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Environmental Practicum Report

By
David Mueller
Environmental Health Student

Organisation
Gold Coast Public Health Unit

Duration
August and September 2016
(240 hours)

Practicum Report David Mueller

Content
Section

Section

A
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B
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C
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D
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Headings

Page

Introduction to the organisation

Communicable Disease Control


Environmental Health Hazards
Epidemiology
Food Safety and Standards
Immunisation
Medicines, Therapeutics and Poisons
Partner National Centre for Neuroimmunology & Emerging Diseases
Public Health Incident Management
Tobacco Regulation
Water Quality and Fluoridation

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5
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Complaint/Audit: Labelling of food items

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Introduction
Aim
Background
Procedure
Discussion
Conclusion
Learning Outcome

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Investigation Report: Scheduled Drugs

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Description of the incident


The role of the enforcement agency involved
Relevant Legislation, Standard, Code
Normal Procedure for CD4 and SD in Pharmacies
Investigation
Identification of potential offence
Findings & Conclusion
Options for resolution & future improvement
Recommended course of action

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Student Project

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Purpose of Project/Survey
Objective
Performance Indicators
Rational
Methodology
Activities/Tasks
Results
Discussion
Recommendation

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Practicum Report David Mueller

10.0
11.0
12.0
13.0
14.0

Limitation
Stakeholders
Budget/Resources
Reference List
Appendices

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Practicum Report David Mueller

A.) Introduction to the organisation


The Gold Coast Public Health Unit delivers a range of environmental health and public health
services to protect and promote the health and wellbeing of the Gold Coast community by
addressing factors that cause illness, injury and disease.

Their aim is to minimise adverse health outcomes across the community and prevent re-occurrence
by providing communicable disease control, environmental health and epidemiological services and
immunisation coordination services.
The highly skilled and committed workforce including the service director, epidemiologist, public
health medical officer, public health nurses, environmental health officers and business support staff
who delivers public health services in partnership with Gold Coast Medicare Local, City of Gold
Coast, Griffith University, State Government Agencies and Non-Government Organisations.
Key areas include:
1. Communicable Disease Control
2. Environmental Health Hazards
3. Epidemiology
4. Food Safety and Standards
5. Immunisation
6. Medicines, Poisons and Therapeutics
7. Public Health Incident
8. Tobacco Regulation
9. Water Quality and Fluoridation
10. Alerts and News

Practicum Report David Mueller

1.) Communicable Disease Control


Communicable diseases contribute to mortality and morbidity in the community and are a significant
public health priority.
Gold Coast Public Health Unit is responsible for the early detection, surveillance, investigation and
control of communicable diseases in the community. In particular, preventing disease spreading
from person to person, from animals to people (zoonotic diseases) and from insects to people
(vector borne diseases).
Key functions
monitor and respond (case management, contact tracing and prevention strategies) to
targeted communicable diseases and conditions notified to Queensland Health under the
Public Health Act 2005, including:
- food and water borne diseases
- vaccine preventable diseases including measles and whooping cough
- serious infections such as meningococcal disease
- mosquito-borne infections such as dengue fever
- infections transmitted to humans from animals including Q Fever, Hendra virus and
Australian Bat Lyssavirus
manage and respond to communicable disease outbreaks and incidents of public health
importance within the community
provide expert communicable disease control advice to and work in partnership with
clinicians, health professionals, governments, industry and the community
provide expert public health advice to health professionals, governments, industry and the
community
develop and implement projects with key partners to prevent and control communicable
diseases in specific settings
monitor, enforce and promote compliance with relevant provisions under the Public Health
Act 2005
2.) Environmental Health Hazards
Environmental health hazards include physical, chemical, biological and social hazards that affect
human health which may be naturally occurring or a result of human activity.
Gold Coast Public Health Unit undertakes health risk assessments and provides advice to other
agencies and the public to mitigate and minimise the impact environmental health hazards, mostly
relating to soil and air, have on individuals and the community.
Key functions
conduct health risk assessments applying knowledge from the areas of public health,
environmental health, epidemiology and toxicology
investigate complaints and notifications relating to asbestos in non-workplace settings,
elevated blood lead levels, non-communicable diseases, cancer clusters and other public
health risks

Practicum Report David Mueller

provide health risk advice on environmental hazards and incidents to government, partners
and the community
monitor and enforce compliance with relevant provisions of the Public Health Act 2005

3.) Epidemiology
Epidemiology is the branch of medicine that studies the causes, distribution and control of disease
across populations. It combines medicine, health sciences, social sciences and statistics to generate
expert and accurate information essential for the delivery of public health services to the Gold Coast
community.
Gold Coast Public Health Unit is responsible for providing epidemiology and health surveillance
services to investigate and monitor disease risks and the health and wellbeing of populations. We
also contribute information gathered on health status and disease trends to the development of
public health policy and preventative health care.
Key functions
recognise disease patterns across the population by monitoring disease data and
undertaking horizon scanning for unusual or emerging communicable disease threats
identify the causes of diseases by statistical analysis of disease data
monitor, analyse and report on trends in data essential for the management, evaluation and
planning of services for the prevention, control and treatment of disease and illness across
the population
4.) Food Safety and Standards
Consumers expect the food they purchase to be safe, of high quality and labelled so they can make
informed choices about the food they eat. Changes in food supply, dining behaviours and food
industry growth increases the risk of foodborne illness outbreaks, misleading claims on foods,
suspected intentional contamination and consumer complaints about food.
Gold Coast Public Health Unit is responsible for monitoring and enforcing certain provisions of the
Food Act 2006 and Australia New Zealand Food Standards Code to ensure food for sale is safe and
suitable for human consumption, to prevent misleading conduct relating to the sale of food and to
ensure food complies with prescribed standards.
Key functions
manage and investigate foodborne illness outbreaks and consumer and industry complaints
relating to food safety and standards
provide expert advice on food safety, composition and labelling of food to businesses and
the community
respond to and investigate prescribed contaminant in food notifications, food recall,
suspected intentional contamination of food incidents and ACCC mandatory reports relating
to food
conduct audits of state school tuckshops, hospitals and other food businesses and undertake
microbiological and compositional food sampling surveys as part of local and statewide
compliance programs

Practicum Report David Mueller

monitor, enforce and promote compliance with the Food Act 2006
work in partnership with key stakeholders including local government and Safe Food
Production Qld

5.) Immunisation
Gold Coast Public Health Unit coordinates the delivery of national and state immunisation programs
within the Gold Coast Hospital and Health Service. We work with over 300 Vaccine Service Providers
including General Practitioners, Aboriginal and Torres Strait Islander health services and hospitals.
The objective is to maintain and enhance immunisation rates to minimise the incidence of major
vaccine preventable disease for the well-being of individuals and the community.
Key functions
Provide free, accessible immunisation clinics across the Gold Coast to implement the
National Immunisation Program Schedule Queensland
Provide School Immunisation Program to year 7 and 8 students provide immunisation
education and advice to the community
Maintain and increase immunisation coverage rates for vulnerable groups with a focus on
minimising disparities between Indigenous and non-Indigenous Australians
Provide ongoing education, training and technical support to vaccine service providers
Improve accuracy and quality of immunisation data
Investigate and report on adverse events following immunisation
Investigate cold chain breaches and coordinate intervention strategies.
6.) Medicines, Therapeutics and Poisons
Queensland Health administers legislation to monitor how scheduled medicines and poisons (eg
controlled drugs, restricted drugs, poisons) are obtained, stored and used in Queensland to protect
public health and safety.
Gold Coast Public Health Unit enforces the Health Act 1937, Health (Drugs and Poisons) Regulation
1996 and the Pest Management Act 2001 to minimise harm from misuse or inappropriate supply or
access to medicines and poisons.
Key functions
investigate consumer and industry complaints relating to controlled, restricted and other
scheduled medicines, poisons, therapeutic goods, pest management and fumigation
conduct compliance audits of pharmacies, hospitals, aged care facilities, veterinarians and
other health professionals, pest management technicians and fumigators as part of local and
statewide compliance programs
assess, grant or recommend suitability for persons to hold licences (eg pest management)
and permits (strychnine, cyanide)
monitor, enforce and promote compliance with the Health Act 1937 and Pest Management
Act 2001.

Practicum Report David Mueller

7.) Public Health Incident Management


Major public health incidents can arise from natural disasters including cyclones, bushfires,
heatwaves or disease outbreaks like dengue fever and pandemic influenza. Public health incidents
can also arise from criminal acts, bioterrorism and environmental or food contamination.
Gold Coast Public Health Unit contributes to a multi- agency response during disasters and events.
Our objective is to help prevent, prepare for, respond to and recover from events causing public
health risks in the community.
Key functions
prepare, plan and respond to public health risks arising from disasters, pandemics and public
health incidents within local, state and national disaster management arrangements
provide expert advice and work in partnership with government, non- government agencies
and the public regarding public health risks during events
provide public health messages to the public through fact sheets and media
deploy staff to assist in responses to public health events in other jurisdictions
8.) Tobacco Regulation
Tobacco laws in Queensland include smoking bans for indoor and outdoor public places, as well as
tough restrictions on retail advertising, display and promotion of tobacco products.
These laws have directly factored in reducing the publics exposure to environmental tobacco smoke
across the community, contributing to a culture that supports smokers trying to quit and
discouraging young people from taking up smoking.
Gold Coast Public Health Unit is responsible for enforcing Queenslands tobacco laws.
Key functions
investigate public and industry complaints regarding smoking bans in the general community
conduct compliance audits of tobacco retailers, major events, liquor licensed premises,
major sports facilities and other places as part of local and statewide surveillance programs
promote compliance through educational activities
conduct surveillance of tobacco retailers to detect the unlawful supply of smoking products
to minors
monitor, enforce and promote compliance with the Tobacco and Other Smoking Products
Act 1998
9.) Water Quality and Fluoridation
The Gold Coast community predominantly source their household water from reticulated town
supply, dual reticulated town supply and rainwater tanks.
Many factors can cause drinking water to become unsafe for human consumption or use such as
microbial and chemical contamination or contamination from bushfires, cyclones or floods.

Practicum Report David Mueller

Gold Coast Public Health Unit assesses and investigates public health risks associated with
reticulated drinking water provider notifications, dual reticulation cross contamination and recycled
water incidents and fluoridation incidents.
Key functions
respond to public health risks that arise from drinking water quality and recycled water
incidents and notifications in partnership with the Water Supply Regulator and other
agencies
investigate Legionella and other waterborne disease notifications and incidents;
conduct public health risk assessments and provide expert advice on drinking, recycled and
recreation water quality and safety
assist public hospitals with legionella control strategies
investigate complaints and conduct audits of fluoridation facilities at water treatment plants
monitor, enforce and promote compliance with the Public Health Act 2005 and Water
Fluoridation Act 2008

Practicum Report David Mueller

B.) Complaint/Audit: Labelling of food items


1.) Introduction
Following a complaint from a member of the public a compliance investigation was undertaken by
the GCPHU in respect to unlabelled honey being sold at a fruit store in the Gold Coast Hinterland. As
stated on the Food Standards Australia New Zealand (FSANZ) website, good labelling will empower
consumers to make the right and safe food choices. They therefore protect the communities
wellbeing and safety in such a way that they display information about use by and best before dates,
certain allergens, storage instructions and preparation of the food item, the codes are advisory and
issue warnings if applicable. Under the Food Act 2006 the State is responsible for the enforcement of
section 39(3) which states A person must not sell or advertise food that is packaged or labelled in a
way that contravenes the Food Standards Code.
Details about labelling are set out in the Food Standard Code. Gold Coast Public Health Unit
provides food businesses with a 14 page Label Buster brochure which contains the most important
and common labelling practices.
2.) Aim
The aim is to ensure compliance with the Food Standards Code and The Food Act 2006 because
inadequate or wrong labelling can cause a severe health risk to the public, for example allergens.
This can be e a major health risk for affected people. Even when there is the possibility that a
product can contain small traces of a certain allergen, these traces can have dramatic effects on
sensitive people. Therefore labelling must be accurate to ensure that every label reflects the content
of the product to reduce the risk to the public to a minimum, or at best eliminate it.
Another important factor is to protect the consumer from fraud. In our investigation with honey, the
consumer cannot make an educated decision about the origin of the honey. It could be bulk bought
honey from another country and might contain addictives like preservatives or cheaper ingredients
to increase the amount of the product and therefor increase the profit of the manufacturer.
Consumers pay more money to get a local produced and pure hone , but with no labelling they do
not have a guarantee for the origin and quality of the product and can not challenge it at court.
3.) Background
A member of the community issued a complaint to the Gold Coast Public Health Unit about
unlabelled honey being sold at a fruit store in the Gold Coast Hinterland. It was an anonymous call,
therefor no information about the complainant were obtained. Information about the product, the
time when it was observed and the location of the business were obtained.
4.) Procedure
4.1) Preparation Stage administrative
All obtained information will be transferred into the Maple system from QLD Health
by the EHO who was on telephone duty
Maple assigns a unique investigation number (INV) to each case
INV is sent to the team leader of the complaints unit

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Team leader assigns the investigation to an EHO

4.2) Preparation Stage by assigned EHO


Searching computer data bases and documents if there is a history of the business (=
background search)
Contacting the complainant to inform that a case is established and who is the EHO
in charge and that he will be informed once the case is finalised. Providing contact
details of EHO if there are further questions about the case (not possible in this case,
because the complainant was anonymous. QLD Health has to investigate all
complaints)
Booking a car for site investigation three days later (labelling is coded as medium, 5
working days, to high, 2 working days, risk priority and honey is a low risk food)
Reading relevant section in Food Standard Code to refresh knowledge
Print out Label Buster document for the business owner and making sure to have
all needed equipment like note taking book, pen, camera and identity card and be
sure of their powers of entry
4.3 Investigation
Identify yourself to shop assistant, display your ID describe why you are at their venue,
tell them the nature of the complaint and what your investigation will entail and inform
them about their rights,
Obtain the contact details of the owner of the business eg is company involved in the
ownership, company name, director and address.
Conduct your inspection of the product (honey) assess labelling. There were 25 tubs of
honey on display that was found to have no labelling on it only a price tag.
Gather evidence ( eg photographs of the product /documents relating to the supplier of
the product Interview k shop assistant about the product and try to gather as much
information as possible, especially in regards to the manufacturer
Instruct the shop assistant to remove the product from display/sale if the product was
deemed to be a significant health risk it could be seized as evidence of an offence
against the Act.
4.4 Post assessment
Following the inspection the owner of the business was contacted to advise him of
the nature of the complaint and the action taken during the inspection Informed
him that an He was advised that an Improvement Notice will be issued in respect to
the non-compliant labelling on the product and that a follow up inspection will take
place around four weeks from now
Education of the shop owner that adequate labelling is his responsibility
Advice to the shop owner to return the honey to the manufacturer to get it labelled
correctly
Preparing a memorandum for Team Leader

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Enter all information into MAPLE system


Prepare an Improvement Notice to owner
Place a bring up on the file for follow up inspection

5.) Discussion
This case Illustrates that even a small case like this can have a significant impact on an individuals
health. If wrong or misleading labelling is not discovered early, it can affect a broad number of
people and pose a major risk to the community. The loss of work hours of affected people and their
recovery costs over the MediCare system exceeds the costs for any inspection and administrative
procedure.
Proper labelling also protects Australian manufacturer and their contribution to the economy and
employment market. This will have a huge impact on the Australian economy and can encourage
manufacturers to produce in Australia. Many Australians trust and support the label Made in
Australia and good food labelling will support customer choices and national and local producers.
Good labelling also encourages a responsible and controlled use of substances that can possess a
hazard to the environment. All ingredients are listed on the label, therefor a control what is in the
food and therefor what the manufacturer needed is known and a management of potential
hazardous substances is possible.
The most important point is to give important information to the consumer. Allergens play a major
role, but also nutrition information is very important. This has a broad importance ranging from a
healthy nutritious diet to specific dietary needs like low fat, carbohydrates or low level of salt.
6.) Conclusion
Community and individual health, economic interests and environmental protection all justifies good
labelling practices and the costs involved in controlling and enforcing them in Australia. The practice
of QLD Health in providing small manufacturers and retail owner with a Label Buster brochure is a
good way to reduce a big code into an easy to use and to understand piece of paper for small retail
owners. A recommendation for a future program would be to educate the public about their rights
to bring any concerns of labelling to their local Public Health Unit to establish a watchdog function
of the broad public like in other areas eg. environmental protection in the developing industry.
7.) Learning outcome
This activity covered most of my learning goals which I developed prior to the placement. I gained
firsthand experience about the knowledge, skills and role of an EHO employed by QLD Health. Which
covered the objectives of shadowing a senior EHO and a deeper understanding of occupational
relevant legislations and how they are integrated (Goals 1&2)
During the process I discussed the matter of the case, possible legal frameworks and how to proceed
with the investigation with the assigned EHO. Once at the place I could observe how the EHO is
communicating with the shop assistant and later at the office his communication skills on the phone.
This gave me a very good picture on how to communicate within the profession and towards the
public (Goal 3).

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I also gained in insight of how to obtain and analyse information, starting to develop the ability of
critical judgement for a situation and working in a team to find a solution to a specific problem (Goal
4).

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C.) Assignment 2 - Investigation Report


1. Description of the incident
On 30 June 2016 an email was received from Director of Pharmacy advising of a drug discrepancy of
9 x clonazepam 2mg tablets (DS4) reported missing from pharmacy on 29 June 2016. Drugs is listed
under the Queensland Health (Drugs and Poisons) Regulation 1996. The stack count on the
28/06/2016 was recorded being tablets. There was a distribution of 20 tablets to EDSSU on the
24/06/2016 and the person in charge recalled counting the amount of tablets, but did not have a
clear memory of counting the remaining tablets.
Clonazepam is listed as a CD4 under the Controlled Drug (S8) or Designated Drug (DS4) Gold Coast
Hospital and Health Service. This requires pharmacies and hospitals to lock the drugs in a safe place
and counting them with every change of working shift. Counting has to be conducted by two people,
for example a registered nurse and a second person as a witness. Any discrepancy has to be
immediately reported to the director of pharmacy.
Pharmacy staff already

Checked the distributions and orders for clonazepam 2mg and .5mg;

Checked all disposals;

Checked all returns of clonazepam;

Checked the count of clonazepam 0.5mg (all balanced);

Physically checked the count of clonazepam and CD books on wards C3W and EDSSU as they
were the only wards that had received clonazepam 2mg on 28 June 2016 and 29 June 2016

Checked lorazepam in case the wrong drug had been dispensed (all matched); and

Physically checked the floor, fridge, night cupboard and safe for loose tabs.
The Director of Pharmacy reported also that they had reviewed the CD safe swipe card entry records
and there was no indication that anybody had entered the CD safe that was not authorised to enter.
A list of employees who were working in the CD safe area preparing the ward orders when the
discrepancy was identified and the preceding day was made. Furthermore the Director of Pharmacy
provided paperwork of all transactions, returns, Ipharmacy stock movement etc. There had been
one return of clonazepam to pharmacy from C4E on 27/06/2016 conducted by a pharmacist and this
consisted of 8 x tabs of clonazepam 2mg and 1 x tablet of clonazepam 0.5mg

2. The role of the enforcement agency involved


The role of the GCPHU under the Controlled Drug (S8) or Designated Drug (DS4) Gold Coast Hospital
and Health Service was to investigate the case, because it is considered as a minor incident and is
therefor directed to the unit for an internal investigation. The aim is to find out if it was a criminal
act or a matter of bad book keeping and/or bad handling practises of drugs. For this, the Department
of Pharmacy (DOP) is sending out a request to the Gold Coast Public Health Unit to investigate the
case and report results back to the DOP.

3. Relevant Legislation, Standard, Code


Queensland Health (Drugs and Poisons) Regulation 1996
The Health (Drugs and Poisons) Regulations 1996 (HDPR), is the legislation that governs medicines
management, storage and access in Queensland
Controlled Drug (S8) or Designated Drug (DS4) Gold Coast Hospital and Health Service
This document outlines the Gold Coast Hospital and Health Services (GCHHS) procedures for
applying that legislation specifically for CD (CD) and Designated Schedule 4 medications (DS4). The

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procedures are intended to ensure the safe use of these medications while providing detailed
guidance on how to operationally apply the requirements of the Regulations, in addition to
Queensland Health (QH) corporate policies. These procedures apply to all staff working within the
Hospital and Health Service (HHS) in all settings, during the performance of their required duties.

4. Normal Procedure for CD4 and SD in Pharmacies


In the Pharmacy Departments, all transactions will be processed through the State-wide Pharmacy
Information Management System (QHPIMS). However, at present, these records do not meet
Legislative requirements as the sole record for a transaction and therefore manual records must also
be maintained. The way of making records is documented in the Pharmacy department specific work
instructions. Every form and every strength of a drug will generally have its own register, except in
unusual circumstances of an item that has very infrequent usage.
Within the pharmacies, CD/DS4 will be stored at all times in the approved safe. This will include all
inventory, dispensed medication and medication waiting for destruction. The combination of the
safe will be known only to pharmacists. Suitably qualified dispensary assistants will have daytime
access to the safe to perform their imprest and dispensing duties under the personal supervision of a
pharmacist.
The safes at both Robina hospital and GCUH support individual access codes and swipe cards and
their use will be regularly reported and audited. Access codes will be set up and maintained by the
Director and Assistant Director of Pharmacy.

5. Investigation
The appropriated procedure to be followed in possession, storage, distribution and the use of CDs
and DS4 is written out in the QLD Health Controlled Drugs (CD) and Designated Schedule 4 (DS4)
Medicines Management, Gold Coast Hospital and Health Service document. In accordance to the
information given in point 4 (Normal Procedure for Cd4 and SD in Pharmacies) of this report , the
officer undertook the following investigation measures:
The officer met with the Director of Pharmacy who advised that following action were taken by
pharmacy staff to locate the clonazepam:

Checked the distributions and orders for clonazepam 2mg and .5mg;

Checked all disposals;

Checked all returns of clonazepam;

Checked the count of clonazepam 0.5mg ( all balanced);

Physically checked the count of clonazepam and CD books on wards C3W and EDSSU as they
were the only wards that had received clonazepam 2mg on 28 June 2016 and 29 June 2016
respectively ;

Checked lorazepam in case the wrong drug had been dispensed (all matched); and

Physically checked the floor, fridge, night cupboard and safe for loose tabs
Furthermore the Director of Pharmacy undertook the following actions to help to identify the cause
of the missing drugs:

advised that they had reviewed the CD safe swipe card entry records

list of employees who worked in the Cd safe area at the time

paperwork (refer folio 2) of all transactions, returns, Ipharmacy stock movement etc.
The officer undertook the below described actions to investigate the case after receiving all tge
information from the Director of Pharmacy:
Reviewed the CD book for the clonazepam and confirmed the count was correct.
Interviewed stuff of the pharmacy department
Request official statement of all involved people

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Conduct a count of the clonazepam and check the CD book and all balanced
check all Pharmacy CD order forms for June

6. Identification of potential offence


The investigation revealed no provable offence for any investigated person.

7. Findings & Conclusions

It is possible that the 9 x Clonazepams were stolen by a person within pharmacy and with
access to the CD safe, however the officer was unable to determine who may be responsible

Whilst the officer was unable to account for where or how the clonazepam was taken, the
fact that it was the pharmacists first 2 days working in that position in the pharmacy I cannot
discount that there has been an error made somewhere but it could not identified where in the
system

In addition the officer feels that if a person was going to steal drugs the question arises why
would they take 9 x Clonazepams an S4 drug when they could take any number of controlled drugs
from the safe. Further Clonazepam and other S4s are disposed of in the purple discard bins within
pharmacy and can be easily accessed without going into the safe. In addition the drugs in the purple
bins are not accounted for and would not raise any suspicion if taken

8. Options for resolution & future improvement


In accordance with the pharmacy unit management the following actions will be taken to
ensure that similar cases will not occur in the future.

Recommendation for a CCTV camera to be installed in the pharmacy CD safe


Ensure all stuff is well trained in bookkeeping
Allow extra time, especially for new team members, to allow proper bookkeeping and
counting of drugs

These actions were suggested by the pharmacy unit itself as a proactive action and to demonstrate
the will to fulfil legislation requirements.

9. Recommended course of actions


No further action required

But an EHO will be always available to answer questions and help to solve arising problems
within the pharmacy unit to support and ensure that legislation requirements are met

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Title

Microbiological Contamination of Deli Meats on the


Gold Coast
Description
Identification of microbiological contamination among different delicatessen venues
and supermarket delis on the Gold Coast

File Description
Food Safety Projects
Sale of Deli Meat Products
File # n/a

Date Created
08/08/2016

Accountable Officer/Project Leader


David Mueller (EHO Student)

Supervisor
Dieter Jurgeneit TL

Time Frame
August 2016- November 2016

Completion Date
n/a

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Practicum Report David Mueller

Content

Number

Title

Page

1.0

Purpose of Project/Survey

19

2.0

Objective

19

3.0

Performance Indicators

19

4.0

Rational

19

5.0

Methodology

20

6.0

Activities/Tasks

21

7.0

Results

22

8.0

Discussion

22

9.0

Recommendation

23

10.0

Limitation

23

11.0

Stakeholders

23

12.0

Budget/Resources

23

13.0

Reference List

24

14.0

Appendices

25

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1.0 Purpose of Project/Survey


The purpose of this survey is to identify if there is an increased risk to the public caused by
the increasing popularity of deli meats, especially with the rise of small delicatessen venues
on the Gold Coast.
To evaluate the risk to the public, I investigate this kind of venues and compare them to
delis from big market venues like Woolworth and Coles. With this, we hope to extract
data that will answer the following questions:
1.) Is there an increased public health risk from deli meats in general?
2.) Is there an increased public health risk from small businesses compared to big food
chains?
3.) When there is a microbiological contamination, which are the pathogens of most
concern and what is their source.

2.0 Objectives
By the end of the project I aim to have:
Determined if all results meeting the QHF&SS Standards
Collected 60 samples of three different types of deli meats (chicken roast, beef roast and
ham) and sent them to QHF&SS for analysis.
Randomly sampled meats from an even number of supermarkets and delicatessen
venues
Spatial regional contribution over the Gold Coast area
All unsafe results will be reported to CoGC for further investigation in regards to
complying with the Food Standards

3.0 Performance Indicators


Performance indicators of these objectives will be:
Number of food samples collected (Target = 60).
Even contribution of supermarket and delicatessen venue
Even regional contribution of venues
Proper sampling techniques and storage of the food samples to guarantee adequate
results
All unsafe results identified reported upon and communicated to City of Gold Coast
(CoGC).

4.0 Rationale
Small continental delicatessen shops are an fast growing market in Australia and on the
Gold Coast. They supply the public with European and Australian luncheon meat and a
variety of cheese delicatessen like prosciuttos, salami, lioner and up market quality ready to
eat items of chicken breast, ham and roast beef.
There might be an increased public health risk due the increasing numbers of venues and
customers who purchase these products. Most businesses are small, family owned
companies and concern arrives on safe food handling practices and hygiene of the facilities
with a special focus on the meat slicer which is a critical control point for cross contamination
of food borne illness (FBI)

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OzFoodNet (2011) site reported for the year 2002 that there were 92 foodborne disease
outbreaks affecting 1,819 persons, of whom 5.6 per cent (103/1,819) were hospitalised and
two people died. There was a wide range of foods implicated in these outbreaks and the
most common agent was Salmonella Typhimurium. In the 2011 Annual Report there were 2
outbreaks related to delicatessen stores with 55 affected people. From this 100% were
caused by Salmonella. Source was roast chicken pieces served cold and the contamination
pathway was via cross contamination from a point source cohort (45 cases) and from a case
series (10 cases). The presence of Salmonella, e.coli, staphylococci and camplobacter
indicates poor food preparation and handling practices such as inadequate cooking or cross
contamination. Whereas the presence of listeria may indicate a failure with food handling
controls.
As seen in the reviewed literature and on the list of pathogens, poor food handling and t
cross contamination are the area of biggest concern. The cross contamination via a point
source is the leading cause of microbiological contamination of deli meats and here the meat
slicer is of most interest. A mathematical model developed by Sheen and Hwang (2009) for
the cross contamination of E.coli from the slicer to ready-to-eat-meat (RTE) revealed that
there is a high risk of spreading the pathogen and once the blade is incubated, a large
number of follow up slices will be affected. Because bacteria attach to food contact surfaces
by residual food components and transfer to other food items. The second most common
bacteriological species found on blades are from the family Enterobacteriaceae. This result
is confirmed by another study that found out that the meat slicer is a major source for cross
contamination of enterobacteriaceae pathogens (Koo et al, 2012)
the meat slicer as the biggest risk of a point source and with it poor food handling and
hygiene practices in combination with an emerging market of small family sized businesses
might possess an increasing risk for public safety.

5.0 Methodology

Conduct sampling at delicatessen stations of two major retailers, Delicatessen Delis


and small supermarkets

Spatial distribution for each type of premises: 1x GC North, 1x GC South, 1x GC


West, 2x GC Central. A total of 5 premises for each type of business.

Purchas 3 food samples from each premise for analysis. The samples are ready to
eat ham, chicken breast and roast beef, with a sample size of 100g per sample.

Purchased samples were kept under temperature control as recommended in the


QHF&SS Sampling Guidelines.

All samples were delivered to the laboratory by the next day


The Food Standards Australia New Zealand Guidelines for the Microbiological
Examination of Ready-to-EatFoods (December 2001) was used by QHFSS to
provide quantitative levels of microbiological quality for ready-to-eat-foods. These
guidelines identify four categories of microbiological quality ranging from
satisfactory to potentially hazardous. This reflects both the high level of
microbiological quality that is achievable for ready-to-eat-foods and indicates the
level of contamination that is considered to present a significant risk to public
health. The four categories are outlined as follows:
o (S) Satisfactory: Results indicate good microbiological quality. No action
required;

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Practicum Report David Mueller

o
o

(M) Marginal: Results are borderline in that they are within limits of
acceptable microbiological quality but may indicate possible hygiene
problems in the preparation of the food;
(US) Unsatisfactory: Results are outside of acceptable microbiological
limits and are indicative of poor hygiene or food handling practices:
(PH) Potentially Hazardous: The levels in this range may cause food
borne illness and immediate remedial action should be initiated.

Microbiological Quality ( CFU per gram)


Test

US

PH

Standard Plate Count

Level 1

< 104

< 105

Greater than
or equal to
105

Indicators

Escherichia coli

< 10

10- 100

Greater than
or equal to
100

**

Pathogens

Coagulase +ve
staphylococci

<102

102-103

103-104

Greater than or
equal to 104set
+ve

Clostridium perfringens

<102

102-103

103-104

Greater than or
equal to 104

Bacillus cereus and


other pathogenic Bacillus
spp

<102

102-103

103-104

Greater than or
equal to 104

Salmonella spp

not detected
in 25g

detected

Listeria monocytogenes

not detected
in 25g

Detected
but
<102++

Greater than or
equal to 102##

**Pathogenic strains of E. coli should be absent.


Obtained from FSANZ http://www.foodstandards.gov.au/scienceandeducation/publications/guidelinesformicrobi1306.cfm

6.0 Activities/Tasks
1. Present project plan to Queensland Health Forensic and Scientific Services for

advice on their capacity for sample quantities and analysis timeframes. Request for
food samples to be analysed for Standard plate count, Salmonella spp, E. coli,
Coagulase Positive Staphylococci, Bacillus cereus, Listeria and Clostridium
perfringens).

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Practicum Report David Mueller

2. Create an individual folder on the hard drive (MAPLE and EH InfoNet) for the project
3. Create a hard copy for book keeping
4. Identify potential venues for food samples
5. Create a sampling plan for an even contribution over the Gold Coast
6. Collection of 9-12 samples from 3-4 venues each Monday morning
7. Sending samples of to QHFSS for analyses
8. Discuss results and further project plan with team leader
9. Enter all received data onto hard drive and print out copies for folder
10. Student EHO to evaluate results of laboratory analysis.
11. Non-compliant samples may require follow up sampling, with possible joint inspection

with CoGC.
12. Data to be collated and analysed.
13. Student EHO to prepare project completion report and submit to TLEH(C).

7.0 Results
As of 18/10/2016. For a full list of results refer to Appendix 1, for visual presentation to
Appendix 2.

In total, 1 samples (3.5%) contained Listeria welshimeri. This sample was


considered an unsatisfactory sample, although Listeria welshimeri is not specified
in the FSANZ guidelines for microbiological examination in ready-to-eat foods.
QHFSS provided comment that other Listeria species indicates that there is an
environment present that facilitates the growth of Listeria including Listeria
monocytogenes.

1 sample (3.5%) contained Listeria monocytogenes.

6 samples (10.5%) were of a marginal microbiological standard;


o

6 samples (15.8%) contained high plate count (>2.5 x 105 cfu/g)

9 samples (12.3%) were regarding as being of an unsatisfactory microbiological


standard;
o

9 samples (15.8%) contained high plate counts. (>2.5 x 108 cfu/g)

The laboratory reported the cases of Listeria monocytogenes in a timeline manner (24
hours) to the GCPHU, because Listeria monocytogenes is under the Food Act 2006
Section 270 a described contaminant.

8.0 Conclusion
The project revealed no elevated risk of microbial contaminated of deli meats from small
delicatessen venues. The negative results are caused only by high SPC and indicate that
better general hygiene and food handling practices needs to be in place. On the contrary,
samples with listeria were only found in samples from supermarket delis.
This demonstrates that the size of a venue is not important and that good food handling
practices and cleaning schedules are the most important factors to guarantee public health
safety. In regards to public health safety, the listeria results are much more concerning and
any kind of further investigation should take place into this direction.

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Practicum Report David Mueller

9.0 Recommendations
Future recommendation should include a state wide investigation of supermarket delis and
more frequent inspection of them from local councils. An information letter to the
supermarkets and delicatessen shops explaining the findings of the project and a
recommendation to re-evaluate their cleaning schedule and food handling plan should be
also send out. Referral of the results to CoGC environmental Health section

10.0 Limitations

Sampling from only 4 small supermarket delicatessen instead of five

New guidelines for microbial contamination were introduced on the 01/10/2016. This
report was conducted with the old ones

11.0 Partners/Stakeholders
City of Gold Coast
Queensland Health Forensic and Scientific Services
Gold Coast Public Health Unit

12.0 Budget/Resources
Base.

Signature of Accountable Officer


Name:

David Mueller

Position:

Student Environmental Health Officer

Date:

29/08/2016

Signature of Approving Officer (MEH/TLEH)


Name:

Dieter Jurgeneit

Position:

A/Team Leader (Compliance)

Date:

/2016

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Practicum Report David Mueller

13.0 Reference List


Koo,O., K., Mertz, A., W., Akins, E., L., Sirsat, S., A., Neal, J., A., Morawicki, R., Grandall,
P., G. and Ricke, S., C. (2012). Analysis of microbial diversity on deli slicers using
polymerase chain reaction and denaturing gradient gel electrophoresis technologies.
Letters in Applied Microbiology, 56(2), 111-119.
doi: 10.1111/lam.1202
Monitoring the incidence and causes of diseases potentially transmitted by food in Australia:
Annual report of the OzFoodNet network,2011. (2015). Retrieved from
http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-cdi3902g.htm
Sheen S. & Hwang, C.A. (2010). Mathematical modeling the cross-contamination of
Escherichia coli O157:H7 on the surface of ready-to-eat meat product while slicing.
Food Microbiology, 27(1), 37-43. doi: 10.1016/j.fm.2009.07.016

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Practicum Report David Mueller

14.0 Appendices
Appendix 1
Laboratory Results
Product

SPC

Salmonella

Camphylobacter

Listeria

Chicken Breast

>2.5x10*7

Not detected

Not tested

Not detected

Roast Beef

<1.0x10*3

Not detected

Not tested

Not detected

Ham

5.6x10*4

Not detected

Chicken Breast

2.1x10*4

Not detected

Corned
Silverside

4.0x10*4

Not detected

Ham

7.4x10*4

Not detected

Chicken Breast

1.0x10*3

Not detected

Roast Beef

5.9x10*5

Not detected

Ham

2.5x10*7

Not detected

Chicken Breast

2.5x10*7

Not detected

Roast Beef

4.5x10*6

Not detected

Ham

8.2x10*5

Not detected

Chicken Breast

3.0x10*4

Not detected

Roast Beef

1.2x10*4

Not detected

Ham

1.0x10*3

Not detected

Chicken Breast

1.6x10*6

Not detected

Roast Beef

1.9x10*7

Not detected

Ham

7.1x10*4

Not detected

Chicken Breast

1.3x10*7

Not detected

Roast Beef

2.5x10*7

Not detected

Ham

1.0x10*3

Not detected

Not tested
Not tested
Not tested

Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested

Not detected
Not detected
Not detected

Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Detected
Detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected

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Practicum Report David Mueller

Chicken Breast

1.0x10*3

Not detected

Roast Beef

1.0x10*3

Not detected

Ham

1.0x10*3

Not detected

Chicken Breast

1.0x10*4

Not detected

Roast beef

2.5x10*7

Not detected

Ham

3.6x10*4

Not detected

Chicken Breast

2.5x10*7

Not detected

Roast Beef

2.5x10*7

Not detected

Ham

1.5x10*6

Not detected

Chicken Breast

7.8x10*4

Not detected

Roast Beef

7.5x10*4

Not detected

Ham

1.5x10*3

Not detected

Chicken Breast

4.5x10*3

Not detected

Roast Beef

6.0x10*5

Not detected

Ham

2.0x10*5

Not detected

Chicken Breast

7.7x10*4

Not detected

Roast Beef

1.5x10*5

Not detected

Ham

8.0x10*5

Not detected

Pastrami

1.0x10*4

Not detected

Krakowska

3.0x10*3

Not detected

Ham

4.9x10*6

Not detected

Ham

1.1x10*7

Not detected

Roast Beef

2.5x10*7

Not detected

Chicken Breast

1.2x10*5

Not detected

Chicken Breast

1.3x10*6

Not detected

Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested

Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Detected
Detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected
Not detected

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Practicum Report David Mueller

Roast Beef

1.6x10*6

Not detected

Ham

1.0x10*3

Not detected

Ham

4.5x10*3

Not detected

Turkey Breast

2.0x10*3

Not detected

Roast Beef

7.4x10*6

Not detected

Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested
Not tested

Yellow = Marginal

red= unsatisfactory

Not detected
Not detected
Not detected
Not detected
Not detected

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Practicum Report David Mueller

Appendix 2 Visual Presentation

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Practicum Report David Mueller

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Practicum Report David Mueller

30