Month: April 2018

Keep it in the ground

April saw the UK manage 76 consecutive coal-free hours of electricity – partly due to renewables and partly due to lower demand.   (Coal use increased when the Beast from the East hit and the cost of gas spiked.)  

This coincides nicely with a Royal Society of Chemistry book I am currently reading; ‘Coal in the 21st Century’.  My interest is mainly from an Energy Manager’s background; the burning of coal being responsible for 31% of all greenhouse gas emissions.  Living in the UK, where coal use has dropped by 80% in the last 5 years, and where coal is expected to be phased out by 2025, I don’t think too much about the direct health effects of coal anymore.  (I was born post-Clean Air Act before which the world was in black and white and you couldn’t see the hand in front of your face.)  But, whilst climate change is, according to the Lancet, the biggest threat to human health of the 21st Century, for a lot of the world’s population the health issues related to coal are much more immediate than those from climate change, which sometimes seem distant both geographically and temporally.  

Suffice it to say that I am halfway through the book and it has already opened my eyes to the reasons that burning coal for electricity generation is something we should be stopping with all haste.

The issues with coal start with the mining – even ignoring the environmental aspects.  Miners themselves, are often exposed to dust, causing Black Lung Disease, with underground mining obviously much worse than surface mining.  Then there are the accidents, which when they do happen, often kill many in one go.  

The mined coal doesn’t automatically resemble the shiny black anthracite that some of us remember from our childhood.  It is brought out along with a lot of impurities and waste which have to be cleaned off.  This may be stored on the surface near the mining complex, polluting ground and surface water with toxins and acidic runoff.  Those living adjacent to surface coal mines in the USA have an increased mortality due to the toxins emitted from the process.  Water is used to clean the coal, the waste from this process is stored in large ponds behind dams.  These are not checked for leakage and there have been cases of complete collapse, causing millions of gallons of toxic waste and water to pour into nearby towns.

Burning the coal causes air and water pollution.  The air pollution comes from some the expected pollutants, and some lesser known ones.  These include PM2.5 – particulate matter that can make it into lungs, bringing all sorts of nasties with it.  PM2.5 is linked to various cancers as well as stroke, respiratory and heart disease.  Also on the list are NOx and SOx, causes of acid rain and respiratory problems, Mercury about which I don’t think much else needs to be said (445 tonnes is released each year from burning coal for electricity) as well as Arsenic, Cadmium, Chromium, Lead, formaldehyde and many other metals.  Some of these are scrubbed from the air, so at least they aren’t dispersed as far.  However, they still end up in the waste ash that comes out of the coal station; its disposal is a major health issue.

The coal ash contains many metals and toxins, in even greater concentrations than in the coal itself.  Whilst the toxicological effects of many of them are known individually, there has been little to no research on the synergistic effects of these pollutants combined.  The ash is created in huge volumes; in the USA it is estimated that 140 million tonnes are generated each year, this is then stored in dry landfills and wet ponds.  The nature of many of the toxins in ash, such as mercury and other metals, means that they persist in the environment, never degrading, and they are likely to remain a problem for decades, if not centuries.   The dry landfills are not usually required to be covered, thus exposing nearby communities to airborne pollutants either directly, or as they settle onto land.  The wet ponds also have containment issues, with liners not always employed, allowing the water to leach into ground water thus contaminating drinking water, or entering the food chain through contaminated fish.  Then, as mentioned earlier, there is the potential for the walls containing the water to break, thus releasing the concentrated toxins into the local water courses and often onto land and into buildings.

There are many examples of coal mining and power generation polluting the local environment and causing health issues cited in the book that I am reading.  All of the examples are in the USA where, until recently at least, one would hope there is some degree of regulation.  (I haven’t read the chapter on regulation yet.)  But the majority of new coal-fired power stations planned or in construction are in India and China, where there are already examples of much weaker regulation for environmental protection (see my earlier post about antibiotic manufacture) and where the local communities are more likely to draw water directly from local wells and to fish from local rivers. 

Whilst there are pressing climate change arguments for removing coal from the energy mix, surely the dirty nature of its production and use, and the health impact on all those living nearby make keeping it in the ground even more of an imperative.

Antibiotics in livestock

In the UK, 44% of antibiotics are prescribed to non-humans – that’s livestock, including gamebirds, (37%) and pets (7%)1.   That’s not to say there are likely to be antibiotics in your meat, there is a mandated withdrawal period before any animal is slaughtered for meat or before milk enters the food chain.    However, the overuse of antibiotics as a cause of antibiotic resistance applies as much to veterinary use as for human use.  Despite the emergence of antibiotic resistance shortly after the discovery of antibiotics in the 1940s, and many reports in the 1960s and 1970s, it wasn’t until 2006 that the use of antibiotics as growth promoters was banned in the EU.  The good news is that government targets to reduce antibiotic use in livestock are currently on track.  The bad news is that they are finding antibiotic resistant genes in meat around the world.

The Guardian recently reported on an increase in the proportion of chickens found in UK supermarkets that had campylobacter resistant to the antibiotics used to treat it.  (Campylobacter can cause serious food poisoning in humans.)  Whilst there are differences in many of the bacteria that infect animals and humans, there is the potential for resistance to be transferred between species (horizontal transfer) and there are some bacteria that are shared; Salmonella and Campylobacter being two examples.

It is also worth noting that 83 billion tonnes of livestock manure is spread onto land each year in the UK, and in one gram of manure there are 1×1011 bacteria, which means that if just 1% of the bacteria have resistance to antibiotics, then there are more resistant bugs than there are grains of sand going onto UK fields each year.

So, given that it might be a problem, what are the supermarkets doing about it?  To date, there are only three supermarkets publishing data on the use of antibiotics in their supply chain; Marks and Spencer, Waitrose and Asda, all seem to have less than the sector average which means someone is using more than average.  With the exception of Lidl, all of the supermarkets publish their policy online; many contain the same aims.  Most are targeting a reduction in the amount used in their supply chain, although some are only just starting to monitor and establish their baselines.  All of them say that they will only allow the use of antibiotics under veterinary supervision.  But some of the pledges are not entirely clear; for example, Aldi state on their website that they don’t support the use of antibiotics as prophylactics (used to treat an animal to prevent disease e.g. if others in the herd are ill), but then in their policy they state that prophylaxis is only permitted under veterinary supervision.  Sainsbury’s have something similar on their website.

But, most concerning to me is the stand on CIAs – Critically Important Antibiotics – antibiotics important to human health.  Only M&S states that they prohibit the use of these, including Colistin, the last resort antibiotic for humans.  All of the other supermarkets mention them, but they only go so far as to state that they can only be used as a last resort.  Whilst these antibiotics only make up around 1% of the total use in animals, M&S seem to be saying that they don’t need to be used at all.  With the first bacon labelled as being raised without antibiotics hitting supermarket shelves2, perhaps change is on the way?

  1.  https://www.farmantibiotics.org/science-facts/antibiotic-infographs/human-vs-animal-antibiotic-use/
  2. https://farming.co.uk/news/antibiotic-free-meat-goes-on-sale-in-uk

The Impending Antibiotic Crisis – Who’s to blame and what can we do about it Part 1

In 2009 The Lancet said that Climate Change was the biggest threat to human health of the 21st Century.  I would say that Antimicrobial Resistance (AMR) is close behind.  Following the description of AMR as a catastrophic threat by the Chief Medical Officer in 2011 there seems to have been more of a focus from governments on the issue.  Indeed, during antibiotic awareness week last year there were even radio adverts with catchy ditties.    The UK government published its five year AMR strategy in 2013, interestingly they are about to need a new one!  

The main issue is that bacteria and other microscopic organisms can evolve to have resistance to our currently used antimicrobials and have done since shortly after the widespread use of penicillin.  We are also not currently bringing any new drugs to market, possibly because there’s not a lot of profit to be had in it.  We depend on antimicrobials for both human and animal health.  Without antimicrobials there will be no safe surgery, no chemotherapy and no caesarian sections.  We will be back at the point where there is the potential to cut yourself in the garden or even bite the inside of your own mouth and a few days later have died from the infection.  Despite this there is not even much funding for the research into new antimicrobials.  In the business as usual scenario it is estimated that by 2050 more people will die worldwide from antimicrobial resistant infections than from cancer; including 390,000 in Europe.

Most bacteria in a colony are killed by the antibiotics, but some with a resistance remain.  These no longer have to compete with the other bugs so can multiply more rapidly and the population grows, AMR develops.  For a brilliant depiction of this, see the excellent MIT video.   Antimicrobials can get into the environment during production, during use and in the waste.  Therefore, there are many areas that need action and there doesn’t seem to be agreement on how big each of the problems is and how to tackle them.

The government, in its action plan, has recommended better stewardship of the antimicrobials we currently have.  Public Health England have recently said that one in five GP antibiotic prescriptions is inappropriate  But, within the EU, the number of antibiotics prescribed varies massively.  The standard measure is the Defined Daily Dose (DDD) per thousand of the population per day.  In the UK we currently stand at a level of 22.84 (as of the last available figures published for 2015).   This means that on average each of us in the UK gets 4 days of antibiotic treatment each year.  However, the DDD for the Netherlands is 11.7 – half that of the UK.  Do those living there get sick less often?  Do they have better hygiene or vaccination standards which means that people don’t have the bugs in the first place and therefore don’t need the antibiotics?  Or does this mean that rather than 20% of antibiotics being unnecessary we are closer to 50%? For the record  France and Belgium have DDDs of over 30.  

The UK government aims to cut innapropirate prescriptions by 50% by 2020 (that is inappropriate prescriptions, not antibiotic use), but will this be enough to make a difference, will the reduction in the level of antibiotics in the system reduce the probability of resistance in human pathogens ?  It is not clear that these levels will be enough, and the 2% reduction in all prescriptions for antibiotics that was achieved from 2013-2015 is certainly not likely to make any impact.

Part of the issue of incorrect prescription comes back to the fact that in many cases antibiotics are prescribed for things that are not bacterial infections – flu (proper flu, manflu and diva flu) being a case in point, but other illnesses do not always have an obvious cause and look like an infection.  Also, when a patient is prescribed an antibiotic which doesn’t cure the infection, it doesn’t mean it hasn’t worked, the non-resistant bugs will have been killed, but a different antibiotic is needed to kill these double-hard b******s, therefore promoting further resistance.

There is debate about whether hospitals are a major source of antimicrobial resistance, after all they use a lot of antimicrobials every day.  In fact in one conference with four speakers, one didn’t mention it, one said that the bugs were so diluted and disperse when they entered the waste water treatment plant (WWTP) that it wasn’t a problem, another said that there was resistance found in waste water treatment plants to antibiotics that are only used in hospitals, and another pointed to a far bigger problem, but one that the health sector could again help deal with.   Which one is right? 

The issue with the antibiotics from hospital is not to do with the way they dispose of them – all waste medicines are incinerated, but it is to do with poo – we don’t metabolise all of the antibiotic, so much is flushed away.  The problem with hospitals is therefore perhaps not how much they use (only about 10% of that DDD) but what they use.  As they use some of the last resort antibiotics then resistance to these has a higher probability of occurring in the waste water from hospitals.  

Most of the antibiotics in use come from the community and again get flushed to the WWTP.  So, again is this a problem?  Unfortunately yes.  Unlike us mammals who can only pass our genes between the same species, bacteria can pass genes between different species (known as horizontal transfer).  Therefore different bugs can pass on different characteristics, such as resistance to drugs, to completely unrelated species – including potential human pathogens such as E Coli.  The WWTP can act as a big mixing vessel and unfortunately they are mainly set up to take solids out of the water and some chemicals, not bacteria.  In fact, they rely on bacteria to do some of the work of cleaning up the water – will the antibacterials in the water affect these bugs?

Once the water has been cleaned up, the sludge is then put onto the fields, along with anything living in it – will it then end up back in the food chain?

However, one of the biggest causes of antimicrobial resistance in the environment is from the production of the drugs themselves.  Most of these are manufactured in China and India where the outflows into the local rivers are not monitored or regulated.  Studies have found levels in some waste water that were as high as would be found in patients being treated with the antibiotics.  With the movement of people and food round the world in a matter of hours, it takes little time for antimicrobial resistant genes formed from these effluents to find their way to major centres of population.  

In the UK government strategy on AMR, there is little mention of the role of the pharmaceutical industry’s impact on the environment, most of the emphasis is on finding new drugs:

  “Industry has a corporate and social responsibility to contribute to work to tackle AMR by finding ways of extending the life of antibiotics, making the supply of effective antibiotics sustainable, facilitating society in being better custodians of these valuable resources and using them optimally both now and the future. “

Most pharma companies do not disclose how much they or their third party manufacturers discharge.  And, here’s where the Health Sector comes in.  Whilst it continues to reward companies for bringing in cheaper alternatives, rather than for having a sustainable supply chain, there is little incentive for companies to clean up their act.   In Denmark and Norway this is changing with hospitals creating incentives for pharma companies to improve pollution control during their procurement of drugs.  It is time the UK government and NHS followed their lead.

Supermarket Pledge

Following on from Blue Planet 2 Teresa May set out her vision for plastic free aisles in supermarkets.  Judging by the amount of tweeting about the subject, as well as the general opinion (see last week’s post) that suppliers have a responsibility to reduce packaging, it would seem that this is a vision shared by a large percentage of the population.  So it is interesting to note that there is now such a thing – the first plastic free supermarket aisle has been introduced – unfortunately in the Netherlands, but did Ms May specify that it was in British supermarkets that she wanted to see the plastic free move?

There then followed a flurry of announcements from supermarkets pledging various things over the space of a month as well as pointing out how much they had reduced their packaging since whenever.  All very laudable, but the thing most noticeable is that with the exception of Iceland, none of them have committed to removing plastic packaging from any of their own brand products, and none of them have pledged to put pressure onto their supply chain to change from plastic.

Supermarkets (and they are not the only purveyors of plastic) will claim that plastic packaging can reduce food waste by extending the life of food (and of course food is not the only thing wrapped in plastic).  For example on M&S’ website they claim that ‘1gm piece of film can double the life of a cucumber, apples and bananas ‘  But Apples already have a long storage life and bananas are shipped around the world in perfect health and I don’t often see lots of loose bananas going off in Waitrose.  I would argue that, judging by the mushrooms being sold off sweating under film in their plastic punnets that their shelf life is not enhanced (I rarely see loose mushrooms going off mainly because they sell out very quickly or do they stock too few?).  Likewise, potatoes and bread seem to sweat and go off more quickly in plastic.  In some products, e.g. Cheese I can taste the plastic on the slices from the outside of the block – possibly due to chemicals leaching from the film into the fats?  More on that in another post.  

But this is what they say, and not necessarily what they do – the advent of social media has resulted in the outing of various poor examples of packaging – for example the Metro headline ‘Marks & Spencer is being slammed by shoppers and scientists for selling apples in a plastic tube to fit in car cup holders.’ and from Sky News ‘Lidl has come under fire for selling peeled onions wrapped in “unnecessary” plastic packaging. ‘.

The majority of the supermarkets have reduced their packaging, or at least the weight of their packaging – they have made thinner films or thinner card, or, like Asda have switched from glass to plastic bottles for their vinegar.  Not necessarily a move in the right direction.  There are some good moves such as removing the plastic lining in boxes of tissues and polystyrene boards in pizza boxes (which makes sense from a health perspective as well).

So, the majority of the pledges include a reduction in packaging (that will be packaging weight, not necessarily the items in plastic), making their own brand packaging widely recyclable, reusable or compostable by some time in the mid-2020s, supporting Deposit Return Schemes and phasing out single use plastic bags (now that the government has done the hard bit and made them charge for them).  To be fair Lidl has been charging for years and has already removed them from their stores.  I don’t see a backlash from consumers yet?  Cotton buds and drinking straws get a mention, as do the almost impossible to recycle black plastic trays – but, I am not sure why the supermarkets find these so difficult to get rid of  – I can only assume it is aesthetics rather than necessity – especially for things like baby sweetcorn!

 

The widely recyclable is also open to interpretation.  The supermarkets have the same frustration as I do – try telling people what they can and can’t recycle at work when even in the same county there are different collections.  But, there are things that all councils will collect – such as plastic bottles, and yet only 58% are recycled – the rest are landfilled, littered or incinerated.  So, is the widely recyclable the answer, rather than elimination?  Statistics would suggest not.  One of the big things they can do (and some are looking at this) is to make their packaging from one plastic only which does increase both its value and its recyclability.  I’d like to see more of a commitment to this too.

But, by talking about the difficulty and inconsistency in recycling, they are passing the buck.  In a recent survey on Moneysavingexpert.com for over half of the examples they bought, the cost of buying  fruit and veg without packaging was higher than with packaging.  And, that is assuming that you can actually buy fruit and vegetables not wrapped in plastic (not always the case).

So, good for Iceland (although most of its sales are prepackaged food which in itself is an issue) and shame on the rest of the supermarkets.  Although they are all pledging to increase the recyclability of their packaging, or to reduce the packaging (and, with about 1 million tonnes of plastic being generated by the supermarkets they have a lot of work to do), none seem to be giving the consumer the option of going completely plastic free, even for fresh food.   As with most environmental improvements, perhaps a change in the law is required – if Ms May really does want a plastic free aisle, she might have to legislate for it, just as they finally did with the single use plastic bags.

Things you can do to reduce your plastic:

  • Buy fruit and veg at the market – often this is cheaper (I have started doing this as Waitrose seem to have fewer and fewer items not in plastic)
  • Switch to glass bottles from the milkman (but this is more expensive and doesn’t work for everyone)
  • Take your own bags to the supermarket for fruit and veg
  • Leave the plastic wrapping at the supermarket – let them pay for it rather than the cash strapped councils 
  • Don’t buy bottled water – buy a reusable bottle instead
  • Buy in glass rather than plastic e.g. Vinegar

The Blue Planet Effect – is it real?

Even without a television, I am aware of the so-called Blue Planet 2 effect.  Or at least one manifestation of it – the ‘concern’ about the plastic pollution in the oceans.

We now have a Prime Minister calling for the removal of single use plastic ‘wherever possible’.  Michael Gove has mentioned plastic and Blue Planet in the House of Commons.  There is some rejoicing on social media as the government is consulting on a deposit return scheme for plastic – just as we did in the 1970s for glass.  At work I have even had people asking me if we can do some more recycling because ‘We have to save the fishes’.

My first thoughts were why can’t we do the same for Climate Change – make it something people care about?  After all, climate change is arguably an even bigger problem.  But, I am reliably informed that the series also emphasised the devastating impact of climate change on our oceans – but somehow this seems to have been lost in the press.  I am sure there are many theories out there as to why this is the case, but I can think of a couple of reasons.  You can see plastic; pictures of seahorses with cotton buds and turtles with plastic in their mouths are memorable.  Other than a polar bear without an iceberg, what does the impact of climate change on the oceans look like?  Possibly just as important though is that to make an impact on climate change, we all have to change our lifestyles.  Whilst these solutions will save households money,  for most people not flying, turning down the heating, cutting car use or going meat light are not things that we are willing to do just to save the planet.

But, I hear you say, there are things individuals can do to mitigate the plastic issue – and indeed there are.  We can stop using plastic bags (although that only worked when the government slapped a 5p tax on them).  We can get a reusable water bottle – that would definitely save money (and I see them being used much more frequently) or a reusable coffee cup (again, I think a tax is the only way, because I rarely see anyone taking a coffee cup into most coffee shops).  But these are hardly going to be a lifestyle change compared to giving up a Caribbean holiday or fancy new SUV.

But, once we have our reusable bottle and cup, we can sit back and be pleased with ourselves, because it is the supermarkets’ faults and there is not much more we can do about it, even if we wanted to.  And, there is a point – there are increasing shouts on Twitter about the fact that some supermarkets are charging much less money for veg in plastic than loose and unfettered as nature intended, and it seems that the number of items sweating in plastic on the shelves is increasing.  Going plastic free often seems to be the expensive option.  I can (and now do) buy my milk in glass, but the increase in cost is about having it delivered rather than being in glass  – that adds just 1p over the delivered plastic version.  The switch to glass is costing me about £100 – but then I have saved half of that amount (and probably done my health some good) by cutting my milk consumption by about 2 pints a week.

If you think I am being a little harsh on my fellow British humans and their motivations, I would point to a recent IPSO Mori poll about the British attitude to plastic.  Whilst 85% of those polled were concerned about plastic to some extent (interestingly it was the millennials and GenX who were the least concerned) only 3% believed we consumers had the biggest responsibility to reduce packaging, 27% thought it was down to the companies that make the goods.  Most think it is a shared responsibility between companies producing and selling packaged goods, the government and consumers (and I would tend to agree).

Given that 85% of us think there needs to be a solution, it appears that other than reusing bags and bottles (but worryingly only 75% of those polled are willing to make this small change) only a measly 14% would pay more Council Tax to improve recycling and only 12% would pay more for goods with no packaging that can’t be recycled.

Hmm, something doesn’t add up because although we are not willing to pay more, almost half of those questioned felt that in order to help sort the plastic pollution problem there should be a tax on retailers who produce a lot of unrecyclable packaging (which there already is) and that councils should be forced to spend more on recycling facilities (a lot of the facilities are already there…)  Surprisingly (not) a fine on householders that don’t recycle (yes, some of my neighbours, that’s you) was not deemed likely to be effective to solve the plastic problem.

So, I am not convinced there is a Blue Planet 2 effect. If there is will it last? (Not if it requires consumers to take the initiative and change things.)  And, why have the Netherlands got the first plastic free supermarket aisle and not the UK?