Norway’s undying
gratitude
to Shetland
With one final
shove, the bin
clicked shut
The tribe:
Rangers and
Scottish literature
Alasdair McKillop reflects on his recent interview with novelist Alan Bissett
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Rubbish in the river Clyde at the Broomielaw
Photograph by
Islay McLeod
The Cafe
The Cafe is our readers’ forum. Send your contribution to islay@scottishreview.net
After this outbreak
in Edinburgh, don’t
knock health and safety
Anthony Seaton
The good news for Edinburgh is that the doctors were on the ball and the public health authorities very quickly took appropriate action by finding
the likely sources and acting to decontaminate them.
If sufficient numbers of legionella build up and are released in vapour from the system, as may happen in factories, hospitals and hotel showers for example, people in that vicinity are at risk. Thus, outbreaks such as the Edinburgh one may occur, but also sporadic cases happen quite frequently as a result of the misfortune implicit in life when a vulnerable person encounters droplets containing the organisms.
The two sides of legionnaires’ disease are prevention and cure. Prevention is dealt with by informing the owners of buildings and factories of the need to take certain precautions if they have circulating hot water systems that can release vapour, an important role of the oft derided Health and Safety Executive. The media reports have emphasised disinfection but this, using chlorine releasing agents, is only a part of the management and though essential may be dangerous by causing complacency, since if sludge builds up the disinfectant has difficulty penetrating it. It is therefore critically important to prevent this build up of sludge by cleaning of cooling towers. It may also be necessary to raise the temperature of the system to a level at which the organism’s growth is inhibited.
Cure depends on doctors being aware of the possibility of this cause of pneumonia and making the diagnosis early, not as easy as you might think. Happily, most chest specialists are well aware of the possibility and facilities for quick diagnosis and for treating the most severely affected are widely available, as they were in the Edinburgh outbreak.
As with all infective diseases, the organism does not cause disease in everyone who is exposed to it; personal resistance differs greatly and (inevitably, I’m afraid) smokers and people with other lung disease are particularly vulnerable. In such people particularly the illness may be severe, complicated by other manifestations, and sometimes fatal. Fit young people may well get a good dose of bacteria and develop no more than an antibody response in their blood. If treated with appropriate antibiotics, the large majority recover from the acute illness quickly, though it often leaves them feeling ill for weeks afterwards.
The good news for Edinburgh is that the doctors were on the ball and the public health authorities very quickly took appropriate action by finding the likely sources and acting to decontaminate them. But the sad news of death and serious illness is a reminder that we are but part of the great ecology of the planet and have to coexist with its other inhabitants, making sure we are as well adapted to our environment as possible and pay due respect to bacteria. Next time you read of complaints about ‘health ‘n safety’ and reducing red tape in industry, remember that there is a reason for this.
