Environmental factors and food safety

Introduction

Environmental risk and protective factors are comprised of a broad range of physical, chemical, biological, cultural and ergonomic exposures that influence our health and wellbeing at home, in the outdoors and at work. They may be part of our natural or built environments and many exposures devised for human purposes, such as the burning of fossil fuels, poisons (for example pesticides) and plastics can contaminate our soil, air and water. Although human health has improved dramatically since 1950, this gain has been accompanied by environmental degradation globally that now threatens both human health and life-support systems.¹

The World Health Organization (WHO) estimates that 24% of all global deaths and the loss of 602 million disability-adjusted life years (DALYs) are linked to the environment in 2016.²

The 2018 Australian Burden of Disease Study includes environmental risk factor information for:

• Air pollution that accounted for 1.3% of the total burden of disease (DALY)
• Occupational exposures and hazards that accounted for 1.8% of the total burden of disease (DALY).³

In 2018–19, health system spending attributable to those risk factors was $550.9 million and $352.0, respectively.⁴

Built environment

Housing

Housing strongly affects health and wellbeing. Homelessness, poor quality housing, frequent moving and being in financial housing stress are associated with greater psychological distress and poor physical health outcomes. Because affordable housing is located further from city centres, travel times can increase, reducing time for healthy behaviours and contributing to health disparities.⁵

Household crowding indicates socioeconomic disadvantage, contributing to a range of adverse physical and mental health outcomes.⁶ A 'severely' crowded dwelling requires four or more extra bedrooms to adequately house usual residents and is a risk for future homelessness.⁷ In 2021, Queenslanders in private dwellings had:

• 6% living in dwellings considered crowded and 16.6 per 10,000 living in severely crowded dwellings
• 1 per 10,000 First Nations peoples living in severely crowded dwellings—6.7 times higher than for Queensland overall.⁸

Homelessness is rising in Australia— in the four years to 2021–22:

• the average monthly number of people using homelessness services nationally increased by 8%— double the national population increase over that period
• there was a 22% increase in homeless people in Queensland and regional Queensland had one of the fastest growing rates in Australia for people accessing homelessness services (up 29%)
• Increasing cost of living and housing stress are key drivers—the average number of people accessing homelessness services because they could not pay rent increased by 27%.⁹

Urban form

Urban form, the shape, size, population density and city layout, can have environmental, social and economic impacts affecting health.¹⁰ For example, urban development commonly occurs on green spaces—reducing biodiversity, areas for agriculture, social and recreational activities, and causing tree canopy loss that increases ambient temperature.

Liveable, walkable neighbourhoods have social, economic, environmental and health benefits.¹¹ Brisbane’s 2018 walkability scores showed wide variability with the highest for inner suburbs and lowest for outer regions.¹²

In 2017, 43% of residential street blocks in Brisbane met the length and width targets for street connectivity in order to create walkable block sizes within a maximum perimeter of 560m.¹³ In addition, for the density targets:

• 2% of Brisbane suburbs met the 30 dwellings per hectare target for urban neighbourhoods
• 13% of Brisbane suburbs met the 15 dwellings per hectare target in suburban neighbourhoods.¹³

Travel

Effective transport systems support health by promoting active and public transport options, reducing dependence on travel by cars, and minimising air and noise pollution. In 2018, the vast majority (82.7%) of South East Queensland travel was by private vehicles. Only 9.9% of all trips used active transport (walking or cycling) as the main transport mode and 6.8% used public transport.¹⁴ In 2021, the proportion of South East Queensland’s population that has access to essential services via public transport (within 30 minutes) was 35%.¹⁵

Green and public open spaces

Green and open spaces are important for both physical and mental health to promote physical activity, facilitate social interaction and support biodiversity. More time spent in such environments leads to higher levels of self-reported health and wellbeing. In 2022:

• from 2017 to 2022 there was an overall increase in South East Queensland’s Regional Biodiversity Network from 1,105,900 to 1,177,000 hectares
• the areas identified as community greenspace in South East Queensland had increased from 469,770 hectares in 2016 to 485,442 hectares in 2022.¹⁵

Water quality

In Queensland, drinking water safety is overseen by Queensland Health and the Department of Regional Development, Manufacturing and Water. Key regulatory requirements are:

• all registered drinking water supplies must be operated in accordance with an approved Drinking Water Quality Management Plan (DWQMP)¹⁶
• all DWQMPs are audited regularly to ensure drinking water service providers are complying
• DWQMP plans remain relevant to the drinking water schemes they operate.

Drinking water advisories from Queensland registered drinking water providers declined from 2009 to 2019, which was attributed to overall improvements to Queensland drinking water supply management.¹⁷ More recently, for the period 2020 to 2022, drinking water advisories increased, driven mostly by boil water alerts (Figure 1).

This is thought to be a result of three years of La Nina-associated excess rainfall in Queensland. Frequent, heavy rainfall events can lead to small, and even some medium-sized, drinking water treatment plants being overwhelmed with heavily sediment-laden water. For service providers, their ability to deliver fully compliant drinking water to their customers can become dramatically more difficult—although in most cases water quality returns to normal within a few days.

COVID-19 wastewater surveillance

During most of the COVID-19 pandemic, Queensland Health managed a wastewater surveillance program to track the presence of COVID-19 in the community through wastewater analysis. When this ended in September 2022, over 7,000 samples had been collected and analysed from over 110 locations throughout Queensland. The results from this program added to the information obtained through clinical testing and enhanced Queensland Health’s already comprehensive response to the COVID-19 pandemic.

Safe and healthy drinking water program for First Nations Local Government Areas

Queensland’s 17 First Nations local governments face many challenges providing safe drinking water due to factors such as remote locations, a harsh climate, extreme weather events, limited financial resources and difficulties with recruitment and retention of skilled water treatment plant staff. Since 2017, Queensland Health has led the Safe and Healthy Drinking Water Program for Indigenous communities,^18,19 helping to improve treatment plant operator skill levels, promote local decision-making and enhance the community standing of these essential service workers.

Climate change

Climate change has created significant risks to public services by affecting financial security, insurability, and legal liability and is one of the biggest global health threats of the 21st century. The health system plays a unique role, both contributing to carbon emissions and responding to the health challenges caused by climate change. Nationally, the health sector is responsible for 7% of greenhouse gas emissions and, in Queensland, nearly 50% of government emissions are from the public sector health system, primarily driven by electricity consumption.²⁰

Queensland Health has taken numerous steps to respond to climate-related risks including:

• Released the ‘Climate Risk Strategy 2021–2026’ and related resources outlining the agency’s plan to provide quality and dependable health care services to respond to climate-induced risks—supported by climate risk management training for Hospital and Health Services (HHS).
• Established the Office of Hospital Sustainability (OHS) in 2020 to support energy efficiency and emissions reduction initiatives across Queensland Health, including Solar PV and upgrades to lighting and Heating, Ventilation and Air Conditioning (HVAC) systems. From the Energy Efficiency Program and earlier initiatives, over 130 Queensland Health facilities now have roof-top solar, saving 7,300 tonnes of CO₂ equivalent emissions each year.
• In total, energy efficiency and emissions reduction initiatives have reduced Queensland Health’s carbon emission output by around 60,000 tonnes of CO₂ equivalent each year—equal to taking 12,244 cars off the roads each year.

Air quality

In 2021, air quality in Queensland was monitored in South East Queensland, Gladstone, Mackay, Townsville and Mt Isa. Major pollutants monitored at various places and times include carbon monoxide, nitrogen dioxide, ozone, sulphur dioxide, lead and particulate matter (PM). PM monitoring includes particles less than 10 micrometres in diameter (PM10) and less than 2.5 micrometres in diameter (PM2.5).

In addition to national air quality monitoring, the statewide ambient air monitoring program in Queensland monitors health-based air quality standards. From January to December 2021, no environmental standard exceedances were recorded for carbon monoxide, nitrogen dioxide, ozone or lead at any Queensland monitoring station. However, some exceedances occurred for:

• 1-hour and 1-day average sulphur dioxide concentrations at The Gap in Mount Isa due to industrial emissions
• 1-day average PM10 concentrations at Flinders View in South East Queensland and The Gap in Mount Isa due to regional windblown dust and local dust-generating activities, and at North Ward in Townsville due to smoke from a bushfire
• 1-day average PM2.5 concentrations at The Gap in Mount Isa due to smoke from a bushfire.

All remaining exceedances of the PM10 and PM2.5 1-day standards were directly attributed to an exceptional event (regional dust or bushfire smoke) and could be excluded from compliance with the relevant air quality goals.

Lead

There is no threshold or level of lead known to be safe for our bodies.²¹ Lead and lead compounds are not beneficial or necessary for human health and can be harmful to the human body. Factors that influence symptoms or health effects experienced by lead exposure include:

• a person’s age
• the amount of lead
• the exposure period (long or short)
• the presence of other health conditions.

Although lead can harm people of all ages, unborn babies, infants and children are most at risk. One reason is because they often put their hands and other objects that may be contaminated with lead from dust or soil into their mouths.

Blood lead levels accurately monitor lead exposure. If blood lead levels are greater than 5 micrograms per decilitre (µg/dL), it is recommended that the exposure source be investigated and reduced, particularly for children or pregnant women.²²

Many lead exposures in Queensland are associated with the workplace.²³ Queensland Health supports both the Department of Natural Resources and the Office of Industrial Relations (Workplace Health and Safety Queensland) in their activities to improve the health of workers exposed to lead.

Lead testing at Mount Isa

The Mount Isa Lead Health Management Committee continues to support the point of care testing (PoCT) program undertaken by the North West Hospital and Health Service (HHS) Child Health Services. The PoCT program is supported by the Mount Isa community and is the preferred method to measure a child’s blood lead level. It allows at risk children to be identified and referred to their general practitioner earlier for follow-up and case management if necessary.

The COVID-19 pandemic, along with test consumable material recalls, impacted the program, which was suspended from September 2021 to April 2022. This reduced test numbers from 284 in 2020–21 to 148 tests (144 individual children) in 2021–22. From these:

• 98 children had low to negligible blood lead levels <5 µg/dL
• 38 children had moderate blood lead levels ≥ 5 µg/dL but < 10 µg/dL
• 8 children had high blood lead levels ≥ 10 µg/dL.

Notifiable dust lung diseases

Dust lung diseases (part of a group commonly referred to as Occupational Respiratory Diseases) are a group of debilitating and potentially fatal diseases caused by long-term exposure to high concentrations of respirable dust, most commonly generated during construction, manufacturing, mining and quarrying activities. Dust lung diseases include:

• pneumoconiosis (coal workers’, mixed dust, silicosis, asbestosis and other)
• chronic obstructive pulmonary disease (chronic bronchitis and emphysema)
• cancer (predominantly mesothelioma).

A re-emergence of coal workers’ pneumoconiosis in Queensland in 2015, and a national increase in silicosis over the past two decades, led to the establishment of a time-limited National Dust Disease Taskforce²⁴ and the Queensland Health Notifiable Dust Lung Disease Register (NDLD Register)²⁵ in 2019. In 2021–22 the NDLD Register reported:

• 259 confirmed notifications (255 workers)
• 95% were male
• 56% were 60 to 79 years old
• mesothelioma (28%) and asbestosis (24%) were the most commonly reported diseases
• construction was the most commonly reported primary industry (33%)
• asbestos was the leading exposure reported (55%).²⁶

Food safety and security

Salmonella and Campylobacter notifications

The Food Ministers’ Meetings, with representation from the Australian and New Zealand federal governments and all Australian states and territories, makes food policy and priority decisions to further strengthen food safety. One priority area is to reduce foodborne illness, particularly related to Campylobacter and Salmonella.²⁷ Eggs and egg products continue to be the largest contributor to foodborne salmonellosis cases in Queensland.^28,29

Following a steady decline from 2015 to 2018, Salmonella notification rates have remained relatively stable from 2019 to 2022 (Figure 1).³⁰ However, notification rates in Queensland have been consistently higher than national rates for the past decade.³¹ Work continues with the food service sector in Queensland to improve the handling of eggs and preparation of products containing egg, including the introduction of a new food safety standard, Standard 3.2.2A Food Safety Management Tools,³² and a new guideline for the safe preparation of raw eggs.³³

Campylobacter is a leading cause of foodborne illness, not only in Australia, but internationally.³⁰ In contrast to salmonellosis, campylobacteriosis rates increased over time in Queensland (Figure 1). Reduced testing due to COVID-19 lockdowns may contribute to the decrease in 2020. Nevertheless, Campylobacter remains the most notified cause of gastroenteritis, with poultry confirmed as the main foodborne source in Queensland.^31,34

The Food Pantry

The Food Pantry,³⁵ a digital food safety online portal launched in 2021, provides a one-stop shop for legislative, licensing, and training requirements including:

• online tools such as a self-assessment tool for businesses, food safety complaint form, food label development assistance, and free interactive online training
• educational materials such as food business checklists, fact sheets, templates and posters
• annual reports on food regulatory activities undertaken by Queensland local governments.

The Food Pantry web pages were viewed over 227,000 times in 2021–22.

Kava pilot program

Queensland Health led the Food Regulation Standing Committee National Kava Working Group to assess if national food standards were fit for purpose in light of a Commonwealth proposal³⁶ to allow commercial importation of kava. As a result, urgent amendments were made to the Australia New Zealand Food Standards Code to only permit specified kava plant varieties and explicitly prohibit the use of additives and processing aids in kava. This effectively limits kava to traditional use and prohibits the sale of flavoured and preserved pre-packaged kava beverages, to help prevent the broader unsafe uptake of kava products in the general community. Queensland Health is also assisting the Commonwealth with an evaluation of the health, social, cultural and economic effects of kava in Australia.

Climate change impacts

Extreme weather events such as droughts, floods, cyclones, bushfires and heat waves can have serious consequences for food safety and security. In 2022, significant flooding in Queensland affected food supply chains and subsequently food prices. In addition, 27 local government areas were affected by drought in 2022, representing nearly half of the land area of Queensland.

Climate change increases the risk of food contamination and foodborne illness, for example:

• Environmental stressors, such as extreme temperature variation, can increase Salmonella shedding in chickens.
• Excessive rainfall in 2022 caused heavily seeded pastures in some areas, leading to a mouse plague, which was linked to a higher prevalence of Salmonella in poultry from affected farms.

Substitution of foods that are in short supply, due to local extreme weather events, the COVID-19 epidemic and internationally due to the crisis in Ukraine, is causing labelling and potential allergen issues for Queenslanders. A national coordinated effort is being undertaken to consistently manage food supply chain disruptions for our communities.

Additional information

Data and statistics

The Queensland Government’s State of the Environment Report reports on key priorities for Queensland’s built and natural environment to monitor and evaluate environmental policies and strategies.

Information about national ambient air quality monitoring is available from the National Environment Protection (Ambient Air Quality) Measure report.

Visit the Queensland Health Notifiable dust lung disease register for monitoring reports, making notifications, and patient information.

Strategies and information

For more information about:

• housing strategies visit the Queensland Department of Communities, Housing and Digital Economy Aboriginal and Torres Strait Islander housing webpage
• urban and rural design policies visit the State of the Environment report Liveability webpage
• Queensland Health’s response to climate change, visit the Climate Risk Strategy and Adaptation Planning Guidelines webpage
• Food Ministers’ meetings, which is responsible for developing domestic food regulation policy in the form of policy guidelines nationally
• The Food Pantry, which is A Queensland Government portal for food safety for both businesses and consumers.

Section technical notes

Walkability is measured based on access to shops and services, street connectivity and infrastructure that supports walking or cycling as alternatives to driving.

References

1. Gupta J., Hurley F., Grobicki A., Keating T., Stoett P., Baker E., Guhl A., Davies J. & Ekins P. 2019. Communicating the health of the planet and its links to human health. The Lancet Planetary Health. 3(5): e204–e206. doi: 10.1016/S2542-5196(19)30040-3.
2. World Health Organization. 2023. The Global Health Observatory: public health and environment. Accessed: 12 March 2023.
3. Australian Institute of Health and Welfare. 2022. Australian Burden of Disease Study 2018: interactive data on risk factor burden among Aboriginal and Torres Strait Islander people. Accessed: 23 August 2022.
4. Australian Institute of Health and Welfare. 2022. Health system spending per case of disease and for certain risk factors. Accessed: 10 January 2023.
5. Australian Institute of Health and Welfare. 2022. Australia’s health 2022: data insights. doi: 10.25816/GGVZ-VR80.
6. World Health Organization. 2018. WHO Housing and health guidelines. Accessed: 12 March 2023.
7. Public Health Information Development Unit. 2022. Notes on the data: housing/transport - crowded dwellings. Accessed: 12 March 2023.
8. Public Health Information Development Unit. 2023. Social health atlases: data. Accessed: 12 March 2022.
9. Pawson H., Clarke A., Parsell C. & Hartley C. 2022. Australian homelessness monitor 2022. Sydney.
10. Zapata-Diomedi B., Brown V. & Veerman L. n.d. The effects of urban form on health: costs and benefits: evidence review. Sydney: The Australian Prevention Partnership Centre and the University of Queensland.
11. World Health Organization and UN-Habitat. 2016. Global report on urban health: equitable healthier cities for sustainable development. Italy: World Health Organization.
12. Australian Urban Observatory. 2020. Livability report scorecards. Accessed: 30 March 2023.
13. Gunn L.D., Rozek J., Hooper P., Lowe M., Arundel J., Higgs C., Roberts R. & Giles-Corti B. 2018. Creating liveable cities in Australia: a scorecard and priority recommendations for Brisbane. Melbourne: Centre for Urban Research.
14. Department of Transport and Main Roads. 2019. Queensland household travel survey interactive report (South East Queensland, 2011, 2017 and 2018). Brisbane: Queensland Government.
15. Department of State Development, Manufacturing, & Infrastructure and Planning. 2019. Measures that matter. Accessed: 14 September 2022.
16. Business Queensland. 2022. Quality management plans for drinking water providers. Accessed: 2 January 2023.
17. Queensland Health. 2020. The health of Queenslanders: report of the Chief Health Officer 2020. Brisbane: Queensland Government.
18. Queensland Health. 2019. Queensland Aboriginal and Torres Strait Islander environmental health plan 2019–2022. Brisbane: Queensland Government.
19. Hall N.L., Grodecki H., Jackson G., Go Sam C., Milligan B., Blake C., Veronese T. & Selvey L. 2021. Drinking water delivery in the outer Torres Strait Islands: A case study addressing sustainable water issues in remote Indigenous communities. Australasian Journal of Water Resources. 25(1): 80–89. doi: 10.1080/13241583.2021.1932280.
20. Queensland Health. 2021. Climate Risk Strategy 2021–2026. Brisbane: Queensland Government.
21. World Health Organization. 2022. Lead poisoning. Accessed: 22 December 2022.
22. National Health and Medical Research Council. 2015. Lead blood levels. Accessed: 26 January 2023.
23. Forbes M. & Taylor M.P. 2015. A review of environmental lead exposure and management in Mount Isa, Queensland. Reviews on Environmental Health. 30(3). doi: 10.1515/reveh-2015-0011.
24. National Dust Taskforce. 2021. National Dust Taskforce: final report to Minister for Health and Aged Care. Canberra.
25. Queensland Health. 2020. Notifiable dust lung disease register.
26. Queensland Health. 2022. Notifiable Dust Lung Disease Register annual report 2021–2022. Brisbane: Queensland Government.
27. Food Standards Australia New Zealand. 2022. Australia’s foodborne illness reduction strategy 2018–2021+. Accessed: 30 March 2023.
28. The OzFoodNet Working Group. 2022. Monitoring the incidence and causes of disease potentially transmitted by food in Australia: Annual report of the OzFoodNet network, 2017. Communicable Diseases Intelligence. 46. doi: 10.33321/cdi.2022.46.59.
29. Laidlow T.A., Stafford R., Jennison A.V., Bell R., Graham R., Graham T., Musgrave N., Myerson M., Kung N., Crook A., Wang Q., Richards A. & Lambert S.B. 2022. A multi‐jurisdictional outbreak of Salmonella Typhimurium infections linked to backyard poultry—Australia, 2020. Zoonoses and Public Health. 69(7): 835–842. doi: 10.1111/zph.12973.
30. Munck N., Smith J., Bates J., Glass K., Hald T. & Kirk M.D. 2020. Source attribution of Salmonella in macadamia nuts to animal and environmental reservoirs in Queensland, Australia. Foodborne Pathogens and Disease. 17(5): 357–364. doi: 10.1089/fpd.2019.2706.
31. Queensland Health. 2022. Notifiable conditions register. Accessed: 22 November 2022.
32. Food Standards Australia New Zealand. 2021. Overview: What is Standard 3.2.2A? Accessed: 12 March 2023.
33. Queensland Health. 2022. Safe preparation of raw eggs - a guide for food businesses. Brisbane: Queensland Government.
34. The OzFoodNet Working Group. 2022. Monitoring the incidence and causes of disease potentially transmitted by food in Australia: Annual report of the OzFoodNet network, 2017. Communicable Diseases Intelligence. 46. doi: 10.33321/cdi.2022.46.59.
35. Queensland Government. 2023. The Food Pantry. Accessed: 28 April 2022.
36. Department of Foreign Affairs and Trade. 2019. Australia’s kava pilot. Accessed: 13 March 2023.