MNZEH Newsletter #4
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In this quarter's newsletter:
MNZEH Update
The MNZEH team would like to thank all our colleagues, collaborators, and supporters for your encouragement and advice during the past year. We have been delighted with the enthusiastic responses we have received about our work in monitoring the environmental health of New Zealand. In consultation with our Technical Advisory Group and major stakeholders, the Ministry of Health, Ministry for the Environment, and the Environmental Protection Authority we are developing a number of enhancements to our programme and new information products which will be implemented in 2014.

Best wishes to you and your families for the Christmas and New Year - we hope you have a really enjoyable rest and relaxation period.



Farewell and Welcome

At the end of September the MNZEH team said farewell to Melissa who organised the MNZEH roadshows and helped with the admin work of the team. She is also the former editor of the MNZEH newsletter. As Mel has left windy Wellington for her hometown of Tauranga, we welcome on board Kylie Mason and Gaelyn Douglas.
Kylie Mason has joined the team to work on the environmental burden of disease study. Kylie has a background in health statistics and applied epidemiology. She has a Masters degree in Applied Statistics, and for the last 8 years she worked at the Ministry of Health. She also has a keen interest in how to best communicate statistics and research. 

Gaelyn has a background in teaching and has recently completed her Masters in education with an e-learning endorsement. She has joined the team to contribute to the MNZEH online environment through the development of instructional resources and will also be involved in the translation of our science into evidence for policy development and decision making across the health sector, and assisting in the dissemination of our information products.
If you are interested in the environmental health and its relevant indicators in New Zealand, the website of Environmental Health Indicator (EHI) ( would be a good place for you to visit. Our EHI team analyse existing data collected by other agencies, interpret the results and publish the findings in the factsheet. Over 60 indicators of environmental health, including population growth, recreational water quality, energy consumption, notifiable disease etc. are updated annually on the website. Report cards on major Ministry of Health environmental health priorities will be updated on request. 

The information on the website will be of interest to the Ministry of Health, the Ministry for the Environment, Public Health Units, District Health Boards, the wider health sector, regional councils, local councils, and the general public.

Recently updated factsheets (click here for more information):
  • Vector-borne disease notification in New Zealand
  • Vector-borne disease notifications in New Zealand, by exposure risk factors
  • Notifications of malaria cases in New Zealand, by exposure risk factor and year
  • Notifications of dengue fever cases in New Zealand, by exposure risk factor and year
  • Notifications of confirmed and probable meningococcal disease cases in New Zealand
  • Notifications of confirmed rheumatic fever cases in New Zealand
  • Livestock type in New Zealand
  • Livestock in New Zealand, by region and TA
  • Dairy cattle in New Zealand, by region and TA
  • Gross weight (millions of tonnes) of imported cargo into New Zealand
  • Sea containers imported into New Zealand, by type, port and last country or region of loading
  • Recreational marine beaches exceeding guidelines for enterococci levels
  • Recreational freshwater beaches exceeding guidelines for E. Coli level
  • Exceedance rates from samples taken at monitored recreational beaches in New Zealand
The Hazardous Substances Disease and Injury Reporting Tool (HSDIRT) is now available in all regions of New Zealand. 

The HSDIRT is an electronic form that simplifies notification of hazardous substances injuries, from primary health care to Medical Officers of Health.  It has been developed by CPHR in conjunction with bestpractice Decision Support (BPAC), and is funded by the Ministry of Health.  The HSDIRT has been piloted and refined over the course of 2013 and is now fully implemented.

A hazardous substance is defined as anything that can explode, catch fire, oxidise, corrode or be toxic to humans.  Medical practitioners are required by law to notify hazardous substances injuries.  The HSDIRT has also been designed to allow notification of lead absorption ≥0.48micromol/L, and injuries arising from chemical contamination of the environment (both notifiable under the Health Act 1956).

Improving data collection about hazardous substances allows us to recognise patterns of illness and prevent future disease and injury. 

With the HSDIRT now fully operational, the next phase of the project involves publicising the tool to primary health care professionals, to ensure that they are aware of the reporting requirements and the tool’s existence.  This work is being coordinated by Maria Poynter, and will see hazardous substances articles in several primary health care publications over the next few months.
The Fluoride Debate
The subject of Community Water Fluoridation has become a topic of much debate over the past six months following Hamilton City Council’s decision to cease adding fluoride to the city’s water supply in June. This decision was not supported by a referendum, held alongside local council elections in October, where 66% of those who voted were in favour of adding fluoride. The issue remains unresolved however, with the council putting off a decision on whether to reintroduce fluoride.
Over the past two and a half years, Caroline Fyfe and Barry Borman have been monitoring and critically reviewing the literature on fluoride on a monthly basis for the National Fluoridation Information Service (NFIS). A comprehensive literature search is undertaken to find new studies on fluoride exposure and its impact on both oral and general health. In partnership with the National Poisons Centre, which reviews toxicological and pharmacological research, papers identified are summarised in terms of key findings, validity (the quality of the study) and relevance to water fluoridation in New Zealand. The review is designed to give an impartial analysis of the science behind the use of fluoride as a preventative oral health intervention. “Review of Scientific Papers’ compiled from these summaries are published bi-annually on the NFIS website:
We recently completed a series of maps for the Hawke’s Bay District Health Board showing where licenced alcohol outlets are located in regards to social deprivation. These were on a regional and local town centre scale to give a comprehensive view of the region. An example of this work can be found here in our previous newsletter.
The project team was originally scheduled to release the first data for the Ministry of Health and MBIE from the Occupational Disease Surveillance in September-October 2013. However, there has been a delay in obtaining the requisite data and now we expect to release the report about February 2014. The report will present data on the pattern of diseases/conditions which have been identified in the previous Department of Labour’s Occupational Health Action Plan.
On 21st November 2013, the Technical Advisory Group (TAG) met with the MNZEH Team at the Centre for Public Health Research (CPHR), where the MNZEH team presented their work and progress they were making in the programmes for Monitoring New Zealand’s Environmental Health (see accompanying photos).

These presentations included the Environmental Health Indicator factsheets (Fei Xu, Andrew Parnell), the online interactive mapping system - CPHROnline (Caroline Fyfe, Andrew Parnell), the Hazardous Substance Surveillance (HSSS) (Helene Marsters)  and Hazardous Substances Disease and Injury Reporting Tool (HSDIRT) (Maria Poytner, Deborah Read), the Environmental Burden of Disease (Kylie Mason) programme as well as collaborative projects with  Energy Efficiency and Conservation Authority (EECA)  and the Environmental Protection Authority (EPA) (Barry Borman). The MNZEH team is also producing an analytical standards guidebook for future reference.  Interesting and fruitful discussions were generated from the presentations given by the MNZEH team. The team also received a great deal of useful and valuable feedback from the TAG members in terms of improving the accessibility of the MNZEH programmes as well as developing CPHR into the national hub for environmental health in New Zealand.

The members of the technical advisory group and the MNZEH team also evaluated the existing indicators, possible new indicators (including indicators related to climate change) and proposed indicators for a Waikato Progress Indicators as part of a collaborative project with the Waikato DHB. 
More Profiles of the TAG Members
Christian Hoerning is a Senior Technical Advisor at the Energy Efficiency and Conservation Authority (EECA) in Wellington. Since joined EECA in 2006, Christian has worked on a variety of government initiatives to promote energy efficiency, conservation and renewable energy in New Zealand.
Josh Fyfe has been working at the Ministry for the Environment for the past five years. His work has largely been on environmental reporting and in the subject areas of air quality, waste (including waste greenhouse gas emission calculations) and biodiversity.
Meeting and Presentations 
During the past three months:
  • Barry Borman gave a presentation on 6 December to the Ministry of Health’s Annual Mortality Forum entitled: ‘You can’t manage what you don’t measure: the importance of recording occupation on official health records’.
  • Barry Borman, Mathu Shanthakumar, together with Bill Glass gave a presentation to the MBIE Asbestos Panel on the initial results from their study of the mortality and hospitalisation of people who had enrolled on the asbestos exposure register since 1992.  
  • Barry Borman and Caroline Fyfe recently met with Dr Russell Wills, Children’s Commissioner, to discuss opportunities for collaboration between the two groups. One exciting avenue is presenting more children related data on CPHROnline.
  • Maria Poynter has been meeting with a range of key informants about environmental health indicators for climate change, to inform CPHR’s climate change EHI development. 
  • Maria Poynter has given 2 presentations on “Hazardous Substances Surveillance and the HSDIRT” in the last 2 weeks. This was at the Hazardous Substances and New Organism (HSNO) Foundation Course and HSNO Refresher Course, run by Southern Monitoring Services (SMS) for the Ministry of Health.
Meet our team:
  • The EHI team is collaborating with the Energy Efficiency and Conservation Authority (ECCA) in a project to investigate any changes in the health status (e.g. hospitalisations, pharmaceutical use) of populations living in houses after the installation of home insulation.
  • Congratulations to Dr Saira Dayal who recently passed her final examination to become a Fellow of the New Zealand College of Public Health Medicine.

Kylie Mason
Winner: Best Plain English Technical Communicator 2013

Emily Cotlier, Awards judge and member of TCANZ (Awards sponsor) with Kylie Mason (right)

Kylie Mason recently won an award at the 2013 Writemark New Zealand Plain English Awards, for work that she was involved in while employed at the Ministry of Health. 

Judges' comment

This entry, on the medical side of technical communication, was a unanimous favourite with all the judges. We praise the clear Plain English language throughout; the balanced use of writing, graphics, and charts to present large amounts of information; and the teamwork behind its attractive presentation.

At its best, Plain English is nearly effortless for the reader, and seems as if it was effortless for the writer. For an entry laden with statistics and medical information to give this impression shows that it is a Plain English winner.

The winning reports, published by the Ministry of Health, can be found through:

Environmental Health Websites

The MNZEH team recommends you visit:
More recently Caroline’s reports and interactive maps stimulated a lot of interest and questions, and the website has subsequently had thousands of hits. In the coming month, fact sheets regarding notifiable diseases, New Zealand energy consumption and safe drinking-water supplies will be updated on our EHINZ website, be sure to have a look.

Postgraduate Study

We would like to bring your attention to training opportunities CPHR is providing in environmental health. Firstly, the Environmental Health paper which is part of our postgraduate diploma in public health. Click here for more details.
Copyright © *|2013|* *|Centre for Public Health Research|*, All rights reserved.
*|Environmental Health Newsletter Issue 4|*

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*|Centre of Public Health research, Level 1, 102 Adelaide Road, Wellington, New Zealand. 6021| 

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