council taking a lead role in relation to health considerations. However, it was agreed that the enHealth Council might have a role at the national level particularly in relation to water quality and availability in remote areas. A small group will conduct a scoping exercise to detail the problem and options for the role of the enHealth Council in this area.

Council also noted the Colilert trial being conducted in some 30 Indigenous communities across 5 jurisdictions as an example of a project that is trying to overcome some of the water quality issues in rural and remote areas.

Recreational Water

A significant amount of work is being progressed in relation to recreational waters both nationally and internationally. A mapping exercise will be undertaken by Western Australia to document what information jurisdictions are collecting. Earlier work on spas and swimming pools by the National Environmental Health Forum and Western Australia respectively, may be revisited under the enHealth Council workprogram.

Approval of water treatment chemicals was discussed. Concern was again expressed regarding the absence of a national approach to the approval of chemicals for the treatment of water, since the National Health and Medical Research Council ceased such activity.

Council noted that Standards Australia, following consultation with the National Health and Medical Research Council and the National Environmental Health Forum Secretariat, had agreed to develop a standard for water treatment chemicals.

Council confirmed the importance of a national approach to the toxicological assessment and efficacy of water treatment chemicals and agreed to continue to pursue the establishment of appropriate arrangements with Standards Australia and the National Health and Medical Research Council.

Air

Council agreed that indoor air quality was the first priority for progression nationally in relation to air quality. Options for enHealth Council action in this area will be scoped and presented at the 2^nd Session for discussion, following receipt of information from a scoping exercise undertaken on behalf of the Commonwealth.

Built environment

Council agreed that a project on the non-auditory impact of noise should be incorporated into this section of the Implementation Framework. The project outline on the non-auditory health effects of noise was endorsed and will be managed by the Commonwealth.

The first phase of the project is a systematic literature review of up-to-date national and international information on the non-auditory health effects of both occasional and routine exposure to environmental noise (principally from transport and industrial sources). will be to ascertain the current level of knowledge on the issue.

A project on the built environment in government premises, being managed by Queensland Health, was noted and a business plan is to be presented to the 2^nd Session.

Food

Given existing bodies involved in the management of food, the enHealth Council agreed to maintain a watching brief at this stage and focus on strategic issues at a national level.

Vector-borne disease

Council agreed that this matter was primarily the responsibility of States and Territories rather than for the enHealth Council nationally. Western Australia agreed to take the lead on this issue and in the first instance map the range of information collected by jurisdictions around Australia.

New Items for enHealth Council

Review of environmental toxicology expertise in public health

Council agreed in principle to oversee a Steering Committee for the Review of environmental toxicology expertise in public health. The Review is an initiative of the National Public Health Partnership Group and will be undertaken by a consultant.

The Council will await further advice on the completion of the contract negotiations and will consider nominations from the National Public Health Partnership Group in the New Year.

Carry-over items from the National Environmental Health Forum

Risk Perception

Progress on the development of a Risk Perception Survey was noted. Council looks forward to receiving the results of the Survey in mid 2000.

New Monographs

Disaster management

Council considered the draft document on disaster management prepared by Western Australia. In order to determine the appropriate level of consultation on this, and future enHealth Council publications, a decision on this document was deferred until the Framework or Protocol for Consultation is developed.

Carting Drinking Water

This item was deferred until the 2^nd Session of enHealth Council.

Exposure settings and health investigation levels

The Council considered the changes to the two monographs ("Health-based soil investigation levels" and "Exposure scenarios and exposure settings"). Given the revised drafts were released for public consultation as part of the development of the National Environment Protection Measure on the Assessment of Contaminated Sites, by the National Environment Protection Council, the enHealth Council endorsed both documents and gave approval for them to be reprinted as enHealth Council publications.

Recommendations from National Indigenous Environmental Health Workshop, Broome May 1999.

The Council considered the recommendations of the Broome Workshop and ratified responses made earlier by the National Environmental Health Forum. A number of recommendations relate to jurisdictions and as a result, the Council will refer those recommendations to the National Public Health Partnership Group for consideration and possible referral to the Australian Health Ministers Advisory Council.

The recommendations will also inform the development of the enHealth Council business plan on Indigenous Environmental Health.

Standing Items

Report from Chair

Council noted the report from the Chair on attendance at the National Public Health Partnership Advisory Group (5 November 1999) and the National Strategy Chairs meeting (19 November 1999).

Report from NPHP Group

Council noted the report provided on relevant outcomes of the National Public Partnership Group meeting of 16-17 November 1999.

Reporting of hazardous incidents

Western Australia reported on the recent incident of an arsenic leak into the Coburn Sound over a 6-month period. There was a significant disturbance in the harvesting and selling of mussels in particular and the event highlighted some problems with testing for inorganic arsenic in the laboratories. The management of the incident did, however, demonstrate successful collaboration between the sectors involved.

Reports from associated organisations

Council discussed the importance of maintaining links with the National Environment Protection Council (NEPC) and of health input in the development of relevant National Environment Protection Measures. The existence of a formal agreement between the National Environmental Health Forum and the NEPC in 1997 was noted. The Council will revisit this agreement and re-establish formal links with the NEPC.

No reports on Therapeutic Goods Administration or National Health and Medical Research Council activities were available for this meeting.

Register of Monographs

Manual for Indigenous Environmental Health Workers

The Council supported the development of a Manual for Indigenous Environmental Health Workers. A project plan will be considered by the enHealth Council at its 2^nd Session.

Aromatic total petroleum hydrocarbons

Council considered the draft document, which provides a mathematical model for aromatic total petroleum hydrocarbons released from contaminated sites. It was agreed that a contextual introduction was needed which summarises what the document is and does and who the target audience is before consultation.

An interim guideline for benzene is to be included in the document to enable the determination of a draft soil criterion. In the absence of an Australian guideline value for benzene, the Council agreed to adopt the UK guideline as an interim value pending a formal Australian health risk assessment.

Information Items

Reports on the following items were noted for information:

Report from First International Congress on Integrating Sustainable Development into Environmental Health Practice
Potable reuse of waste water
ARPANSA
Wildlife Health
Other water issues
Safe Water Partnership
Colilert testing
Air Ventilation
Minutes of September 1999 meeting of the NEHF and action sheet
High Court Decision on Government Liabilities

Other Business

Health Warning Triggers

Council noted the request from the New South Wales Environment Protection Authority for advice on national health warning triggers.

The National Environmental Health Forum (predecessor to the enHealth Council) previously considered a document on "Health Warnings for Air Pollution Forecasting" prepared by Queensland Health in 1997. In its development, the draft was circulated to environment protection agencies for comment.

Council agreed that the document be reviewed, given the length of time since it was first developed, and would reconsider the draft at its 2^nd Session for possible release for consultation prior to publication.

Legionella pneumophila and Legionella lonbeachae

Council discussed the outcomes of a recent case-control study in South Australia on Legionella lonbeachae. An options paper was considered and Council agreed that this be revised and submitted to the Communicable Diseases Network of Australia and New Zealand (CDNANZ).

Council also noted information on Legionella pneumophila.

Review of Australian Building Codes Board

The enHealth Council considered a motion to prepare a submission to the review of the Australian Building Codes Board. Members confirmed the centrality of health in the development of standards and the regulation of buildings and will write to the Board to express this view.

Technical Advisory Group on Air Toxics

The enHealth Council was invited to join the Technical Advisory Group (TAG) for Air Toxics, being managed by Environment Australia. Council confirmed the importance of participating in the program, through the TAG. Dr Kevin Buckett was asked to attend the first meeting of the TAG, on 16 December 1999, on behalf of the enHealth Council with the formal representative to be confirmed at a later date.

Avian Tuberculosis

Council heard that Avian TB was of some concern to one jurisdiction in particular. It was agreed that consideration at a national level was required and Council agreed to consider a discussion paper on the issue at its 2^nd Session.

Pest Industry and Government Sector (PIGS)

Council considered correspondence from the Chair of the Pest Control and Government Sector Advisory Committee (PIGS), seeking recognition of the Group as an advisory group for matters that impact on the pest management industry.

The membership of the PIGS was acknowledged and Council agreed to utilise this group when advice was required on such matters. However, the Council did not formally adopt the PIGS as an official subcommittee within the enHealth Council structure.

Next meeting

The 2^nd Session of the enHealth Council will be held on 8-9 February in Canberra.