Managing water safety in healthcare. Part 1--Strategies and approaches for waterborne pathogen control.

Summaries in 2 parts are presented from a conference held in London at the Royal Society for Public Health on 16-17 May 2012, on the latest developments in dealing with waterborne hospital-acquired infections (nosocomial), from the UK perspective. Also included were some views from continental Europe. The first part, focuses on management strategies and plans that are either in use or recommended by domestic/international guidelines, such as the WHO, for prevention, control and risk assessment of disease outbreaks resulting from the presence of these pathogenic microorganisms in water appliances/supplies. Various solutions are discussed, some more effective than others, but all require a comprehensive strategy and technical expertise run by properly trained and dedicated professionals.

Public health hazards in Poland posed by foodstuffs contaminated with E. coli O104:H4 bacterium from the recent European outbreak.

Shiga toxin producing Escherichia coli (STEC) are the most virulent diarrhoeagenic E. coli known to date. They can spread with alarming ease via the food chain, as recently demonstrated by the large outbreak of STEC O104:H4 borne by sprouted seeds in 2011, clustered in northern Germany, and subsequently affecting other countries. Indeed, a significant number of infections to verocytotoxin producing Escherichia coli O104:H4 have been reported from the WHO European Region resulting in many cases of bloody diarrhoea and haemolytic uraemic syndrome in Germany, 15 other European countries and North America. Eventually, the European Food Standards Agency, (EFSA), identified the likely source to a single consignment of fenugreek seeds from an Egyptian exporter as being linked to the two outbreaks in Germany and France. The situation was closely monitored by the Chief Sanitary Inspectorate public health authority in Poland where actions undertaken ensured that the public was well informed about the dangers of STEC contamination of food, how to avoid infection, and what to do if infected. Tracing the fenugreek distributors also enabled the identification of suspected batches and their isolation. As a result, there were very few reported cases of STEC infection in Poland. Effective control over such outbreaks is therefore a vital public health task. This should include early detection and rapid identification of the contagion mode, followed by removing the foodstuff(s) from the market, providing consumer advice, and preventing secondary spreading. As a mitigation measure, screening/monitoring those involved in food handling is also warranted to exclude carriers who can be asymptomatic.

Managing water safety in healthcare. Part 2--practical measures and considerations taken for waterborne pathogen control.

These summaries form the second part of presentations made at a recent conference held at the Royal Society for Public Health in London, 16-17 May 2012, on the latest developments in combating waterborne hospital-acquired infections (nosocomial). The first part (Ann Agric Environ Med 2012; 19(3): 395-402) has focused more on the adopted strategies/approaches from the UK perspective, (some also from continental Europe), whereas the presented second part (sections 1-7 below), is dedicated more to practical solutions, and examples of features used in water systems that are or have been considered effective.

Designer Drug (DD) abuse in Poland; a review of the psychoactive and toxic properties of substances found from seizures of illegal drug products and the legal consequences thereof. Part 1--cannabinoids and cathinones.

Faced with the rapidly growing increase of designer drug abuse, particularly amongst the younger generation, various legislative strategies are currently employed world-wide for tackling this problem - however with mixed results. The key issue is that the producers of DDs are able to either exploit existing legal substances intended for other uses, but which have been found to possess psychoactive properties, or to synthesise new psychoactive substances by introducing chemical modifications, often very minor ones, thereby avoiding the prohibited use of chemicals included on any banned lists. Some countries opt to ban new drugs as and when shown or considered to be harmful, while others introduce sweeping bans based on chemical structure. Nevertheless, an ever increasing diversity of new DDs are constantly appearing on domestic and Internet markets. Poland, together with the UK and Eire, has placed temporary bans on all DDs whenever they have been identified, thus enabling sufficient time for assessing their potential hazards to health. Part of this 'holding' strategy entails a thorough review of the scientific literature, including expert opinion when direct evidence is lacking, as well as information received from EU support organisations Europol and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). This paper, in two parts, therefore aims to provide an up-to-date summary review of available scientific evidence on the harm caused by the six main chemical groupings of DDs found in drug seizures of illegal products recently made in Poland. The first part is devoted to Cannabinoids and Cathinones derivatives. Ensuing legislation can therefore be rapidly formulated to make the bans permanent as appropriate.

Designer Drug (DD) abuse in Poland; a review of the psychoactive and toxic properties of substances found from seizures of illegal drug products and the legal consequences thereof. Part II--piperazines/piperidines, phenylethylamines, tryptamines and miscellaneous 'others'.

As the second and concluding part, this paper continues the summary review of the scientific evidence obtained from the literature and focuses on the remaining 4/6 groupings of DDs identified in illegal products found in the huge drug seizures made recently in Poland. They consist of piperazines/piperidines, phenylethylamines, tryptamines, (briefly mentioned), and a miscellaneous 'others' category; cannabinoids and cathinones derivatives having being reviewed in the first part. Also included in the introduction and discussion sections, in both reviews, are some legal aspects variously interwoven with the science. It is thus intended that these two articles may help suitable legislation to be rapidly devised to make the prohibition of DDs permanent whenever deemed necessary, as well as providing an up-to-date reference source for those engaged in the DD issue; whether scientists or regulatory bodies.