1997 Spring

May, June, July 1997 VolumeXIX, No. 2

O TA ZO_2

_ A Journal for Public Health Inspectors

WaterQuality& Safety! ,_

Congratulations are in order for CIPHI, Ontario Branch Inc., President J_Re_in his new position as Director of Middlesex-London Health Unit.Also, we would like to extend _Be_-WL_._r' to Mr. Ro_e4_-C__,

/_ former Director of the Middlesex-London Health Unit, on the occasion of

his retirement. Additionally, we would like to extend _Be_-W_'to B_

WrL_-of the Middlesex-London Health Unit upon his retirement. Bill isalso a past president of CIPHI Ontario Branch Inc.

i_ In this issue,we have various articles to report relevant to the field. These ,_are as follows: \_l

_ P0_r_VIII Program

Com__e Dilates

Fo dS%ty

_ I _ternet SitesC_g Events.

O We would like to receive articles on the successes / failures involving theenforcement of the Tobacco Control Act.

B e_t Wi_es, _eyou at t_e B_l To_r_"71 eE tcr '

P.S. Thanks to Ar_orvy DiP_etro, Ryerson EHAD Course President, fororganizing a successful day. This provided an opportunity forstudents and the Ontario Branch Inc. Executive to network!

I PAGE 2 ONTARIOBRANCH NEWS- SPRING/SUMMER'97]

iphC ICanadianInstituteof

PublicHealthInspectors(OntarioBranchInc.)

EDITORS i::!ii:;i'i!::?ii!i'i_:!!]2!_:ii:_i

Manuelde Freitas Mike Pape ................ _i=:_::._!!:j:iili-i!:i.:::!:_=,4,11!iil"OxfordCountyHealthUnitn519-539-6121 .................

ONTARIOBRANCH EXECUTIVEPRESIDENT ......._.=::::.

! JamesRcffle' Middlesex-LondonH.U.. 519-663-5317€ .....

PAST PRESIDENTMike Reid ................._=;.'!::"..

807-824-2075

SEC.-TREASURERBen Vacca

Niagara Regional H.U.. 905-688-3762

COUNCILLORS 1996- 1998SuzanneShaw Central Area

EastYorkH.U.. 416-461-8136ToniD'EttorreEastern Area

Ottawa-CarlctonH.U.. 613-722-2200

Bey MiddletonWestern AreaGrey-Owen SoundH. U.. 519-379-9420

Peter KastorisSouthwestern AreaHaltonRegional H. U.. 905-825-6060

COUNCILLORS 1995 - 1997Judith de Grosbois Western AreaPerth District H.U.. 519-271-7600

Manuelde Freitas Western AreaOxfordCounty Board of Health. 519-539-6121

Charles Diosi Northern AreaSudburyDistrict H.U.. 705-523-2881

HISTORIANBill O'Donnell Algoma Health Unit

_, 705-759-5286

COMMITTEE CHAIRPERSONS

Healthy Environment DivisionJudy de Grosbois

Projects DivisionSuzanne Shaw

Food Division loom ....................................Toni D'Ettorre :.i!_:iMgi!.RegistrationNb:._3:: he_._W_sto_, ontario(=Changesofaddress_,(!_::'

b::;;,undeli_ieredcopies,a'nd_.Dixlei_:.f0i;Subscripti0ns,tobe isentto.OntarioBranch':_.:iNews_-4i0 BullerSti;i_:iiW_t0ck'[Ofita_i_N4S!_CN2: .;:=.%:=,!: i:.: i:;! :i.. :..(. _.

Water Division i::"i: .:_:_...:,..;i_'.i::

General Government DivisionMike Reid

'_":_" ::"_:_),:_!!!:.;;_ii:_.._,.:.(__..:..iCommunicable Disease Division

Bev Middleton

Community and Corporate Liaison DivisionPeter Kastoris

Regional ChaptersManuel de Freitas

[ ONTARIOBRANCHNEWS- SPRING/SUMMER'97 PAGE3 ]

"j_" _1,4,,_Y'_"_/'_" inspectors to go through a training program andlicensing process being developed and provided bythe MOEE. Our position was that certified PHIs have

_dO,4_iA;If_:). the experience, academic training, and a moreintegrated perspective of the potential impacts septicsystems have on the health and environment on the

James Reffle local community. Our interaction skills with people,President politicians and other professional groups, provide for

excellent public relations opportunities.CIPHI (Ontario Branch Inc.)

Lettersto the Ministers of Environment & Energy,c/o Middlesex-LondonHealthUnit Health, Community & Social Services and Municipal

Affairs & Housing have been sent. The Reliable50 KingStreetCommunity Resource document was referenced inLondon,Ontario,N6ASL7 this correspondence. Ongoing attendance at MOEEmeetings related to Part VIII is prudent in order to

remain aware of the issues and to help influence• • • • • •_ decisionsrespectingtechnical and regulatory aspects.However, in light of the situation the decision wasmade to suspendour Universityof Guelph seminar onPart VIII for 1997.The Ontario Branch continues to work in

the best interests of our members and the public. The Branch had three representatives on theLetters have been sent to the Minister of Health Technical Review Committee of the Food Safetyadvocating for and promoting the use of certified Mandatory Program Review that was undertaken byPublic Health Inspectors in many areas within a the Ministry of Health, in February and March 1997.revampedhealth and social services delivery system. The reps were Henry Chong, Toni D'Ettorre andThe Reliable Community Resource document has Robert Hart. As you all know, the Mandatory Programbeen developed. While theOntario Branch offered its review process was fast tracked to include allservices to participate in the Social and Community programs. I participated with the OPHA Board ofHealth Services Implementation Team, the Directorsin developing the framework for a collectivemembership has been limited to municipal and response to the Ministry on the draft programs thatprovincial appointees. Any dialogue regarding an were circulatedto all health units, OPHA and ALPHA.integrateddelivery system for public health programs The processdid not provide for direct submissions byhas been through directsubmissions by the Branch or organizations such as ours, due to the tight timethrough the collective responses by OPHA. targets. I did distribute our follow-up comments to all

For advocacy and promotion purposes, the health units for consideration while preparing theirReliableCommunity Resource document was drafted own responses.with input from the Executive. This document has A joint position paper is developed with ASPHIObeen used in correspondence with various on the municipal role PHIs can play when the newgovernment Ministers and officials of other CFIS system has been completed. Robert Hart andorganizations. Many Health Units called to receive a Peter Willmott authored this report. The Branchcopyofthis resource. Executive is in the process of reviewing the

Ongoing discussions with the Ministry of the recommendations made and will be working withEnvirOnment & Energy (MOEE) re. Part VIII EPA ASPHIO to develop a follow-up plan. All Directors ofamendments and regulatory reviews have been EnvironmentalHealthshould have received a copy ofundertaken by Judy de Grosbois, Healthy the report from ASPHIO.EnvironmentsChair, Brian Hatton ,andI. On behalf In December,I communicatedwiththeChairof theof the Branch, and in consultationwith ASPHIO, I InteragencyCouncilon FoodSafety (Ontario)seekingresponded to the amendments by submitting our Ontario Branch representation.We are awaiting acommentsas pertheconsultationprocessoutlinedon decisionbythecommitteeregardingthisrequest, rvethe EnvironmentalRegistryunder the Environmental asked Peter Kastoris, as Chair of the Community&Billof Rights.Ourpositionis thatcertified PHIs should CorporateLiaisonCommittee,to exploreour ...=_be grandfathered from the requirementfor all new

PAGE4 ONTARIOBRANCHNEWS- SPRING/SUMMER'97

reiOon,Coot,nooO... 1997options and position for reapplication for designationunder the Regulated Health Professions Act. rvebegun early discussions with a local representativewho has been named to the government committeeoverseeing this process.

Peter Kastoris, Manny de Freitas and myselfattended a CIPHI Promotionevent at Ryerson onFebruary21,1997.The informalsessionattractedover

50 students. _rQ@In his role as Chair of the 1997 Ontario Branch

Conference, Wally Adams has assembled a workingcommittee that is well under way in their planningefforts. The Western Area is collectively hosting this

event scheduledfor September 17,18 and 19,1997 in Caf_ ,-,.ILondon. Stay tuned for more details, x.,, _'*

The Communicable Disease Conferencecommittee has assembled a full day session to beheld on June 10that the Central Public Health Lab inEtobicoke. Check for details on this informative

educational opportunity. _la_The Projects Division has distributed the ClPHI

Needs Assessment Survey to all Health Units. Theresults will assist the Ontario Branch in improving

service to our members and help us to attract new ep;e- -rmembers and retain current ones.

Concerns regarding membership dues payments

hopefully have been rectified and problems will be 17th 19thminimized. I have been working with Manny de iFreitas and Greg Thibault in trying to rectify thedatabaseinformationdiscrepanciesand logistics.

On February3,1997, an Ontario BranchBulletinwas issuedto all Directorsof Public Health Inspectionin Ontario health units to facilitate the speedy andefficient notification of all Public Health Inspectors(membersand non-members)of the Ontario Branch'srecent activities in response to emerging matters ofstrategic interest.This was well received and will be auseful way to communicate in between issues of theOBN.

The Ontario Branch continues to work in the bestinterests of our members and the public. As you cansee, the first eight months of this Executive's tenure

has been quite active and crucial. I appreciate the For more information contact:supportand assistanceof the Executiveand membersat large during this difficult period.D

Wally Adams519-663-5317 Ext. 2316

I ONTARIOBRANCH NEWS - SPRING/SUMMER'97 PAGE 5 I

retained the responsibility for approval andPosition Paper inspection of unconventional systems and

Canadian Institute of Public Health ApprovalsBranchpersonnelare well respectedand consulted on a regular basis for their

Inspectors expertise.Ontario Branch Bill 107, The Ontario Branch fully supports the

Water and Sewage Services direction in which the regulations are moving;performance based regulations, standardizedImprovement Act, 1997 approvals and training and certification of

installersandhaulerswillservethe provincewell,aswillthe removalof provincialsubsidiesso as torun the program on a cost-recoverybasis. Wewould like to point out, however, that beforecertification,studentsinthe EnvironmentalHealthProgramat RyersonPolytechnicalUniversity havehad a minimum of seventy-eight hours ofclassroom instruction in wastewater technologyand watertechnology. This does not include timespent in instruction in the field. The British

We thank the committee for giving us the Columbia Instituteof Technologyoffers a similaropportunity to present this submission. My name is Jim program. In order to receive their certification, thestudents must have three months of supervisedReffle and I am attending as President of the Ontario experience in the field. If the regulations are notBranch. Also in attendance are Judith de Grosbois who revised from their current form, Ontario will be inchairs the Healthy EnvironmentsDivisionof the Branch and the unique position of being the only province orBrian Hatton., who directs the sewage program for territory in Canada that does not recognizeWaterloo Region. Certified Public Health Inspectors as qualified

We will be restrictingour comments to the impact of Bill sewage system inspectors. We fully support the107 on the inspection and approval process for private recommendation for scheduled recertification forsewage systems, also referred to as on-site sewage inspectors. Our Branch has had a long history ofdisposal systems. We will also address the effects of the providing an annual in-service course in privateproposed amendments to the associated regulation for sewage systems for Inspectors through Guelphsewage systems. Public Health Inspectors, as employees University, in association with the Ministry ofof Health Units have been the traditional service delivery Environment and Energy. Advances in sewagepersonnel for decades, technology occur slowly, and so re-certification

The administration and delivery of the septic system could occur as infrequently as every five years.programhas profound effects upon both human health and There are reservations concerning thethe environment. The Environmental Protection Act (EPA) proposed timeline for bringing the new Act andwas brought into existence to addressthe need for environ- regulationsinto effect. Completion of training andmental protection in a province that was undergoing rapid certificationof inspectors, installers and pumpersgrowth. Prior to the EPA, protection of our recreational before October 1, 1997 is very optimistic,waters and supplies of safe drinkingwater, both private and considering that the training and certificationcommunal sources, was sporadic in many areas of the process and logistics have yet to be established.province. Ponding of raw sewage and pollution of our Weather conditions restrict program delivery tonatu'tal environment created numerous hazardous the months proposedfor training and certificationconditions detrimentalto human health. Health Units spent and program directors will not be able to deliverconsiderable time investigating and correcting conditions the programif staff are not available. The Ontariowhich spread disease such as typhoid, bacillary dysentery, Branch believes it would be advisable to reviseand salmonellosis. The EPA was brought into existence the timetable. A target date of March 31,1998upon formation of the Ministry of Environment and Energy would be feasible,which would coincide with both(MOEE) to correct the inconsistencies and deficiencies ofprivate sewage system inspection in Ontario. Because the the end of the fiscal year for most program _...MOEE did not have the personnel required to carry out theprogram agreements were signed with local agencies,which were Health Units for the most part. The MOEE has

I PAGE6 ONTARIOBRANCHNEWS-SPRING/SUMMER'971

Position Paper-continued... underestimated. A complaint investigation maytake hours and may conclude with charges beinglaid. This is not done on a cost-recovery basis,

deliveringagenciesand the start of a new building season, and the agency responsible for program deliveryAny legislation concerned with private will need to build these expenses into the charge

sewage systems must balance health and environmental for a Certificate of Approval.concernson one hand, with convenience for the public on Concurrent with the proposed changes in thethe other. Because of the strong connection between present legislation is the suggestion that the Billuntreatedhuman sewage and communicable disease, the and Regulations be transferred to the OntarioOntario Branch believes health protection and Building Code. Our organization has strongenvironmental protection must outweigh all other objectionsto this course of action. The disposal ofconsiderations, human sewage has no relation to the structure of

Bill107 transfers the responsibility of program delivery a building and has serious public health andfor low volume on-site sewage system(flows under 4500 environmentalimplications. The primary mandateLt./day) to lower-tier municipalities and to MMAH in of the legislation should be protection ofunorganized areas. Upper tier municipalities will be groundwater, which is the drinking water sourceresponsible for large volume systems (flows over 4500 for a large percentageof Ontarians. GroundwaterLt./day). There is provision in the legislation for protection cannot be addressed as a local issuemunicipalitiesto enter into an agreementwith the upper tier only; the entire watershed must be taken intoto deliver the program,or for severalmunicipalities to jointly account. If the Act and Regulations fall under theadministerthe program.The proposed amendments would BuildingCode, the perception will be that Buildingenable local municipalities to name the designated Inspectors would have the ability and training toauthority for administering this program. The Ontario deliver the program adequately, which is not theBranch interprets this as a clear opportunity for Public case. Delivery agents must be trained in soilHealth Units to be open for consideration, morphology, groundwater movement and

We understand that the reasoning behind dividing the epidemiology, at a minimum.responsibility for approval and inspection of larger and In conclusion, leaving the responsibility forsmaller systems was to allow "one-stop shopping" for programdeliveryfor low volume systems with theconsumersseeking a building permit. However, more than lower tier municipalitieswill lead to a patchwork offifty percent1 of Certificates of Approval are issued for inconsistent enforcement and inefficient andreplacement systems, which do not require a building costly administration, especially in areas with lowpermit. Septic systems have a natural lifetime of fifteen to population. Assigning the responsibility fortwenty years, and so those installed in the 1970s and inspection and approval of all on-site sewage1980s are currently requiring replacement, systems to upper tier municipalities will remove

It is in the interest of lower-tier municipalities to any confusion aboutwhich level of government isencouragedevelopmentas that is where the greater part of responsiblefor a particularsystem and will ensuretheir revenues are generated. In the past, concern for cost-effective coverage for all areas of thehealth and environment has been the limiting factor for province. Program delivery is optimized bydevelopment. Public Health Agencies and Conservation retaining it at the provincial level. If it is theAuthorities,who have been deliveringthe program in all but government's decision that the program must bea few areas of the province for several decades, have divested to the municipal level, we urge that thefrequently found themselves at odds with the local entire program be allocated to upper tiermunicipality over development proposals. If lower tier municipalities. The municipal department ormunicipalities take the responsibility for program delivery, agency providing the service will be able toitwill appearthat this systemof checks and balances will all support a larger staff, lower programbut disappear, administration costs and ensure experienced

Giventhe cost-recovery nature of the program, unless personnel will always be available.all lower-tier and upper-tier municipalities within a Thankyou again forthe opportunity to present :designatedgeographicarea agree on one program delivery the views of the Ontario Branch of the Canadian iagency, the cost of providing the service may be Instituteof Public Health Inspectors regarding Bill iprohibitive, without raising the price of a Certificate of 107.1"1Approval Application substantially.

Whoever takes on this program also assumes 1 Ministry ofEnvironmentandEnergy, Approvalresponsibility for all current and future systems. The costs Branchof liability, along with complaint investigations, is easily

SOUTHWEST []REGIONAL

FOOD SAFETYCOMMITTEEREPORT aSubmitted by: Corrinna Brudner, SWRPSC Chair

Theneed for a reviewof thefood preventativefoodsafetyprograms.The determinethebesttrainingstrategies.

safetyprograminOntario'sHealthUnitsis securityOfCanada'sfoodsupplyis the Onceaclearneedhadbeenidentifiedobviouswhenoneconsiderstherecently envyoftheworldandOntarioiscurrently thenmandatorylegislationisrequiredannounced realignment of health viewedasaninnovatorandleaderinfood to ensurethat the appropriatefoodprograms,the driveby governmentfor safety.ThroughoutCanada,PublicHealth servicespersonnelobtainit.greatereffectivenessandefficiency,and Inspectorsprovidecomprehensiveand 3. Innovativefoodsafetystrategiesandthe limited and shrinkingresources effectivefoodsafetyservicesdirectlyto methodsdevelopedatthe locallevelavailableto carryoutprograms.Ashealth theconsumeratthelocallevel, needto beexplored,evaluated,andprofessionals,PublicHealthInspectors PublicHealthInspectorsworkingin supported.Inthiswaymoreeffectivehavea uniqueroleandresponsibilityin partnershipwiththe OntarioMinistryof and costefficientmethodsmaybedeliveringfoodsafetyprogramsinOntario Healthintroducedthe HACCP(Hazard developed.andthroughoutCanada.Overthepastsix AnalysisCriticalControlPoint)processto 4. Methodsneedto be exploredandmonths,the SouthwestRegionalFood complementtraditional"inspections"and developed to encourage,evenSafetyCommittee(SWRFSC)incooperation bringgreatereffectivenessandefficiency legislate,the foodretailandservicewith the Associationof Supervisorsof in food safety operations.This new industriestoadopttheimplementationPublic Health Inspectorsof Ontario approachis nowviewedas the best ofHACCPstrategies,(ASPHIO) Southwest Region, has availablemodelfor afoodsafetysystem 5. The food safetyprogrammustbeundertakena reviewof Ontario'sfood and is beingcopiedthroughoutNorth adequatelyfundedandsupportedtosafetyprogrambeingdeliveredat the Americaandtheworld,Theinfrastructure maintainourcurrentpositionin foodmunicipallevel, currentlyinplaceinOntarioevolvedover safety and to addressnew and

Thefollowingis an exertfromthe manyyearsthroughthe assistanceof emergingdiseases,conclusionsandrecommendationsofthis Public Health Inspectorsand their 6. In the publicinterest,the Ministryofpaper, professionalbodies,Supportby local Healthmustretainitsroleinsetting

Therehavebeendramaticchangesin governmentandtheProvinceofOntariois standardsand regulationsinvolvingCanadianlifestylesover the past few an essentialelement.Thisapproachhas the qualityand safetyof foodanddecades.Current estimatestell us workedwellto dateasevidencedbyour ensuringfood safetyprogramsare

Canadiansarespending25 billiondollars currentstrengthinfoodsafetyinOntario. carriedout consistentlythroughoutannuallyfor foodandbeveragesoutside The needfor continuedresearchand Ontario,the home.Theboomin foodretailand evaluation in applyingfood safety 7. HealthUnits should continuetoserviceestablishmentshoweverhasnot strategiesmustcontinueif we are to develop and use multi-strategy

beenmatchedbya similargrowthinfood maintain our controlover foodbome approachesin deliveringthe foodillness.Thepapermakesthe following safety programat the local level.safetycontrol,EachyearinCanadaupto

one billion dollarsis spenton medical recommendationtothosepartiesintegral Professionalbodies such as thesupport, lost income and associated in reviewingthefoodsafetyprogram. CanadianInstituteof PublicHealthexpensesrelatedto overtwomillioncases I, Researchisneededto evaluateand Inspectors(CIPHI)and associationsof illness originating from food. determinethe effectivenessof all such as the AssociationofConsideringthesecostsfood safetyis majorfoodsafetystrategiescurrently Supervisors of Public Healthworthyofeveryone'sattention, in use.Suchresearchshouldbe Inspectors(ASPHIO)have been

Safe food does not happenby continuousandbesupportedbythe invaluable in partnering theaccident,Currentlythe government,the ProvinceofOntarioandcardedoutat developing of new strategies.foodindustryandtheconsumerallplaya thelocallevel, Considerationshouldbegivenofhowrole.Wehavebeen fortunatein Canada 2, Researchis specificallyneededto partneringcan occur with otherandparticularlyOntariothatgovernments evaluatethe effectivenessof food agencies,thefoodindustry,corporatehave recognizedthe advantagesof handlerandoperatortra!ningandto bodiesandthemediato more_'-_,,,

[ PAGE 8 ONTARIO BRANCH NEWS- SPRING/SUMMER'97]

FOODSAFETYCTEEE- continued...

effectivelyreachthedesiredgoalsin HEALTHY TheWaterandSewageServicesthefoodsafetyprogram." ENVIRONMENT improvement Act, 1997, received

first reading in the legislature on8. Strategiesfor consumereducation DIVISION REPORT January20,1997. The Act transfersneed to be reviewedto ensure a

coordinated approachis applied Judith de Grosbois, Chair responsibility for inspection anduniformlythroughoutthe province Healthy EnvironmentDivision approval of classified sewageResourcesneedtobe developedthat February 21, 1997 disposalsystemsunder Part VIII ofthe Environmental Protection Actfocus an producingan informed In September of 1996, _ to lower and upper tierconsumer, document entitled "Moving9. The food safety programshould municipalities. There is provisioncontinuesto be deliveredat the local Forward; Program Review" was within the legislation for the lowerlevelby personnelwithexpertise, circulatedbythe Approvals Branch tier municipality to transfer itstraining,skillsandknowledgeinfood ofthe Ministryof Environmentand authority to the upper tiersafetyand communicabledisease.At Energy. The document outlined municipalityif it so desires. MOEEthe present time Public Health various issues that would be will be retaining the responsibilityInspectorsaretheonlyprofessionals addressed by a review of the Part for approval and inspection ofthat possess the multifacetedex- VIII program, including program unclassified systems.pertise and meets the require- streamlining, consistency inments.D delivery, training and certification Due to the uncertainty

•/fyou haveanycommentsor wisha copyof the fu// of inspectors, installers and generated by these reforms, thereport, please contact CarrinnaBrudner at the Branch was uneasy about the/_hdsor-EssexCountyHealthUnitby phone (519) haulers/pumpers, reinspection of258-2146ext-243. subsurface sewage disposal financialliability which would be

systems, treatment of hauled incurredby poor attendanceof thesewage/septage, land use planning,! annual "On-site Sewage Systems

Seminar"jointly run by the Branchand a review of the Ministry's"ReasonableUse Policy".The first and the Officeof Open Learning at!issueto be reviewed is training and Guelph University. A jointcertificationof inspectors, installers agreementwas reachedbetween theand haulers/pumpers. Branch, MOEE and GuelphSubcommitteeshavebeenstruck to University to suspend the seminar

until the situation clarifies.Dcomment upon the draft =====================regulations; the Branch will berepresented on the subcommitteereviewing certificationinspectors.The Ministry supportsthe Branch's positionfor provisionof a "grand fathering" clause forcertified public health inspectorswho have significantexperience inadministrating the Part VIIIProgram. Requests for proposalsforthe training courses, which willinclude manuals and courses forboth inspectors and installers andhaulers/pumpers are beingcirculated by the MOEE. Thecoursesand certificationprocessesare scheduled to be completed byOctober 1,1997.

ONTARIOBRANCHNEWS- SPRING/SUMMER'97 PAGE9 ]

Letterto: Ontario Ministry of the Environment and Energy, Approvals BranchMr.W. Gregson, P. Eng.,AssistantDirector- Special Issues/ProgramManagement250 DavisvilleAvenue,Toronto,Ontario M4S 1H2

From: Judith de Grosbois,BA,CPHI(C),Chair,HealthyEnvironmentsDivision,Canadian Instituteof PublicHealth Inspectors(Ontario)

Date: October 21, 1996

Subject: PART VIIIPROGRAMREVIEW- SUBSURFACESEWAGE DISPOSALSYSTEM

Dear Mr. Gregson,This letter will present the response from the Canadian Institute of Public Health Inspectors (Ontario

Branch) to the Part VIIIprogram review document "Moving Forward". We support the direction in which the Part VIIIprogram will move if these proposals are adopted. The document has identified the limitations of the current Act andRegulations and has a_ggested certain remedies. As pubfic health inspectors are "front line"personnel re,sponsible forprogram de#very, I believe our comments will be pertinent.

PROGRAM STREAMLINING to the issuance of every Use Permit may not bePerformanceBased Regulations: necessary.Differinggeography and inconsistent land

The performance-based approach will certainly division policies in each area of the provinceaddressexistingproblemsrelatingto the approvalprocess necessitatethe retentionof flexibilityfor the agenciesfor new technologies.It is inevitable,however,that some deliveringthe program.new technologieswill not perform to standardswhenactually in operation.Failureof an experimentalsystem Training and Certification - Delivery Agents:couldhave a permanentimpact upon publichealth and The majorityof delivery agentsare publichealththe environmentand therefore any suchinstallationwill inspectorsworkingwithin health units. We are notneed to be monitoredand criteriaby whichthe system certainwherethe impressionoriginatedthat there aremaybe deemeda successor failure mustaccompanythe no academic programs offering information onproposal.We believethat any proposalfor development sewage disposal. Public health inspectors havewhichusesunproventechnologyfor treatingwaste should graduated from either the environmental healthincludea reserveareato be used for a septictank system programoffered by the BritishColumbiaInstituteof(orotherreliablewaste disposalmethod) in the event of a Technologyor RyersonPolytechnicUniversity.Wastefailure. Unproven technology should not be used to water and sewage disposal systems constituteadevelopsiteswhichhave been deemedto be unsuitable significant portion of the educational program.for currentwaste disposalmethods. Graduationisthen followedby a specifiedperiodof

fieldtrainingwhichis required in orderto becomeaStandardized Approvals: certified public health inspector. In-service training

Standardized approvals, which would provide and refreshercoursesare a part of any profession,exemptionsfrom obtaininga Certificate of Approval for andthe Universityof Guelphand the OntarioBranchcertainactivities,has itsbenefits.The activitiessubjectto of CIPHI have co-sponsoreda well-attendedthreethe exemptionmustbe selectedon a basisof assessment day courseannuallyfor thispurposefor a numberofof riskto publichealth and the environment, years.

Use Permit: Licensed Installers:The requirementsforthe issuanceof a Use Permitas CIPHI strongly supports implementation of

the final stage of the approval process should not be mandatory training programs for haulers andremoved. However_the necessitvof a site insnectionprior installers. Health units have recognized the=_...

t_AGE 10 ONTARIO BRANCH NEWS- SPRING/SUMMER '97j

...needfor trainingand somehave providedworkshopsorseminars for contractors.It is possiblethat mandatorytraining will reduce the need for Use Permit siteinspectionsinsomeinstances.

REINSPECTION: "The benefits of a re-inspection program are

questionablewhentheresourcesrequiredto carryout theprogramare considered.A malfunctioningsystemusuallycreatesconditionsthatare unacceptableto theownerwiththe resultthat the systemis repairedvoluntarilybeforegovernmentalintercessionis necessary. The goal ofprotectionof groundwaterqualitymaybe accomplishedbyalternativemethodswhichwould proveto be morecosteffective. Well-come, to the newest members of the

Canadian Institute of Public Health InspectorsHAULEDSEWAGE/SEPTAGE: OntarioBranch.The following is a list of Ryerson

It is suggested that reinspection may include studentswho became members, as a result of anmandatory pumping and cleaningof septic tanks. Aregulation requiring periodic inspection of the tank informal meeting at Ryerson. Special thanks tc(ensuring that the baffles are intact and checkingthe _,nthony DiPietro, Ryerson Student Presidentlevelsof sludgeandfoam)mayaccomplishthesame thing ind his assistant Sam Yaacoub for making thewithoutcreatingmoreseptage. Itshouldbe notedthatthis event successful.regulationmay be difficultto enforce.

LAND USE PLANNINGISSUES: Jason AgiusIt is essential that the agency responsible for Andre Blasutig

approvingprivatesewagedisposalsystemshas an input Lisa Bourneintolanduseplanning.Proposalsfor developmentof sites Anthony DiPietronot servicedby municipalwater and sewage shouldbe Pamela Joi Georgeassessedwithrespectto privatesewagedisposalearly inthe reviewprocessto avoidfrustrationfor the applicants. George GiantsesProposalswhichareallowedto proceedwithno reference Peter Wayne Hillto sewage disposaland water supplywill resultin the Anne Manisa Jiaravuthisan

creationof lotswhichcannotbe developed. Barbara Cher yl KinneyREASONABLEUSE POLICY & SERVICING BY Stella Kyritsis

ON-SITE SEWAGESYSTEMS: Hillary Samantha PaziukThe risks posed by nitrate contamination of Michael TravisPhilipation

groundwaterare not dependentuponthe sourceof thepollutionandthereforethereshouldbe onlyonestandard Deborah Joanne Sanfordof allowablenitrateconcentration.This issue could be Dorianna Simone

addressedinthe regulatoryreviewprocess. Alan SolleyCarol Susan Sutherland :

David Tantalo

/n c/osing, / wou/d /ike to thank you for providing us Diana Roza Trokovawith the opportunity to contribute to this discussion Katharine Wieczorekand //ook forward to the resu/ting initiatives. /f you Michelle K. Wilsonhave any questionsregardingthis paper, p/easedo Sam Yaacoubnot hesitate to contact me.#

I

I ONTARIOBRANCHNEWS-SPRING/SUMMER'97PAGE11I

To: The Honourable David J. Johnson From: James Reffle,Minister,Ministryof Health President,CIPHI (OntarioBranch)10th Floor,HepburnBlock80 GrosvenorStreet, Toronto,Ontario M7A 2C4 Date: February3,1997

RE: PUBLIC HEALTH INSPECTORS: A RELIABLE COMMUNITY RESOURCE

Continued on Page 23 =_

Herpes often occurs on the genitals becauselovemakingcan break the skin to let the virus in.

Simple Precautions Sitting on a seat that has herpes virus on it withfor Pools and Hot Tubs broken skin on your legs or buttockscan cause a

recurrentherpesinfection.Hot tubs that have not been adequately

It is extremelyunlikelythat youwillget herpesor chlorinatedcan give you folliculitis,a conditionthatAIDS in a hot tub or swimmingpool,but youcan get causes severeitchingand red bumpson the skin. ItherPesfromsittingon the side of a poolor folliculitis, canbe curedwithantibiotics,butoften goesaway bya bacterialinfectionof yourskin, from a hot tub.The itself withouttreatment. If you use public hot tubs,herpes and AIDS virusesare killedalmostimmediately pools or whirlpools,sit on a towel on the side of thein chlorinated water. As far as we know, the AIDS tub or pool and shower immediately after you leavevirus can be acquired only from infected blood, semen the water. If you start to itch, check with your doctor.and .other body tissues, but the herpes virus can For a free copy of the Mirkin Report on the latestsurvive for up to 4.5 hours onplastic coated benches breakthroughsin medicine,fitness and nutrition, send aor seats. Even if you sat on the same spot that a stamped,self addressedenvelopeto The Mirkin Report,person with active herpetic blisters has just left, you 5618ShieldsDrive,Bethesda,MD 20817. Commentsorprobably wouldn't be infected.To acquire herpes, you questionsmaybedirectedto:gabe,mirkina.mail,wdn.com11need to allow the virus to pass through broken skin.

I PAGE12 ONTARIOBRANCHNEWS-SPRING/SUMMER'971

ONTARIO PLUMBING INSPECTORSASSOCIATION(OPIA)

The CIPHI representativeon OPIA (Bob ,Worsell)COMMUNITY AND CORPORATE has not been able to attend meetings since last fall.

LIAISON DIVISION REPORT Further,Mr. Worsell indicatedthat sincethe majorityof Health Departmentsdo not do specificplumbing

Submittedby: Peter Kastoris-Chair inspections, membership with OPIA should bediscontinued;and insteada regularcorrespondencecouldbe maintained.

CONSERVATION COUNCIL OF ONTARIO (CCO)

STUDENTMEMBERSHIP The current CIPHI representatives for CCO areManuel de Freitas, and I, met with Anthony Richard Boehnke and Marguerite Wong. However,

Dipietro (President-EnvironmentalHealth Student neither of them were able to attend the first CCOExecutive) at Ryerson on January 20, 1997. The meetingof 1997 becauseof insufficientnotification.purpose of this meeting was to promote student Furthermore,provincialgrantshave beencut,andasmembershipandinvolvementwithCIPHI. On February a result,therehas beena shiftfrommonthlymeetings21, 1997, James Reffle, Manuel de Freitas and to quarterlymeetings.Lackof fundinghasalsoleadtomyself,willbe attendinga CIPHI informationsession inadequate staffing. Consequently,communicationat Ryerson.Thiseventwillbe hostedbythe Student betweenmembershas deterioratedand strategizingExecutive,andwillgivethestudentsan opportunityto has becomevery difficult.have theirquestions/ concernsaddressed. Given the existingstate of CCO, Mr. Boehnke

feelsthatit mayno longer beworthwhileforCIPHI toRYERSONACADEMIC ADVISORYCOMMITTEE support it. Therefore, he will discussthe issuewith(RAAC) Ms. Wong and let CIPHI know their final

The last meeting was held in October 1996. recommendation.l=Accordingto Henry Chong-theCIPHI representative

on RAAC-the major topic of discussion was the F,,Gebudget review. This did not leave much time for rms" You can SEEanything else to be addressed.

Nevertheless, the committee did discuss the G L O--G E R IVipossibility of adding a course to the curriculum toassiststudentsin obtainingfield training.The course Since 1968 the GIo-Germwouldbe optional,and thosestudentsthat wouldtake Companyhas providedteachingit, would be placed by the School of Environmental h°spi_Js'f°°dha_dlingfacilides

clinics, schools (including publicHealth in a Health Department. Ryersons' insurance school systems)and inslilutionswould coverthe liability,but the placementswouldbe with this unique product.unpaid. The proven safe inert ingredien_ L,,, _

Another matter that was brought forth at the in the GIo-Germ lotionmeeting was that enrolment in the Environmental or powder cast a revealing glow

when exposed to standard UVHealthProgramis down. In responseto thisproblem, light. Used in a teachingor ,the School of EnvironmentalHealth is promotingthe trainingsession,the glow ,'program in High Schools. graphically shows a student or '

staff member when improper cleaning or htmdwa.shing has takenREGULATED HEALTH PROFESSIONS ACT-PHI place. GIo - Germ is also great for the demonstration ofDESIGNATION contamination/transmission.

The file regarding this matter is currently being Serving the Canadian health care industry since 197(reviewed.As well, the individualsthat were involvedinthe previous attempts to obtain PHI designationare F a E E 1 0- DAY ma i A Lbeing contacted for input and direction. The w, will _nd you, completekit for 10day, with noco_tor o_lig.don.informationretrievedfrom these two taskswill serve - P_,,€,_,€o,c,_t:as the basisfor decidingifanotherattemptto become

designated under the Act shouldbe made. !o Germ CompanyP.O. Be× 537, Moab, Utah 84532

1-800-634-0770 or FAX (801_259-5930.,i

L ters to E tors...

Mr.Thorntonmakes the pointthattreatmentprograms Congratulationson an excellent December issue.get the major fundingand prevention,such as the Talk about jam packed with goodies...Lots ofmajority.ofourfieldis, getsthe leftovers.There isjust comment,picturesandthe personneldirectory.not as;much glory in prevention as there is in I especially enjoyed the two articles by Petertreatment. Just look at the current rage in TV Thornton. The first, '_on't be too comfortablewithprogramming,ER, etc. your monopoly". With the steady erosion of our

He;_furthermakes the point...weshouldnot be powers...Iremember,sometimesfondlywhen I haddoing _ings, just becausethe code says so. If we RIGHT OF TRESPASS, and had occasionto use it.can't convinceothersof the utilityof ourprogram,we Perhapstoday is better for as the saying goes..."Ashould;.:notdo it, or in hiswords,find a way notto do MAN (not politicallycorrect today, but surely weit. understandthe idea) CONVINCED AGAINST HIS

The onlyfailingof hisarticleisthat he is underthe WILL, IS OF THE SAME OPINION STILL." Mr.impressionPublicHealthstarted out as an aspectof Thorntonmakesthe pointthat we musthave industrycontrollingdisease.Letusnotforget,thepublichealth involvement,, or they will not buy into itslaws were initiallySOCIAL measures,designed to implementation,he leaves unsaid, our continuingimprovethe livingconditionsof citydwellers.It was inabilityto nowadaysforce compliance.only after these exceedinglytrivial measures were The secondarticle,"Makingenvironmentalhealthimplemented, that a most astounding thing indispensable",explained something that had mehappened...theoveralldeathrate plummetedbymore confusedfor a long time. Because of our shrinkingthan half. When this phenomenonwas investigated, landbase (farms are being pavedover),the Ministryitwasthenthat PublicHealtharose.We wantedmore of Agricultureislookingfora newbaseto ensuretheirof thisgoodthing,but remembertoo muchof a good continuedpower. I had never consideredthis as tothingisjustas bad.Concernis nowbeingexpressed whytheywere becominginterestedincontrollingfoodthat our immune systems, already stressed by from field to (restaurant)table. In my opinion,this isenvironmentalpollution,are becomingnaivefrom lack kind of like havingthe fox guard the chickencoop.of exposureto accustomedgerm loads.Beforeyou Their argumentseemsto have logicon itsside, theyscream,rememberthat hospitalsare creatingsome oversee productionof food and therefore are bestextraordinarilyvirulent strains of previouslybenign suitedto overseeitsproperservice.Let usnotforgetorganisms. One of the reasons is that because of they also are overseeingthe productionof tobacco,sanitizing, there is a lack of competition for the_ THE definite major health haz.z.ard, facingrequirementsof life (food, moisture, air, space, esp to Ontarionians. Ruth Gordon is credited with saying:rid oneself of wastes, etc). This lack of competition

allows free reign to survivors, and it is only the tough "IT DOES NO GOOD TO FACE FACTSthat survive and therefore we have a race of FACTS NEVER CHANGED ANYONE'S MIND."supergerm. Let us not create the same conditions inrestaurant kitchens.

As regards your editorial...Iwish you luck. It is twoyears now since you very kindly printed my letteri!_equestinginspectorsto share at least one of.their'experiencesworthsharing"as youso properlyputit.

iTo date, I have not had even one reply. I wish youluck, and I bidyoua fond good-byeand keep up thegoodwork. It is appreciated.

...yo s[ PAGE 14 ONTARIO BRANCH NEWS- SPRING/SUMMER '971 Ro IB. Harri2t°n

FOOD DIVISION REPORTSubmitted by: Toni D'Ettorre, Food Division

Currently, we are which examines the Constituent Societyreviewing the Food effectiveness of our Meetings

As youare allaware Handler Training current food safetymany changes have Protocolandsuggesting practices.The review is _1_2ConstituentSocietytranspiredsinceour last necessary changes to intended to provokemeeting and to date enhance the efficiency thoughtful discussion Meetingsperyear (Junemore changesare forth- and effectivenessof our andaction, andNovember}.coming. The funding current food safetyshift fromthe provinceto practices. Our latest OPHA Mandatory "_l_Presidentof OPHAthe municipality have an meeting was held Program Review and the Executiveimpact on all our pro- Friday, February 21, Director are open to

grams and in particular 1997. The protocol has The review is very im- meetings throughoutthethe Food Safety Pro- been reviewed and portant because it will year.gram. With a shift in divided intocomponents, form the basis for:funding, the concept of Each component has a) provincial standards, "_Canadian Publican Integrated Delivery been allotted a percent- b) population health Health AssociationSystem (IDS), the union age with respect to the mandate, (CPHA).of Social and Commun- importance in the c) base funding fority Health Services is reduction of foodborne Social Service and "_National survey ofcrucial, illness (e.g. time for health transition, public health infra-

/temperature 60%). The Review of Mandatory structure is underway.Food Safety percentage will be Core Programs is

Certification Task indicative of the amount currentlyunderway. The "_I_OPHA Members-at-Force of time that should be process is becoming

utilized on this topic quite expeditious be- Large are formingThe last meeting of during your training cause of the many linkage with CPHA

theTask Forcewas held session (e.g. if your changes taking place, throughvarious commit-in October, 1996, at trainingsessionis 3 hrs., An emergency board tees, of which twowhich time the goals, then 60% of thatshould Meeting of OPHA is directly involve healthobjectives,and termsof be time / temperature), scheduledfor March 17, inspectors:reference were deter- The Task force is 1997, to respond to Barbara Marshallmined. This information also in the process of Integrated Delivery Human and Ecosystemalong with the minutes outlining objectives for System(IDS). Health.was distributedatall the each of the components IDS premise is the Winston Miller -Health Units. At this and in turn reviewinga Ministry'sBusinessPlan InternationalHealth.l=time, another request variety of exam quest- - one principleincludedwas madeforrepresent- ionsandrelatingthem to preventionand promo-ation on the task force each of the objectives, tion. The need to moni-either via corres- tor developments inpondenceor attendance Southwest Regional Socialand Communityisat the meetings. As a Food Safety crucial. Public healthresult we have new Committee workers will be moremembers at the table. I accountable and theream very grateful for this The committee has will be a need to bepositive response provided me with a copy more concrete andespecially during these of A Review of Ontario's relevant to local context.times of continuing Food Safety Programchanges.

[ ONTARIO BRANCH NEWS- SPRING/SUMMER'97 PAGE 151

CIPHI Statement of Mission

To advance, promote, and upholdthe profession of public health inspection

&to ensure the attainment of the highest

professional standards of practice for its members,& in so doing,

to facilitate the achievement of optimal healthfor all persons who Hve, work or visit in Ontario

by promoting excellence in environmental managementthrough education, advocacy and research.

Over the years the OntarioBranch of CIPHI has gained recognitionamong the profession for its worksuch as - the Annual Conference, the Ontario Branch News, Info Sharing Day, Workshops inCommunicable Disease and Environmental Health, and others. However, as budgets, priorities andpolitical climate evolve it becomes more critical than ever to evaluate past projects and to set a coursefor the future.

Taking a few minutes to complete the attached questionnaire will help us chart new directions andfocus resources in a way that reflects the will of the membership and promotes the profession.

FAXor mail your completedquestionnairesto;Bob Hart, Waterloo Regional Health Unit, P.O. Box1633, 99 Regina Street, Waterloo, ON N.J. 4V3. FAX: 519-883-2241. Opinions of members and non-members of the Institute are important in this survey.

_yo_.S__eS_w, C_r - Pr_'_ctsD_i_on

CIPHI QUESTIONNAIRE

Please answer every question as thoroughly as possible.

1. What is your present position? (please check one) b) Were you ever a member?

O Director O Supervisor O Senior O YES O NOO Staff PHI

O Other (specify: ) if YES please list the years you were amember?

2. Are you presently a member of the CanadianInstitute of Public Health Inspectors?

O YES O NO

a) If no, please tell us yourreason(s). 3. a) Do you feel the existing institute

membership fee is (circle one only)

i) just right ii)too high iii) too low

b) Do you feel fee payment schedules should be 7. How do you think the Institute couldchanged? (circle one only) increase their membership?

i) keep the same

ii) abilityto pay at anytime throughout the year

iii) other (specify: )

c) Do you feel the fee payment options should bemore flexible? (Circle as many as you feelappropriate)

i) spousal ratesii) method of payment

(ie: monthly, bi-monthly,etc.) PROFESSIONALDEVELOPMENTiii) longterm.membershipdiscounts

(ie:10, 25 and50 years) Overthe pastfew years,variousprojectsandiv)other(specify: events have been provided to Institute

membersand non-membersbythe assortedCIPHI committees.

Please ratethe listeditems belowwere;1 = veryuseful

5. Doyouagreethatall certifiedinspectorsshouldbe 2 = usefulrequiredto be a memberof the Institute? 3 = notso useful

4 = havenotattendedO YES O NO 5 = do notreceive*

6. Does your employer give preference to CIPHImembers for attending institute conferences and PRO3ECT/EVENTEATING COENTSworkshops? (CIRCLEONLYONE)

OntarioBranch 1 2 3 4 5O YES O NO Conference

If NO,do youfeel membersshouldget preference?

O YES O NO Communicable 1 2 3 4 5DiseaseDay

Please give a brief explanation for your response:

Information 1 2 3 4 5SharingDay

OntarioBranch 1 2 3 4 5News*

ONTARIOBRANCHNEWS- SPRING/SUMMER'97 PAGE17

8. What would you like to see the Institute do for you?Should you wish to find out more about theInstitute Committees, please complete thefollowing:

O YES , I am interested in receiving moreinformation on the following committees;

O foodO communicable diseaseO health promotional projectsO waterO healthy environments

Additional Information RequestsO copy of survey results

9. What do you feel the OVERALL focus of the Institute O other (specify: )should be?

NAME:

MailinI Address:

Phonei ( )

10. List 2 areas you feel the Institute should focus their Fax: ( )RESEARCH on: 1_1Plt_asecheck this box if you are willing to be

conrtacted in the future to respond toad_litional questions or to participate inam)ther survey.

FAX OR MAILyour completed questionnaires to;

Bob HartWaterloo Regional Health Unit

P.O. Box t 63399 Regina Street South

Thank you for taking time to complete this Waterloo, ON N2J 4V3questionnaire. A summaryof all responseswillbe printedin the Ontario BranchNews and used by CIPHI InstituteCommitteesto better serveyou. or Fax: 519-883-22411D

f PAGE18 ONTARIOBRANCHNEWS- SPRING/SUMMER'97]

PREVENTING FOODBORNE ILLNESS:Escherichia coli 0157:H7

Escherichiacoil 0157:H7 is an emerging cause of handwashing habits are inadequate. This isfoodborne illness. An estimated 10,000 to 20,000 particularly likely among toddlers who are not toiletcases of infection occur in the United States each trained. Family members and playmates of theseyear. Infection often leads to bloody diarrhea, and children are at high risk of becoming infected.occasionally to kidney failure. Most illness has been Young children typicallyshed the organism in theirassociated with eating undercooked, contaminated feces for a week or two after their illness resolves.ground beef. Person-to-personcontact in families and Older children rarely carry the organism withoutchild care centres is also an important mode of symptoms.transmission. Infection can also occur after drinking What illness does E. coil 0157:H7 cause?raw milk & after swimming in or drinking E. coil 0157:H7 infection often causes severesewage-contaminated water, bloody diarrhea and abdominal cramps; sometimes

Consumers can prevent E. coil 0157:H7 infection the infection causes nonbloody diarrhea or noby thoroughly cooking ground beef, avoiding symptoms. Usuallylittleor no fever is present, and theunpasteurized milk, and washing hands carefully, illness resolves in 5 to 10 days.Becausethe organismlivesin the intestines of healthy In some persons, particularly children under 5cattle, preventivemeasureson cattlefarms and during years of age and the elderly, the infection can alsomeat processing are being investigated, cause a complication called hemolytic uremic

What is Escherichia coil 0157:H72 syndrome, in which the red blood cells are destroyedE. coil 0157:H7 is one of hundredsof strains of the and the kidneys fail. About 2%-7% of infections lead

bacteriumEscherichia coll. Although most strains are to this complication. In the United States, hemolyticharmlessand live in the intestines of healthy humans uremic syndrome is the principal cause of acute& animals,this strainproduces a powerful toxin & can kidneyfailure inchildren,and most cases of hemolyticcause severe illness, uremic syndrome are caused by E. coil 0157:H7.

E. coil 0157:H7was first recognized as a cause of How is E. coil 0157:H7 infection diagnosed?illness in 1982 during an outbreak of severe bloody Infection with E. coil 0157:H7 is diagnosed bydiarrhea; the outbreak was traced to contaminated detectingthe bacteriumin the stool. Most laboratories

i" hamburgers. Since then, most infections have come that culture stool do not test for E. coil 0157:H7, so itfrom eating undercooked ground beef. is important to request that the stool specimen beThe combination of letters and numbers in the tested on sorbitoI-MacConkey (SMAC) agar for this

name of the bacterium refers to the specific markers organism. All persons who suddenly have diarrheafound on its surface and distinguishes it from other with blood should get their stool tested for E. coil

t types of E. coll. 0157:H7., How is E. coil 0157:H7 spread? How is the illness treated?The organismcan be foundon a smallnumberof Most personsrecoverwithoutantibioticsor other

cattle farms and can live in the intestines of healthy specifictreatment in 5-10 days. There is no evidencecattle. Meat can become contaminated during that antibiotics improve the course of disease, and itslaughter, and organisms can be thoroughly mixed is thought that treatment with some antibiotics mayinto beef when it is ground. Bacteria present on the precipitatekidneycomplications.Antidiarrheal agents,cow's udders or on equipment may get into raw milk. such as Ioperamide (Imodium), should also be

Eating meat, especially ground beef, that has not avoided.been cooked sufficiently to kill E. coil 0157:H7 can Hemolytic uremic syndrome is a life-threateningcause infection.Contaminated meat looks and smells condition usually treated in an intensive care unit.normal. Although the number of organisms required Blood transfusions and kidney dialysis are oftento cause disease is not known, it is suspected to be required. With intensive care, the death rate forvery small, hemolytic uremic syndrome is 3-5%.

Drinking unpasteurized milk and swimming in ordrinking sewage-contaminated water can also cause =_...infection.

Bacteriain diarrhealstoolsof infected personscanbe passed from one person to another if hygiene or

:- -. _.° k?,,-•

r "

C][]P]H[][ -

COMM1U[NI[CAIB',]LIE,]D]ISIBA\S]E-...What are the long-term consequences ofinfection? (C(O)_,_[_,vJ[][_]FTF'EE

Persons who only have diarrhea usually recover ,. ._completely.

About one-thirdof personswith hemolyticuremic O ]P ][:_]E S ]E'_"]FS:"syndrome have abnormal kidney function many yearslater, and a few require long-term dialysis. Another

8% of persons with hemolytic uremic syndrome haveother lifelong complications, such as high bloodpressure, seizures, blindness, paralysis, and theeffects of having part of their bowel removed.

What can be done to prevent the infection? - -E. coil 0157:H7 will continue to be an important

public health concern as long as it contaminates meat.Preventive measures may reduce the number of cattlethat carry it and the contamination of meat duringslaughter and grinding. Research into such preventionmeasures is just beginning.

What can you do to prevent E. coli 0157:H7infection?

Cook all ground beef or hamburger thoroughly.Make sure that the cookedmeat is gray or brownthroughout(not pink), any juices run clear, and theinsideis hot.

If youareserved an undercookedhamburgerinarestaurant,senditbackfor further cooking.Consumeonlypasteurizedmilkandmilkproducts.Avoidraw milk.Make sure that infected persons, especially

children,wash their handscarefullyand frequently _FlL][e_(dl(a[_v_), ,![lu[]n[(e][(o)lL]ht,][9)9)7/with soap to reduce the risk of spreading theinfection.Drink municipal water that has been treated with arc

adequate levels of chlorine or other effective .-. ]H[eal[dhdisinfectants.l=

Lalb)(o)Jralt(o)%vFurther information on E. coil 0157:H7 is availableJoin us for a superb day of learning.

from the Division of Bacterial & Mycotic Diseases Many of the most talked about topics areNational Centre for Infectious Diseases Centers for presented by the most renowned speakersDisease Control and Prevention, 1600 Clifton Road including Dr. Allison McGeer on MRSA andMailstop C09 Atlanta, Georgia 30333. VRE. There is still lots to leam on this one!

Also presenting are Dr. Joan Heathcote, arenowned heptologist from the Toronto Hospitalon Hepatitis C, and the Hepatitis BElectroencephalogram Outbreak will bepresented by Dr. lan Johnson,Associate Medical Officer of Health,North York Department.

The recent outbreak of E.coli traced to a churchsupper will be discussed, as well as everythingknown about Strept iniae and more..

PAGE 20 ONTARIO BRANCH NEWS - SPRING/SUMMER '97 Watch for flyer and registrationen route to your health unit!!!

WATER& SANITATION

Everyeight seconds a reaching the unserved has been poor since essential.child dies of a 1990. Approximately one billion people A second element in the

around the world still lack safe water and water and sanitationwater-related disease.

more than two billion do not have adequate development process is theEvery year more excreta disposal facilities. Rapid population use and care of water andthan five million growth and lagging rates of coverage sanitation facilities. Peoplehuman beings die expansion has left more people without must use these facilitiesfrom illnesses linked to access to basic sanitation today than in properly to obtain the healthunsafe drinking water, 1990. benefits inherent in them.unclean domestic envi- Another problem with coverage goals is This means knowing how toronments and improper the magnitude of resources needed to protect and store waterexcreta disposal, achieve them. At the Global Consultation of safely, how to maintain

Safe Water and Sanitation for the 1990s, personal and domesticAt any given time held in New Delhi in 1990, itwas stated that cleanliness, how to care for

perhaps one-half of all universal coverage by the year 2000 would excretadisposalfacilities andpeoples in the developing require US$ 50 billion per year, a five-fold how to avoid or minimizeworld are suffering from one increase in current investment levels, unsanitary environmentalor more of the six main In 1992, WHO concluded its monitoring conditions. Knowledgediseases associated with of the Decade with the estimate that a total transfer, behaviour changewater supply and sanitation of US$ 133.9 billion had been invested in and personal responsibility(diarrhoea, ascaris, water supplyand sanitationduring the pedod are the key factors. :dracunculiasis, hookworm, 1981-1990, of which 55% was spent on The third of theschistosomiasis and water and 45% on sanitation. Urban areas interactive elements is thetrachoma). In addition, the received 74% of the total and rural areas institutional support from thehealth burden includes the only 26%. Contrary to widespread communities, developingannual expenditure of over perceptions, almost two-thirds of all funds agencies and governmentten million person-years of were provided by national sources and only policies that provide atime and effort by women a third by external organizations, framework for water andand female children carrying WHO estimates that it costs an average sanitation improvements.water from distant, often of US$ 105 per person to provide water Experience has shown thatpolluted sources, supplies in urban areas and US$ 50 in rural community-based efforts,

Nearly a quarter of areas, while sanitation costs an average Of whether in a small village orhumanity still remains today US$145 in urban areas and US$ 30 in rural a large metropolis, are mostwithout proper access to areas, effective in identifying andwater and sanitation. Water supply and sanitation can be meeting peoples' needs.

During the International viewed as a process having three interactive Governments, especially atDrinking Water Supply and elements. The most fundamental of these the regional and nationalSanitation Decade elements is the availability of safe drinking levels, are more effective as(1981-1990), some 1600 water and sanitary means of excreta facilitators of themillion people were served disposal. Safe water implies protection of development process thanwith safe water and about water sources as well as proper transport providers of water and750 million with adequate and storage within the home. It also means sanitation improvements.

: excreta disposal facilities, facilities for bathing and forwashing clothes Water contaminated byHowever, because of and kitchen utensils which are clean and human,chemicalor industrialpopulation growth of 800 well-drained.Sanitary excreta disposal is the wastes can cause a varietymillion people in developing isolation and control of faeces from both of communicable diseasescountries, by 1990 there adults and children so that they do not come through ingestion or physicalremained a total of 1015 into contact with water sources, food or contact:_ ....million people without safe people. To break the transmission chain ofwater and 1764 million faecally-relateddiseases, good standards ofwithout adequate sanitation, personaland domestic hygiene, which begin

Overall progress in with handwashing after defecation, are

Water & Sanitation- continued.. ESTIMATESOFMORBIDITY&9 Water-borne diseases; MORTALITYOF WATER-RELATED

caused by the ingestion 1997of water contaminated by DISEASEShuman or animal faeces COMMUNICABLEor urine containing Disease MorbidityMortality Relationship DISEASE

pathogenic bacteria or of Disease (episodes/year, (deaths/year) to COMMI'['I_Eviruses; include cholera, Water Supply and Sanitation or as stated).typhoid, amoebic and Diarrhoeal 1,000,000,000 3,300,000bacillary dysentery and Strongly related to unsanitary excreta Bey Middleton, Chairot he r diarrhoeal diseases disposal, poor personal and Bruce-Grey Own Sounddiseases, domestic hygiene, unsafe drinking water. Health Unit

41 Water-washed diseases: Infection with 1,500,000,000 (1) 100,000caused by poor personal Strongly related to unsanitary excreta Cathy Eganhygiene and skin or eye intestinal disposal, poor personal and Waterloo Regionalcontact with contamin- domestic helminths hygiene.ate water; include Schistoso- 200,000,000 (1) 200,000scabies, trachoma and Strongly related to unsanitary excreta miasis Jane Shimizuflea, lice and tick-borne disposal and absence of nearby sources of City of Yorkdiseases, safe water.

Dracunculiasis100,000 (1) (2) Strongly Barbara Slattery9 Water-based diseases:relatedto unsafedrinkingwater.

caused by parasites York RegionTrachoma 150,000,000 (3) Stronglyfound in intermediate relatedto lack of face washing,oftenduetoorganismslivinginwater; absenceof nearbysourcesof safe water. Lucie Imbiscusoinclude dracunculiasis, Malaria 400,000,000 1,500,000 Related WellingtonDufferinGuelphschistosomiasis and to poorwater management,water storage,otherhelminths, operationof water pointsanddrainage. Susan MorrisonWater-related diseases: DengueFever 1,750,000 20,000 Related

LambtonCountycausedby insectvectors to poor solid wastes management, waterwhich breed in water; storage, operation of water points andincludedengue,filariasis, drainage. Tom Natalemalaria, onchocerciasis, Poliomyelitis 114,000 Related to & Debra Owenstrypanosomiasis and unsanitary excreta disposal,poor personal Cityof Torontoyellowfever, anddomestichygiene,unsafedrinkingwaterNo single type of Trypanosomiasis275,000 130,000 Related Rick Pascoe

intervention has greater to the absence of nearby sources of safeoverall impact upon the water. MuskokaParry Soundnational development and Bancroftian 72,800,000 (1) Related topublic health than does the poor water management, water filariasis Sean Ryanprovision of safe drinking storage, operation of water points and Middlesex-Londonwater and the proper drainage.

disposal of human excreta. Oncho-17,700,000 (1) (4)540,000 Jerry ZalewskiThe directeffects of improv- (5)Related to poor water management ined water and sanitation cerciasislarge-scaleprojects. Kingstonservices upon health are (1) Peoplecurrentlyinfected.mostclearly seen in the case (2) ExcludingSudan. Eric Matthewsof water-related diseases, (3) Case of the active disease.Approximately Hamilton-Wentworthwhich arise from the ingest- 5,900,000 cases of blindness or severeion of pathogens in complicationsof Trachomaoccurannually.(4) /nc/udesan estimated270, 000blind. Nadine Rypalowski /contaminatedwater or food (5) Mortalitycausedby blindness. Diane Pustinaand from insects or other Forfurtherinformation,pleasecontact,Healthvectors associated with Communicationsand Public Relations, WHO, Porcupinewater. Improvedwater and Geneva.Telephone(4122)7912584.Fax(4122)sanitation can reduce mot- 7914858.D Craig Lawriebidity and mortalityrates of Leeds,Grenvillel=some of the mostseriousofthese diseasesby 20- 80%.

PublicHealthInspectors:AReliableCommunityResourcePublic Health Inspectors (PHIs) are responsiblefor a mustmeettheacademicrequirementsof theBoardof Certification

comprehensiveenvironmentalhealthprogramin thecommunity, of the CanadianInstituteof Public Health Inspectors(CIPHI),Usinga varietyof professionaland technicalskillsPHIspromote completea threemonthpracticumin a healthunitldepartment,andindividualand communitywellnessthrough health protection passbotha writtenandoralexamset bythe Boardof Certification.activitiesandenforcementof provinciallegislationandmunicipal ABachelorofAppliedScience(EnvironmentalHealth)degreefromby-laws. Ryerson PolytechnicUniversityin Toronto or a Diploma in

Aspartof a multi-disciplinaryteamof professionals,PHIswork EnvironmentalHealthfromBritishColumbiaInstituteof Technologyto reducethe incidenceof communicablediseaseand health in Burnaby,B.C.are currentlyavailableandhavebeenaccreditedhazards,performtechnicalassessments,provideconsultativeand by the Boardof Certification,CIPHI.PublicHealthInspectorsmusteducationalservices,and ensurethat communitydevelopment becerl_edtopracticeinCanada.encouragesa healthy environment.PHIs identifyhazards inresidential,recreational,commercial,socialand industrialpremises MajorResponsibilitiesof aPublicHealthInspector:andprovideinformationandtrainingoncontemporaryalternatives A. FoodSafetyandtechniques.PHIsrespondto currentenvironmentalproblems I) Assignsa minimuminspectionfrequencyfor everypremiseandconcerns,investigatecomplaints,inspectpremises,assessand wherefoodis stored,manufactured,prepared,transportedorapproveplansto ensurecompliancewithpertinentlegislation, served.AppliesMinistryof Healthprotocolin accordancewith

PHIsareinvestigatorsandeducatorswhoseprimarygoalsare HazardAnalysisCriticalControlPoints(HACCP)principlestothe preventionof illnessandmaintaininga healthyenvironment, assessandclassifycommercialandinstitutionalfood premises

PHIswork in the publicdomaineveryday and promotea to determineriskstatus.

healthyperspectiveonlocalissues.It is this positionthatprovides 2) Inspectsand monitorsfood premisesto reducethe risk ofa valuablelinkbetweenthe publicandgovernment,guidingand foodborneillness.

enforcingmeasuresthat protectand improveour environmental 3) Evaluatesplansandspecificationsfor newandrenovatedfoodhealth.PHIsoftenaddressmeetingsandspecialgroupssuchas premisesto ensurecompliancewithpertinentlegislationandfoodhandlers,recreationalstaff, church, local communityand standards.

institutionalgroups,and municipalcouncils.Lecturesare also 4) Developsa foodsafetyawarenessprogramfor food serviceprovidedat schools,communitycolleges,andat the universitylevel, personnelandthe generalcommunityincludingreligiousand

culturalgroups.Certification(Education)Requirements 5) Participatesin the communicationand verificationof food

Tobecomecertifiedas a PublicHealthInspectora candidate recalls.

I ONTARI0 BRANCH NEWS - SPRING/SUMMER'97 PAGE 2_

6) Investigatesallreportedcasesoffoodpoisoningto confirm 5) Monitorsqualityof municipalwatersuppliesto confirmthatandeliminatethesource, currentstandardsaremet,in liaisonwithothergovernment

agenciesandoperators.B. CommunicableDiseaseControl 6) ProvidesthepublicwithhealthinformationrelatedtodrinkingI ) Completescasemanagementandfollow-upinvestigationsof water.

bacterial,viral,andparasiticinfedionsreportedtotheMedicalOfficerofHealthto determinesourceofinfection,contadsand RecreationalWatercarriersofdisease.Providesconsultationonpreventionand I ) Inspedspublicfacilitiessuchasbathingbeaches,swimmingcontrolofdiseases, pools,waveactionpools,waterslides,spaslwhirlpools,and

2) Collectsappropriateepidemiologicalinformationregarding wadingpoolsaccordingto Ministryof Healthprotocolandcommunicablediseaseswithinthe communityusingthe regulations.Ministryof HealthRDIS(ReportableDiseaseInformation 2) Monitorsqualityofrecreationalwaterbyregularsampling.System)program.RDISisa computerizedprogramwhichall 3) Provideseducationalprogramsandmaterialsaboutwaterhealthunitsutilizetoreportdiseaseincidentsto theMinistry qualityandsafety.ofHealth. 4) Respondstowater-relatedcomplaintsusinga riskassessment

approachandoffersadviceonreducinganypotentialhealth

C. CommunicableDiseaseOutbreakManagement hazard.I) Provides24-houron-callresponseincasesofcommunicable

diseaseoutbreakstodeterminethesourceandtorecommend F. On-SiteSewageDisposaland LandControlspecificcontrolmeasures. I) Experienceandacademictrainingfor the enforcementand

2) Liaiseswithinfedioncontrolcommitteesforhospitals,nursing implementationof PARTVIII(OntarioRegulation358190)ofhomes,homesfor the aged,centresfor developmentally theOntarioEnvironmentalProtectionAct.handicapped,and child care residencesand provides 2) Interpretsengineer'ssoil and hydrogeologicalreportstoconsultationon the developmentof infectioncontrol assessthecompatibilityofanon-sitesewagedisposalsystemproceduresandoutbreakcontingencyplans, installationfortheproposedlocation.

3) Providesin-serviceeducationfor institutionalstaffregarding• 3) Providesassessmentandapprovalsofon-sitesewagesystemscommunicablediseasesincludingpreventionandcontrol, forprivate,commercial,andindustrialapplications.

4) Assesseslandseveranceapplications,zoningamendmentsandD. RabiesControl subdivisionapplicationswhichareintendedto beservicedbyI ) Investigatespotentialhumanexposurestorabiesfromanimal privateon-sitesewagedisposalsystemsandprivatewater

contacts, supplies.

2) Ensuresrequiredisolationandconfinementofanimalsthatare 5) Inspectson-sitesewagesystemsduringconstructionanduponriskassessedaccordingtoMinistryofHealthprotocolinliaison completion.withAgricultureandAgri-FoodCanadastaff. 6) Offersadviceor issuesan "Order",whennecessaryon

3) Visuallyinspectsisolatedanimalsimmediatelypriorto release, correctiveactionfor failedsystems.4) Enforcesmandatoryanti-rabiesimmunizationregulation. 7) Developsinformationsessionsforcontractors,consultantsand5) DevelopsanddeliverspublicawarenessprogramsonRabies. thepublicsector.6) Maintains& implementslocalRaccoonRabiesContingency 8) Conductsenvironmentalsanitarysurveysto identifysewage

Plan. pollutionsources.9) Assessesthesuitabilityof landforthespreadinganddisposal

E.WaterQuality ofseptictankcontents.DrinkingWater I0) ParticipatesintheEnvironmentalAssessmentplanningprocess.I) Monitorsdrinkingwaterqualitybysamplingandinspecting

watersupplies(privatewellsand communalsupplies). G.HealthyEnvironments2) Monitorsthequalityof drinkingwaterofallfoodpremiseson I ) Respondstocomplaintsofquestionableindoorairqualityand

non-municipalsupplies, unsanitaryorunsafeconditionswhichcouldhaveanimpacton3) Interpretslaboratoryanalysisreportsandprovidesinformation the healthof the occupantsin tenantor owner-occupied

regardingpotentialhealtheffectsofcontaminatedwaterand dwellings.adviceoncorrectivemeasures. 2) Recommendscorrectiveactionand,whereapplicable,issues

4) Providesindustryandthe publicwithinformationon water Orderunderthe HealthProtectionand PromotionActtotreatmentandalternativewatertreatmentmethods, eliminateorpreventa healthhazard.

PAGE 24 ONTARIO BRANCH NEWS - SPRING/SUMMER '97]

3) Placardsdwellingsdeemed"UnfitforHumanHabitation". ProtedionAd andtheTobaccoControlAct.4) Enforceslocalby,lawsrelatedto ResidentialHeating,Property 2) Performsa definedrole in the eventof anypublichealth

StandardsandSmokingControl,whereapplicable, emergencyordisaster.5) Respondsandprovidesadviceonoccupationalhealth&safety 3) Utilizesinvestigativetechniquesandthejudicialprocess.

inquiries,and complaintsregardinghealthconcernsin 4) Layscharges,preparescrownbriefs,assistslegalcounselandcommercialandindustrialsettings, testifiesincourt.

6) Assessesthe type of monitoringor testingrequiredto 5) Respondsto andredifiesconditionsinthecommunitythatmaydeterminethesourceof theproblem, behealthhazards.

7) Recommendscorrectiveaction and refers problemsto 6) Providesinformationtothecommunityonenvironmentalissuesappropriateagencyforfollow-up, andwhennecessaryrefers inquiriesto otherministriesor

8) Performsairsamplingltestingfornoxiousgases,(inarenas, agenciesthatprovidethe requestedservice,informationordrycleaningestablishmentsandotherpublicbuildings), expertise.

9) Assessesandprovidesadviceonhealthhazardsinconnectionwith:chemicals,toxins,wastedisposal,pesticides,rodenticides SkillsAndKnowledgeapplication,indoorairquality,foodsafety,pests,waterborne I) PublicHealthInspedorspossessthe followingskillsandpollutantsandsoilcontai!!nationandthechangingprofileof knowledge: Thoroughknowledgeof all legislationandnon-communicablediseases, standardsastheyrelateto environmentallpublichealth.

I0) EnforcestheTobaccoControlActto ensuretheavailabilityof 2) Goodinvestigativeandobservationalskills.smoke-freeenvironments,andpreventthe saleof tobacco 3) Knowledgeofthejudicialprocess.productsto under-agedteensandchildren. 4) Decisionmakingskillsto act independentlyand to take

11) Assessessanitaryconditionsat variousprivateand public appropriateactionin relationto potentialor existinghealthi premisesto ensureregulatedstandardsare met and hazards.i recommendsissuanceof licensesand permitswhere 5) Researchandepidemiologicalskillsto assessproblemsto

applicable,i.e.Grouphomes,daycarecentres,nurseries, determinethecauseandtheappropriatecourseof action.privatehomedaycare,etc. 6) Knowledgeofinfedioncontroltechniquesininstitutionsand

12)Supervisesgravedisinterments, otherhealthcarefacilities.13) Inspedsfuneralhomes(includingembalmingandpreparation 7) Goodoralandwrittencommunicationskills.

room)andenforcesthe pertinentsectionsof the Funeral 8) Soundand diversifiedknowledgeof all the scientificandHomeAd andregulations.Recommendslicenseissuance, technicalaspedsinvolvedinorderto helppeopleunderstand

14) Inspectsalllevelsof learninginstitutions(schools)to ensure thereasonsofthepotentialriskandthelegalrequirements.a healthyenvironmentis maintained.Concernsinclude 9) Aninterestin professionaldevelopmentto keepabreastoftechnicalshops,sciencelabs,artclasspotterykilnsandfamily currentenvironmentallpublichealthissues.studieskitchens. I0) Interpersonalskills(torepresentthehealthunitina courteous

15)Inspedssolidwastedisposalsitesin liaisonwiththeMinistry diplomaticmanner).ofEnvironment&Energystaff. 11) Computerliteracy.

16)Inspectscampsinunorganizedterritoryandseasonalmigranthousingwhereapplicable. PublicHealthInspectorsexercisecontinuousjudgmentin:

17) Reviewsandadviseson landredevelopmentproposalsI I ) Identifyingandevaluatingabroadrangeofexistingorpotentialprojects, healthlenvironmentalproblemsandensuringthatappropriate

correctiveadionistaken;

H.EmergencyResponse 2) Decidingwhenit is necessaryto takelegalactionundertheI) Respondsto emergencysituationswherethepublic'shealth HealthProtection& PromotionAct, the Environmental

; is indanger. ProtectionAct,the TobaccoControlAct,andthe ProvincialI 2) Assistsother agenciesin the control,organizationand OffencesAct;

managementofa communityemergency. 3) Decidingwhento closea premiseorordertheremovalof a3) Providesexpertisein theassessmentof temporaryfacilities potentiallyhazardousthingor substanceinaccordancewith

andservicesduringanevacuation, appropriatelegislation;4) Identifyingtherequirementsforpublicawareness,thetypesof

I. General educationalprogramsneeded,and then developingand

I ) Actsin theroleof ProvincialOffencesOfficerwithrespectto implementingtheseprograms;the HealthProtectionandPromotionAct,theEnvironmental 5) Assessingandanalyzingconditionsleadingtoanoutbreakand

recommendingproceduresto minimizehealtheffeds.D

@ciphiCanadian Institute of Public Health InspectorsL'lnstitut Canadien des Inspecteurs en Sant6 Publique

January 31, 1997

Mr. Remo PetrongoloProgram ManagerOffice of Open LearningUniversity of GuelphGuelph, OntarioNIG 2WI

re: 1997 On-site Sewage System Seminar

Dear Mr. Petrongolo,

As we have discussed, recent government initiatives will completely transform the currentapproval and inspection process for the on-site sewage systems program in Ontario. Theseinitiatives will have a direct effect upon the in-service training program for public healthinspectors that has been offered by the University of Guelph and the Ontario Branch of theCanadian Institute of Public Health Inspectors, with the assistance of the Ministry ofEnvironment and Energy. This program has had an excellent reputation and has been well-attended in the past.

The Water and Sewage Services Improvement Act, 1997 requires that all inspectors of on-sitesewage systems be trained and certified. It is expected that this will be in effect by October1, 1997 and it is my understanding that the training and certification process will beconducted by the Ministry of Environment and Energy. As financial resources are limited,it is doubtful that the On-site Sewage Systems Seminar in Guelph would be well attended.It is the Branch's recommendation that the seminar be suspended for 1997.

The Ontario Branch would like to express its appreciation to the University of Guelph forthe assistance we have received in the past and hope that the partnership can be resumedin the future.

cerely,

• Judith de GI6sbois:- BA, CPH I(C)...... "Chair, CIPHI (Ontario Branch) Healthy Env!ronments Division

cc: Mr. Jim Reffle, President, CIPHI (Ontario Branch)Mr. Harvey Bones, President, ASPHIOMr. Alex Campbell, Ministry of Environment and Energy

/3dgOntario Branch Inc.

PAGE 26 ONTARIO BRANCH NEWS - SPRING/SUMMER '97]

PUSLOWPITCHTOURNAMENT

HOSTED BY:THE HAMILTON-WENTWORTH REGIONAL PUBLIC HEALTH DEPARTMENT

oENTRANCE FEE: $300 1TEAM(no later than June 2nd, 1997)

Make cheques payable to: 1997 PHI Baseball TournamentForward cheques to:

Dene Mawson or Rob HallThe Regional Municipality of Hamilton-Wentworth

Regional Public Health Department25 Main Street West, 2nd Floor Hamilton, Ontario L8P 1H1

ACCOMMODATIONS: RAMADA HOTEL (downtown) 150 King Street East, Hamilton$59.00 1Room (double occupancy), $10.00 / Additional PersonContinental Breakfast Included.Phone: (905) 528-3451 or Toll Free: 1-800-603-0602& ask for "Ontario Public Health Inspectors Baseball Tournament".

BOOK NO LATERTHAN JULY15TH, 1997, to be guaranteed one of the 60 reserved rooms.

FORMORE DETAILS ABOUT THE TOURNAMENT, CONTACT:ROB HALL OR JOHN FORTUNA AT (905) 546-3570 OR FAX: (905) 546-2787

R E T I R E M E N T OIDICSubmitted by: Catherine Egan

--'_II001_ SOPIC Treasurer/Membership Director.SOPIC is a chapter of CHICA-Canada, which is the

ROBERT M. CARSON Community and Hospital Infection Control Association ofCanada. Our mission to provide and promote a regional

ON ,SATURDAY_ professionalorganizationfor those engaged in the preventionAPRIL 5, 1997, a and control of infections.retirement party was SOPIC provides networking, professional support, andheld for Mr. Bob education in current issues that affect everyday practice.Carson, who has SOPIC'sgoals are:recently retired as , to providea forumfor the exchangeof informationamongDirector of the chapter members,

to supportthedevelopmentofeffectiveandrationalinfectionEnvironmental Healthpreventionand control practices, through discussionand

Divisionfor the Middlesex-LondonHealth Unit. Family, problem-solving.friends and colleagues, current and past, came to encouragestandardizationand critical evaluationoftogether for an eveningof good food, good stories and evidence-basedresearchfor infection preventioncontrollots of memories in honour of Bob Carson. Those in practicesattendance included: Michael Bragg, Director of to encouragechaptermembersto engagein researchandtoEnvironmental Health, from Oxford County Board of publishrelevantarticlesHealth, Mr. Mike Gravel, Director of Environmental and, to promoteand facilitate educationof membersandHealth from Peterborough H.U., Mr. Jim Reffle, interestedserviceproviders.Director of Environmental Health, Middlesex-London SOPIC meetsfivetimesa year, in Feb., Apr.,Jun,Sep.& Nov.H.U.,and Dr. Neil Farrell, Dental Director, SOPIC has members from tertiary and teachingMiddlesex-London H.U. and Dr. Graham Pollett, hospitals, acute and community hospitals, long term care,Medical Officer of Health, Middlesex-London H.U. psychiatrichospitals, public health and private industry.

Mr. Carson joined the Health Unit in London in the SOPICmeetingsconsist of a business meeting whereweSpring of 1975, and has been involved over the past discuss issues that affect the entire membership. A formaltwo decades with the Canadian Institute of Public education session is provided by an expert in a relevant

Health Inspectors, as well as ASPHIO. He has served infectioncontrol topic.This personcan be an outside speaker ion many committees and appointments throughout his or a SOPIC member.We also have a question and answercareer, not only as a Director in the Public Health Unit, segmentwhere members present issues that they would like tbut also as a consultant with the Ministry of Health. He feedback on, and the group discusses them in detail. In thewas responsible for helping ASPHIO become final segment of the day, we break into two "Interestestablished in 1982 and as well served as Chair of the Groups",onefor longterm care,and one for acute care. EachBoard of Certification for Canadian Institute of Public group discusses issues of their choosing and produces aHealth Inspectors. He served as a Chair and Co-Chair report to circulate with the minutes so everyone will knowto past conferences held in London in 1976 &in 1993. what was discussed. Some people can't decide which group

We wish Bob and his family all the best for a happy to attend, so the communication between the groups isand healthy retirement.11 essential!

Personally,SOPIChas beenofmonumentalassistance in

William (Bill)Wright my infection control knowledge development. I ,joinedSOPIC six years ago, as a fledglinghealth inspector with aAfter forty years in Public Health, William (Bill) keen interest in communicabledisease. I have learned so

Wright retired from the Middlesex-London Health Unitmuch, and made so many important contacts (and friend!!)

on April 8, 1997. Bill joined the Middlesex-London that I felt confident enough in my knowledge of infectionHealth Unit in 1959. He began his public health career control to attempt the Certification Board of Infectionin 1957 in Fergus, Ontario. Controlexam in 1994. SOPIC has provided so much for me

Bill has been a supervisor in the Environmental that I have volunteered as its Treasurer and MembershipHealth Division. He also served as Ontario BranchDirector for the past three years in, an attempt to givePresident of the Canadian Institute of Public Healthsomethingback. I certainly recommendthis association for

Inspectors from 1977 to 1979. An open house was any public health professional also interested in infectionheld at the London Health Unit in honour of Bill's control. If you would like more information on how to join,dedication to public health. We wish Bill a long and please contact me at (519) 883-2008 ext. 5402.11happy retirement. 'He's all yours now, Linda!'

All the Best.llPAGE 28 ONTARIO BRANCH NEWS - SPRING/SUMMER '971

NEW FOODSCARE HITS

COMMUNICABLE Norwalk virus and care settingsis an ideal BRITAINLegionellosis.Work has opportunity for promo- March 14, 1997begun by committee tional materials. The London - An

DISEASE members to develop committeeisaddressing advisory to Britishthese handouts for the need for promotional parents was

CO_fI_E General Enteric materialslike hand wash issued on FridayPrecautions,HepatitisC, signs designed for for them to wash

REPORT Non-reportable para- institutionaland daycare and peel fruit aftersites, Clostridium uses, Outbreak signs, up to four timesdifficile,Groups A and B etc. If there is a need the recommended

i Submitted by: Strep, and revise the that you have recog- level of pesticidesBcvMiddleton existing Hepatitis B, nized at our health unit, were found onDivision Chair Shigella and Rabies. please contact me and peaches and ap-

Hopefully these will be your ideas will be pies. Thegovem-available by the early presented at our next ment was quick tosummer, meeting, insistthere was no

The communicable The Conference My involvement with cause for concern.disease committee is Subcommitteehas been the Communicable Levels of residuescurrentlydivided into two busy planning our Disease Committee in the majority ofareas of work. This education day and have began as a member fruit and vege-division was created so acquiredsome excellent under the direction of tables fall well be-that programgoals could speakers on some very Jane Shimizu. I was low maximumresi-be accomplishedwithout timely topics. It was duly impressed with the due levels. How-the time and expense of decided to drop back to unselfish time and ever, a small

a one day format due to professional commit- number of a ap-bringing the entire com-mittee together, the uncertainty of health ments that this group pies and peaches,

The Pamphlet Corn- unit funding and we did presented on behalf of including imports,mittee has completed not want to competewith the CanadianInstitute of had higher residueworkon upgrading some the Canadian Public PublicHealth Inspectors, levels than desir-of the existingCommuni- HealthAssociation Com- Ontario Branch. This able. The storycable Disease tear-off municable Disease 4- commitment has been relates this latestinformation sheets and day Conference being extended to my tenure food scare withhave created some new held in Toronto in April. as division chair and I problems Britainones. The new format The workshop will be would like to take this has had over thewill utilize the 8.5" x 11" held at the Public Health opportunity to thank the safety of pre-size paperalso in a tear- Reference Laboratory in members, past and pared meats andoff pad format. This has June. present, who give freely public concernallowed more informa- New issuesconcern- of their time, as well as over BSE recently.tion to be printed and ing antibiotic resistance the health units who It goes to say thathas given the fact and patient care prac- allowthese inspectors to recent polls showsheets a new look. tices have pushed this siton this committeeand widespread dis-Revisions have been area into the forefront, represent our profes- trust of the gov-made to Salmonellosis, Many public health sion.O ernment followingCampylobacteriosis, inspectors are active the fatal foodE.coli 0157:H7, members of Community scares, and theAmebiasis, Hepatitis A and Hospital Infection fracas over fruitand Yersiniosis. New Control Association will do little toinformation sheets have (CHICA) chapters. This enhance its imagebeen created for liaison with infection with consumers.OScabies, Crypotosporid- controlpractitionersfromiosis, Lyme Disease, acute care and Iongterm

I ONTARIOBRANCHNEWS- SPRING/SUMMER'97 PAGE291

PROJECTS COMMITTEE REPORTEnvironmental Health Promotion Ad Hoc Committee

Submitted by: Suzie Shaw, Councillor

The Projects Committee held its first understandingthatsincethistimetheNationalhasmeeting in 1997, on January 17th. The topics for alteredtheir plans.discussionincluded: The use of the displaywould be to promote

the institute,the professionand to educate thei) Response to the fax request general publicof the role we play in preventing

from Jim Reffle, and decreasingthe riskof health hazards in their• Committee members suggested a letter from communities.

CIPHI be sent to all Directorsof Environmental ApproximateCost = $1,000.00Health / Inspection requesting their continued Committee membersare presentlyobtainingquotessupportto the institutevia the promotionof the from variousdisplaycompanies/ representatives.profession.

• Include in the communique,the important role iii) Review of Info Share Day EvaluationDirectorshave in keepingtheir Board'sof Health • Overalltheevaluationsof the Day indicateditwasupdated on the role of the PHI (reinforce well-received.profession). • It was proposedthat the next Info ShareDay will

• Health Unitsmay decide to start time trackingif be held inthe Springof 1998.not already done in order to justify and clearly • There was also some discussionregardingtheshow how time is being used and why the frequencyof thisevent.maintenance of existingstaff is importantandessential, iv) Info Share Binders

• To helpease costs,itwasfelthealthunitsbeginto • Itwas suggestedthe existinginformationsharinglook at the services they are providing more bindersbe put ontodisk.closelyto determineifcharges(ona costrecovery • Thisdatabaseof resourcesisvaluableand itwasbasis)couldbe implemented,i.e. foodcertification felt that its use couldbe increased if each healthcourses,swimmingpool seminar, etc. unithad accessto the contentlist.

• Operate more likea business. • The content list alone may generate morerequeststo see the actualbinders.

ii) Project Planning for 1997 • Binders could still be updated with resources• Project #1 submittedby healthunits.

Needs Assessment Survey • Contact list and disk database to be updatedThe committee members were informed of the annually(thiscouldbe done inwritingleavingtheapprovalgiven to go ahead withthisproject. Liz onuson the healthunitto updatetheirown disk).Haydu will be taking the lead in developingthe • If ableto conductthis project,itwould be great tofinal draft along with two other committee hand out copiesof thisdiskto health unitsat themembers. Bob Hart has agreed to enter the next infoshare day.questionnaireintoEpi-lnfoand to runthe analysis

of the results. To date, the questionnairehas Other Ideas Raised for Discussionbeen reviewed and is ready for Epi-lnoinput. • Developmentof an awardforthe bestpromotional

EstimatedCost: Mailing 42 x .50 = $21.00 x 2(per materialdevelopedby healthunitshealthunit= $42.00 • Creating a promotionalposter and/or buttonsPrinting 82 x .05 = $4.00x 4(pages) (similarto nursing) "Ask Your PHr' slogan:Your= $12.00 Environment,Your Health, Your Public HealthTotal: $60.00- $80.00. Inspector.

• Project#2 • Earth Day- recycled garbage bags, safetyCIPHIDisplay issue for cleaning parks (i.e.

Thisdisplaywas designedin 1996 and put on needles)holdas the NationalBranchexpressedinterestin - keep ideas for future years.taking on the task. It is the committees • Promote "us" = institute via sponsoring /

• supportingevents.n

PAGE 30 ONTARIO BRANCH NEWS - SPRING/SUMMER '971

CI I _.ar._._n_nsututeo_ruoucnea_tninspectorsL'lnstitutCanadiendes Inspecteursen Sant_Publique

February 3, 1997 " -

Ministry of the 'Environment & Energy

Assistant Director250 Davisville AvenueToronto, Ontario

I M4S 1H2

Dear Mr. Gregson,

Re: Consultation Response to the Waterand Sewage Services Improvement Act, 1997EBR Registry Number: AA7E0001.P

I have recently reviewed the background information related to the Water and Sewage ServicesImprovementAct, 1997. sent to me by Environment& Energy Minister Norman W. Sterlingand posted on the province's Environmental Registry in accordance with the public consultationprovisions of the Environmental Bill of Rights.

This particular response addresses the related amendments to Part VI!I of the EnvironmentalProtectionAct (EPA) provisions for the septic system program.

The amendments provide opportunities for certified Public Health Inspectors (PHIs) to beinspectors for the purposes of this program. In fact, for several decades, PI-ilshave beenmanaging and implementing the septic system program throughout most of Ontario undercontract with the MOEE. The Ontario Branchand ASPI-I]O(Association of Supervisory PublicHealth Inspectors) have been involved with the MOEE for many years in various aspects of theseptic system program, particularly with the On-site Sewage System Advisory Committee. TheOntario Branch has also assisted PH!s in maintaining current skills and "knowledgethrough itsPart VIII Seminars held for many years in conjunctionwith the University.of Guelph.

Responsibility for the delivery of this prom'amis more consistent with the public health andenvironmental health aspects of the work conducted by certified PH]s than by any otherprofessional discipline. Local PHIs are involved in the assessment and protection of surfaceand m'ound water supplies, assessmentof food safety and water supplies at many types of

. commercial and institutional facilities servicedby private drinking water systems andindependent sub-surface sewage treatment systems (high volume and low volume).

JamesRe.file,President,CIPHI(OntarioBranch)50 King Street, London; Ontario, N6A 5L7

Tel: (519)663-5317_xt.2251 Ontario Branch Inc.Fax: (519) 663-9581

E-mail:jreffle@lfn.corn

Pigs have extensive experience and formal academic training in wastewater treatmentsoil science, microbiology and ecology, epidemiology and communicable disease control, as

well as investigation techniques and law enforcement. Pigs in Ontario have additional

credibility in regulatory enforcement as they are designated Provincial Offences Officers for thepurpose of all offences under the Tobacco Control Act, the Health Protection and Promotion

Act and the Part VIII of the EPA and their respective regulations. These credentials and set ofskills and knowledge are necessary to carry out the Part VIII Program on behalf of lower and

upper tier municipalities, or any other joint enforcement structure allowed under thislegislation.

Attached is a copy of Public Health Inspectors: A Reliable Community Resource, whichdescribes in more detail the valuable features that make Public Health Inspectors a communityasset.

It isthe position of the Canadian Institute of Public Health Inspectors (Ontario Branch) that a"grandfathering" of certified Public Health Inspectors from the training and licensing provisionsfor new inspectors under the proposed amendments to Part V111ofthe EPA would allow localmunicipalities to take advantage of an existing pool of highly trained, experienced, motivatedand local human resource, to deliver the Part VIII EPA septic system program.

The Ontario Branch will be encouraging all local municipalities and local boards of health to

develop efficient and effective structures of "approving authorities" involving certified PublicHealth Inspectors as the fundamental professional group who can carry, this out in the bestinterests of the public, in relation to health, environment, accessibility and financial efficiency.

The Ontario Branch continues to be interested in participating in the province's review and

improvement of various policy and regulatory aspects of the sewage system program as 1previously discussed under the MOEE's Moving Forward initiative.

PHIs have the experience, academic training, and a more integrated perspective of the potentialimpacts septic systems have on the health and environment on the local community. Ourinteraction skills with people, politicians and other professional groups, provide for excellentpublic relations opportunities.

Thank you for involving the Ontario Branch of CIPIg in this important consultation process.

Yours truly,

'James Reffle, BA, MPA, , •President, CIPHJ (Ontario Branch) In_:':

James Retie, President, CIPHI (Ontario Branch)50 King Street. London, Ontario, N6A 5L7Tel: (519) 663-5317 ext. 2251Fax: (519) 663-9581E-mail."jreffie@ lfn.corn

PublicHealthResourceson theInternets u,c+U u fue to

• Centers for Disease Control and Preventioncontains a considerableamount of public healthrelated information including CDC DiseasesInformation Page (includes prevention strategies),infectious diseases brochures and leaflets,TravellersHealth information, Publications & Productsand the Morbidity & Mortality Weekly Report (in acrobat format)and is now searchable.Note: Aplain text version of the MMWR is also available. The CDC web site can be searched. CDCWonder contains public health information including CDC Prevention Guidelines (lots of full-text

i articles),and searchabledatabases(user ID required).+ World Health Organization is well worth exploring,particularly WHO's Major Programmesalsoavailable on a ogg_p_!!_herserver.

o Australian Departmentof Health and Family Services.The site offers online publications,I National Health & Medical Research Council information,NH&MRC Publications,NH&MRC

Research Grants informationand Casemix information.DepartmentPress Releases are available.i • QueenslandHealth is an Australianstate governmentdepartment. The site is under construction.I • Australianl.nstituteof Health and Welfareoffers an online version of Australia's Health.i Recommended.° New South Wales HealthPublic Health Division.

• Northern SydneyArea Health Service Public HealthUnit.• Departmentof HumanServices(Victoria) Public HealthBranch. Includes a Public Health Index to

its growingcollection of useful public health information.Wortha visit. Food handling andpoisoning pamphlets, pest control and infectious diseases consumer informationare goodexamples of what is available.

® The HealthDepartmentof Western Australiahas a growing amount of useful information.• New Zealand Ministry of Health.• The New York State Departmentof Healthhas online information including Consumer Health

Information such as Environmental Health and CommunicableDiseases.® Health Canada has informationon Canadian Health.. AustralianHealth Online is a "health focused and market driven industry development service".® HealthWorldhas online informationand links to other sources.• Community OutreachHealth Information System of the The Boston UniversityMedical Center

has useful amountsof online health information.r o Look It Up from Time Warner is a powerful and comprehensivesearchable database of health

infbrmation.Recommended.• Findout's HealthLibrary has links to health information.Try also Findout's Home Page.® GoodHealth WebLibrary has a good range of factsheet-typeinformation on health.• Healthtouchhas online health information(factsheet type) and drug information (consumer

information).o MedicineNet's DrugInformation.® The Intemet Drug Index has drug information.Clinical Pharmacology - Drug Monograph Service

and DrugDB have too.• MIMSAustralia has an online pharmaceuticaldatabase available only to paid subscribers (but a

free trial period is available).® ClinicalToxicology tutorial from the Hunter Area Toxicology Service (Aust) is well designed and

I ONTARIOBRANCHNEWS- SPRING/SUMMER'97 PAGE33]

informative.• Office of DiseasePreventionandHealthPromotion(USA).• PutPreventionIntoPractice(USA) - programto improvethe preventionaspectsof clinical

practice.• HealthPromotiononthe IntemetfromMonashUniversity.Includeslecturenotes.• HealthPromotionOnlinefrom HealthCanada(Note:a telnetapplicationis required).• Instituteof HealthPromotionResearch.• UCIHealthPromotionCenter(School of SocialEcology).• CommunityHealthPromotionNetworkAtlantic(Canadian).• FederalOffice of RoadSafety(Aust).• The NRMA (AusQ can have information on road safety in their media releases page. CrashTests

of carssold in Australiaareavailable.• Safety InformationaboutPassengerCarsfrom the InsuranceInstitutefor Highway Safety.

Includes some crash tests.• NationalHighwayTrafficSafetyAdministration.Includes considerable information on Traffic

Safety & OccupantProtectionincluding Injury Prevention,and Vehicle and EquipmentInformation which includes a Vehicle Recalls section (not browsable but searchable on specificvehicle details) and results of vehicle crash testing (USA vehicles only).

• BuildingBridgesBetweenTrafficSafetyandPublicHealth.A newsletter ill acrobat tbrmat isavailable.

• Community InformationClearinghouseon SustainabilityandHealthyCommunities.• American Heart Association has a considerableamount of online publications and resources.• National Injury SurveillanceUnit (Aust)has a good selection of on-line information.• National Center for Injury PreventionandControl.• The Injury PreventionInternetLibraryis a fine collection of links to information on injury

prevention.• WHO Collaborating Centre for Research on Healthy Cities.The Global HealthyCities

InformationSystemgopherin the USA is also available.• The Coalition for Healthy CitiesandHealthyCommunities.The site has a fine collectionof

relatedlinks.• InternationalHealthyCitiesFoundation.• The Change Project:HealthyCommunitiesarticlesis a good collection.• Ontario Prevention Clearinghouse has information on health promotion and community

development.• Children's Safety Networkhas resources for child and adolescent injury and violence prevention.• Centrefor AdolescentHealth(Aust).• The Family Violence PreventionFundhas a considerableamount of information on domestic

violence.• National Clearinghouse on Child Abuse and Neglect Information.• National Ageing Research Institute (Aust).• Alzheimer's AssociationNSW (Aust). Includes good quality helpsheets.• National Mental Health Strategy (Aust). Includes somefactsheets/brochures.• Center for the Studyof Issues in PublicMentalHealth.• Internet Mental Health includes informationon disorders and medications.• Mental Health Infosource has useful information including a disorders index.• Mental Healthbrochuresfrom the Good Health Web.• Schizophrenia Australia.• The Schizophrenia Homepage.• Early PsychosisPreventionandInterventionCentre(Aust).• Suicide PreventionAustralia.• AustralianInstitutefor SuicideResearchandPrevention.• Suicide has information about suicide and its prevention.• CIN HealthRoom from the AustralianCommunityInformationNetworkhas information on

health care, health insurance, Government sickness/disability/welfarepayments, mental health etc.• MedicineNethas a good Diseases and Treatments section, o• National Asthma Campaign (Aust) includes the online Asthma Management Handbook.• Allergy, Asthma & Immunology Online.

This web page is maintained by Tony Ball (a.ball@qut.edu.au) of the QUT School of Public Health.Please send me any comments, suggestions or interesting sites. Last updated: 5 March 1997.

%,

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MEMBERSHIP APPLICATION FORMI hereby make application for [ ] Regular Membership (see dues table below) [ ] Student Membership (dues are $20.00)in the Canadian Institute of Public Health Inspectors. This application implies that membership is to continue untilresignation is tendered,or until membership is discontinued under the conditioncontained in the By-laws of the Institute•

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That the enjoyment of thehighestattainable standardof health is one of thetundamentalrightsof every human beingwithoutdistinctionof race, religion,politicalbelief, economic,or socialcondition.

Thatbeing loyalto myprofession,I willupholdtheConstitutionand By-lawsof theCanadian Instituteof PublicHealth Inspectorsandwill, atall times, conductmyselfin a mannerworthyof my profession.

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I ONTARIOBRANCHNEWS- SPRING/SUMMER'97 PAGE351

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