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To investigate the distribution of blood lead levels in a sample of Victorian children, and to compare current levels with those from a similar survey in 1979, blood was tested for lead in 252 children (123 under five years) attending Royal Children's Hospital as outpatients and having venepuncture blood samples for medical reasons. Blood lead levels were determined by graphite furnace atomic absorption spectrophotometer. The mean blood lead level was 0.26 mu mol/L (5.4 mu g/dL). In the under-five age group, the mean was 0.28 mu mol/L (5.7 mu g/dL). Only 1.6 per cent of this group exceeded the National Health and Medical Research Council action level of 0.72 mu mol/L (15 mu g/dL). Levels in this age group have declined significantly since 1979, when the mean was 0.54 mu mol/L (11.1 mu g/dL) and 12.9 per cent exceeded 0.72 mu mol/L (15 mu g/dL). Average blood lead levels have halved since 1979, with likely contributing factors being reduced exposure from lead in diet, reduced access to lead in paint and reduced lead in ambient air. Children with elevated levels had identifiable risk factors such as pica or exposure to lead-based paint, suggesting the need for ongoing pubic health action to prevent exposure in these groups.

To examine population iodine status in Tasmania after mandatory iodine fortification of bread and assess the magnitude of difference compared with results from a period of voluntary iodine fortification.A cross-sectional urinary iodine survey of schoolchildren from classes that included fourth-grade students was conducted in Tasmania in 2011. Results were compared with surveys conducted before fortification and during a period of voluntary fortification.Three hundred and twenty students aged 8-13 2013s from 37 participating school classes.Median urinary iodine concentration (UIC) and proportion of UIC results50 µg/L.Median UIC in 2011 was 129 µg/L, and 3.4% of samples had a UIC under 50µg/L. This was significantly higher than during the period of voluntary fortification (129 µg/L v 108 µg/L) (P0.001), which was significantly higher than before fortification (108 µg/L v 73 µg/L) (P0.001). There was a reduction in the proportion of samples with UIC under 50 µg/L after mandatory fortification (3.4%) compared with results from the period of voluntary fortification (9.6%) (P = 0.01), which was a further reduction compared with results from the prefortification period (17.7%) (P0.001).Iodine status in Tasmania can now be considered optimal. Mandatory iodine fortification has achieved significantly greater improvements in population iodine status compared with voluntary fortification. However, surveys of schoolchildren cannot be generalised to pregnant and breastfeeding women, who have higher iodine requirements. Measurement of iodine status in population surveys is warranted for ongoing monitoring and to justify the appropriate level of fortification of the food supply into the future.

OBJECTIVE: To assess the impact of iodine fortification of bread on the iodine status of pregnant women, and to determine if studies of iodine levels in school-age children were indicative of women's gestational iodine status. DESIGN: Urinary iodine surveys of pregnant Tasmanian women before and after bread was fortified with iodine in October 2001. PARTICIPANTS AND SETTING: 285 women attending the Royal Hobart Hospital (RHH) antenatal clinic from 1 October 2000 to 30 September 2001 and 517 women attending the RHH antenatal clinic or primary health care centres in 2003-2006. MAIN OUTCOME MEASURES: Median urinary iodine concentration (UIC) for comparison against the World Health Organization recommendation of of 150-249 microg/L for pregnant women. RESULTS: Before supplementation, the median UIC of the 285 women attending the RHH antenatal clinic was 76 microg/L. After supplementation, median UICs were 81 microg/L for 288 women attending primary health care centres and 86 microg/L for 229 women attending the RHH antenatal clinic. Differences in mean UIC were not significant for either the antenatal clinic group (P=0.237) or the primary health care group (P=0.809) compared with the pre-supplementation group. CONCLUSIONS: Iodine deficiency in pregnancy persists despite being corrected in Tasmanian children. Successful iodine supplementation must target reproductive-age and pregnant women and be substantiated by ongoing monitoring during pregnancy and lactation. A robust national program for correcting iodine deficiency is urgently needed. Mandatory universal salt iodisation has international endorsement, and should be considered the preferred strategy for eliminating iodine deficiency in Australia.

This chapter will help you to understand the environmental health in the rapidly changing context of health protection, the usefulness of having a framework for environmental health risk assessment, and the process of identifying, evaluating, and planning a response to an environmental health threat.

From February 1, 2000, to December 4, 2001, a total of 119 bats (85 Megachiroptera and 34 Microchiroptera) were tested for Australian bat lyssavirus (ABLV) infection. Eight Megachiroptera were positive by immunofluorescence assay that used cross-reactive antibodies to rabies nucleocapsid protein. A case study of cross-species transmission of ABLV supports the conclusion that a bat reservoir exists for ABLV in which the virus circulates across Megachiroptera species within mixed communities.

Objective To review epidemiological investigations into the epidemic of eosinophilia-myalgia syndrome which occurred predominantly in the United States of America in mid to late 1989, and examine the implications for similar urgent public health research in Australia. Data sources Published data from epidemiological research, and relevant regulatory statements. Outcome Intensive epidemiological investigations established that eosinophilia-myalgia syndrome was strongly associated with ingestion of L-tryptophan produced by a single manufacturer. It is likely that an identified contaminant has a role in pathogenesis, although the mechanism of action remains unclear. Conclusions Rapid epidemiological investigation led to early containment measures and prevention of further public exposure to the causative agent. The episode highlighted the importance of preparedness amongst public health organisations to promptly initiate investigations of disease outbreaks, and demonstrated the benefits of a nation-wide ability to coordinate these studies. There may be encumbrances to urgent public health research in the form of inadequate mechanisms of data linkage. It is recommended that attention be given to such barriers now rather than in a time of crisis.

This chapter reviews the history of iodine deficiency, supplementation and monitoring of school age children in the state. The history of iodine nutrition from 1949, when the first survey and supplementation program was undertaken, to the late 1980s when the population was considered to be iodine sufficient is reviewed. Details of the surveys conducted to confirm the re-emergence of iodine deficiency following a period without regular monitoring are presented. And the outcomes of a subsequent voluntary program of bread fortification and a series of post-fortification urinary iodine surveys are discussed. The re-emergence of deficiency coincided with a decline in iodine levels in milk at a time when milk was the major dietary source of iodine for the population. Voluntary fortification of bread has led to improved iodine nutrition in Tasmanian children, although girls remain borderline deficient. Reliance on a serendipitous and nonlegislated supply of iodine, as was the case with milk, is dangerous and can lead to a rapid return to deficiency when industry practices change. Mandatory fortification, preferably universal salt iodization, is required to eliminate iodine deficiency in all groups in the population. Ongoing monitoring of the population will help ensure that iodine nutrition is adequate and does not return to deficiency.

OBJECTIVE To describe changes in the iodine status of Tasmanians following voluntary fortification of bread with iodine in October 2001. DESIGN AND SETTING Post-intervention, cross-sectional urinary iodine surveys of Tasmanian schoolchildren aged 8-11 years were used to assess population iodine status. Participants were selected using a one-stage cluster sampling method. The sampling frame comprised classes containing fourth-grade children from all Tasmanian government, Catholic and independent schools. Results were compared with pre-intervention survey results. MAIN OUTCOME MEASURES Median urinary iodine concentration (UIC) and percentage of UIC < 50 microg/L ascertained from spot urine samples. RESULTS Median UIC was 75 microg/L in 1998, 72 microg/L in 2000, 105 microg/L in 2003, 109 microg/L in 2004 and 105 microg/L in 2005. Median UIC in post-intervention years (2003-2005) was significantly higher than in pre-intervention years. The percentage of UIC results < 50 microg/L was 16.9% in 1998, 18.7% in 2000, 10.1% in 2003, 10.0% in 2004 and 10.5% in 2005. CONCLUSION Despite methodological differences between the pre- and post-intervention surveys, switching to iodised salt in bread appears to have resulted in a significant improvement in iodine status in Tasmania. Given iodine deficiency has been identified in other parts of Australia and in New Zealand, mandatory iodine fortification of the food supply in both countries is worthy of consideration. As voluntary fortification relies on industry goodwill, mandating fortification could be expected to enhance population reach and give a greater guarantee of sustainability in Tasmania.

Background Depressive and anxiety disorders are common among working adults and costly to employers and individuals. Mental health screening is often an important initial strategy, but the resultant data are often of unknown representativeness and difficult to interpret. In a public sector workforce, this study used a brief screener for depression/anxiety to: a) compare prevalence of high psychological distress obtained from a researcher survey with an employer survey and population norms and b) verify whether expected correlates were observed in a screening setting. Methods Participants were public servants working for an Australian state government. High psychological distress (Kessler-10 ≥22) stratified by age and sex was compared for a random weighted sample researcher survey (n = 3406) and an anonymous volunteer employer survey (n = 7715). Prevalence ratios (PR) were estimated from log binomial regression. Results Referencing the researcher survey, prevalence of high psychological distress was greater by age and sex in the employer survey but was only dependably higher for men when compared with population norms. Modelling suggested this may be due to work stress (effort-reward imbalance) (PR = 3.19, 95% CI 1.45-7.01) and casual/fixed-term employment (PR 2.64, 95% CI 1.26-5.56). Conclusions Depression and anxiety screening using typical employer survey methods could overestimate prevalence but expected correlates are observed in a screening setting. Guidance for employers on screening and interpretation should be provided to encourage engagement with mental health prevention and treatment programs in the workplace.