HomeMy WebLinkAboutBoard of Health February 3 20041
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DISCLAIMER: This document contains the Whatcom County Council or Committee
minutes, as approved. However, unless an attested signature page is attached, they
are not the final approved minutes.
WHATCOM COUNTY COUNCIL
Board of Health
February 3, 2004
Council Vice -Chair Laurie Caskey- Schreiber called the meeting to order at
10:30 a.m. in the Council Chambers, 311 Grand Avenue, Bellingham, Washington.
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Present:
Barbara Brenner
Sharon Roy
L. Ward Nelson
Seth Fleetwood
PUBLIC SESSION
No one spoke.
Absent:
Dan McShane
Sam Crawford
PUBLIC HEALTH ADVISORY BOARD (PHAB) CHAIR REPORT
David Davidson, Public Health Advisory Board Chair, stated he is in the first
year of his second term. He described the representation on the board. The
County Council drives their work. The board is available to work on Council issues.
The board must also get a sense of whether there are emergent health issues and
bring them forward to the Council. The Council will start seeing him at Board of
Health meetings.
Brenner stated she appreciated Mr. Davidson taking this strong stance as the
chair. She knows how busy all the board members are.
Regina Delahunt, Health Department Director, stated the board is helpful to
the department because it can look at an issue from a variety of perspectives. It's
good to get other perspectives on issues.
3. RABIES VACCINATIONS FOR CATS & DOGS
Regina Delahunt, Health Department Director, stated she provided
background information. The animal control committee has been discussing rabies
vaccination for dogs and cats. Currently in Whatcom County, rabies vaccination is
not mandatory for dogs or cats. In some of the cities, rabies vaccination is
mandatory for dogs. The animal control committee believes that it should be
mandatory countywide for dogs and cats. The Council could pass a health ordinance
to do that. She recommends that the issue be looked at more broadly by the Public
Health Advisory Board (PHAB). Bats are the only species that is a reservoir for
Board of Health, 2/3/2004, Page 1
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DISCLAIMER: This document contains the Whatcom County Council or Committee
minutes, as approved. However, unless an attested signature page is attached, they
are not the final approved minutes.
rabies in Washington State. Occasionally it spills into the pet population. The most
recent domestic animal that was positive for rabies was a cat in Eastern
Washington.
Vaccination breaks the bridge between bats and pet populations. The Health
Department deals quite a bit with exposures to bats. They recommend whether or
not treatment should occur.
Roy asked the number of human cases they've had in Whatcom County.
Delahunt stated there have been no cases. They've had people regularly have to
go through the treatment process because of exposure consequences. They rarely
have the animal for testing. They have had individuals get treatment who have had
positive exposure. A couple of dozen people per year go through treatment.
Roy asked the expense to the average pet owner if an ordinance were
approved. Delahunt stated a vaccination is $10 to $12 per vaccination. Another
expense is to look at enforcement costs to the County. The advisory committee
would consider that aspect of an ordinance. Currently, dogs are required to be
licensed but cats are not. That would also be another enforcement issue.
Brenner asked how the cities enforce it. Delahunt stated that's information
the advisory board would obtain from the cities.
Brenner asked what a pre- exposure vaccination is. Delahunt stated it's a
vaccination for people who would be in contact with bats or domestic animals, such
as veterinary workers.
Dr. Greg Stern, County Health Officer, stated the immunization is given to
those at the greatest risk for exposure. It lasts for several years.
Brenner asked about the different strains. Stern stated strains are adapted
to certain species. In Washington State, have only found the bat strain of the
virus. There was a case of a cat that was identified in Walla Walla. A bat infected
the cat. They're talking about protecting the animals from bat infections.
Delahunt stated that in southern states, the reservoir is dogs and coyote
strains.
Brenner stated that if the PHAB wants to take it on is okay. There are no
real cases around. This would probably cost the county quite a bit to do reasonable
enforcement. Keep that in perspective. There are issues of a higher priority that
the county will focus on. She doesn't see how the County would be able to enforce
it. Delahunt stated those are valid issues. The Health Department does a limited
amount of public education. Another option could be to take a look at the State
Board of Health about the State's position.
Board of Health, 2/3/2004, Page 2
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DISCLAIMER: This document contains the Whatcom County Council or Committee
minutes, as approved. However, unless an attested signature page is attached, they
are not the final approved minutes.
Nelson stated they can also evaluate policies and procedures in case they
recognize an epidemic of rabies, should one occur. He shares Councilmember
Brenner's concerns. They're still trying to get children vaccinated.
Roy agreed. They have so many public health needs. If there are no cases
locally, the issue should be studied on the basis on how to respond if there is some
sort of outbreak. The vaccination is based on risk. If there are no cases, it appears
as if the situation is currently under control. She asked if there is a reason to
believe it could get out of control, down the road. Delahunt stated she doesn't
know there is specific concern. Anything could happen. She's not concerned about
an outbreak. The committee was talking about prevention. It's a fatal disease.
That's where the concern is based, not so much that there will be an outbreak of
rabid dogs. If there is a rabid pet in this county, they'll instantaneously work on
that animal.
Stern stated he didn't know how effective vaccination would be against the
establishment of canine rabies. The case in Walla Walla of a cat infected by a bat,
which exposed about nine people, brought this issue up again. They're talking
about protecting people from bats, through a cat or dog. If they start finding
canine or feline strains in animals, they're approach may change. They'll have time
to deal with it with the State Department of Health because it will be a statewide
issue. They need to set priorities and determine the scope. There is a lot of things
they can spend their money on to prevent fatal diseases. They have to look at the
relative risks and the other things the money could go toward.
Caskey- Schreiber stated that in the last 40 years, only five cats and dogs
have been infected in the State. Statistically, the risk in this state is low. This
might be overkill when they really look at the risk involved.
Brenner stated the real issue is to make sure people know that they should
do something if they're exposed. They do a good job in this State of educating
people. She'd rather educate people on exposure. Let the advisory board deal with
it if they want.
Nelson moved to let the Public Health Advisory Board review the rabies
issue and make a recommendation to the Board of Health.
Brenner asked that the board should look at education efforts.
Motion carried unanimously.
4. TOBACCO PREVENTION STRATEGIC PLAN
Board of Health, 2/3/2004, Page 3
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DISCLAIMER: This document contains the Whatcom County Council or Committee
minutes, as approved. However, unless an attested signature page is attached, they
are not the final approved minutes.
Regina Delahunt, Health Department Director, stated this item relates to the
strategic plan. The County used some State funding to assist the organization
COMMIT for a Tobacco -Free Whatcom County with putting together a plan for their
initiatives and work over the next year. This is an update on the results of that
planning.
Andy Byrne, Human Services Manager, stated in May 2003, the County
Council reviewed and approved a professional services contract to work with the
Health Department and COMMIT to help the organization re- energize itself, develop
an organization structure, and develop a strategic plan for 2004. He will report on
the outcomes. He read his Power Point presentation (on file). He submitted a
pamphlet (on file) that is one of their outcomes. One of the early phases was to
talk with people who had a stake in anti - tobacco efforts. COMMIT drew in a list of
stakeholders and citizens.
Brenner asked if there is a reason why a goal is to regulate, not prohibit,
smoking in all indoor public spaces.
Dr. Chris Covert - Bowlds, COMMIT for a Tobacco -Free Whatcom County
President, stated the intent is to ban indoor public places.
Roy asked if regulation implies that there could be smoking areas. She
asked if that was part of the discussion. Covert - Bowlds stated the contingent to
keep -it -vague won out over the contingent to ban smoking, but that is clearly the
intent.
Nelson asked about what a diversion program in the school district would
mean. Covert- Bowlds stated it's more than sending the kids home if they're caught
smoking.
Roy asked about the committee that's working on getting businesses smoke -
free. Byrne stated some businesses have taken that step. The Pierce County
Health Department has a Human Resources policy that it won't hire someone who
uses tobacco unless they quit. Others may not go to that extreme. The law
doesn't specify how far apart they need to be from a building, except schools, to
smoke. The intent of the law is to provide areas so that people don't have to walk
through smoke when entering a building, and that smoke won't go in through the
ventilation system. It's a formal policy statement that businesses haven't done.
Delahunt stated the hospital campus right now is smoke -free. It took a long
time to do that. They're hoping two more large employers, of which the County is
one, would have a smoke -free campus. From an employer's perspective, it's
difficult to implement. It's something that COMMIT is interested in doing. The
committee who's working on it is interested in breaking down the barriers to do
that.
Board of Health, 2/3/2004, Page 4
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DISCLAIMER: This document contains the Whatcom County Council or Committee
minutes, as approved. However, unless an attested signature page is attached, they
are not the final approved minutes.
Caskey- Schreiber stated it's an enormous issue at Western Washington
University. People smoke outside of buildings and the smoke wafted up into the
building.
Brenner stated the COMMIT brochure looks very expensive to produce. She
hoped COMMIT is very cognizant of costs. Byrne stated they were under - budget for
the entire project.
S. SMOKING IN PUBLIC PLACES
Health Effects of Second Hand Smoke
Dr. Greg Stern, Public Health Officer, stated the evidence is clear that
second -hand smoke is toxic. That's not controversial. He continued the Power
Point presentation from the previous agenda item (on file).
(Clerk's Note: End of tape one, side A.)
Stern continued the Power Point presentation. Studies have shown that the
levels of second -hand smoke in restaurants are higher than in offices where people
can smoke. This is a toxic work environment. They don't allow people to go into
closed environments with carcinogenic materials. There are rules about safe
working environments. If they leave it up to choice, they are going to open it up to
exploitation of workers who may not have the economic choice of working in a safe
environment. The concern is that people are working in potentially toxic
environment. This society protects people from that pressure. Restaurant workers
should be in a safe environment.
Dr. Chris Covert - Bowlds, COMMIT for a Tobacco -Free Whatcom County
President, continued to read the Power Point presentation (on file).
Pierce County & Legislative Update
Alyssa Pavitt, Prevention Coordinator - Youth /Tobacco /Traffic Safety, stated
Pierce County recently passed a clean indoor air resolution prohibiting secondhand
smoke, which prohibits smoking in indoor places. It is the first county to do this.
She continued the Power Point presentation (on file).
Brenner asked the argument in favor of the injunction of the Pierce County
ban. Covert - Bowlds stated the State Clean Indoor Air Act of 1985 requires smoke -
free public places, except in smoking places. That's a contrast. The tobacco
interests got that phrase added. It specifically exempts restaurants, bars, bowling
alleys, and bingo halls. It implies that local governments are preempted from
passing these things. A specific preemption was removed from the bill, but they've
labored under this implied preemption against local action all this time. Pierce
County is challenging the preemption. There's legislation in Olympia right now to
change it and to pass a true statewide smoke -free air law. The Senate Bill (SB)
Board of Health, 2/3/2004, Page 5
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DISCLAIMER: This document contains the Whatcom County Council or Committee
minutes, as approved. However, unless an attested signature page is attached, they
are not the final approved minutes.
5791 hearing was held on January 22. A senator from Yakima is in charge of the
bill. As of this morning, that senator is waiting to see what the House Bill does.
The same bill is in the House. Currently, they're looking for one or two more votes
for it in the House to get it out of the Senate Health Care Committee.
Representative Doug Erickson said he's leaning toward support of this bill which
he's previously opposed. Encouragement from influential groups, such as the
County Council and restaurant and bar owners, would be helpful to encourage
Representative Erickson. That will pass a law statewide, and they wouldn't have to
tackle it locally. The fallback position is the bill that authorizes local governments
to pass these bills locally. They prefer a statewide law.
Caskey- Schreiber asked if HB 1868 will come up for a hearing. Covert -
Bowlds stated it will go forward when they have the votes they need.
Pavitt finished the Power Point presentation.
Regina Delahunt, Health Department Director, stated she originally hoped
the Pierce County ordinance would have been upheld. Right now, they're in a state
of waiting to see what the law will allow the County to do. They should know in the
next few weeks. Now, it would be prudent for the Board of Health to recommend
the Advisory Board local regulation if they get clear approval from the State.
Nelson moved the Board of Health chair write a letter to the legislature in
support of the two bills.
Motion carried unanimously.
Roy stated she would like all the councilmembers to sign this letter, instead
of just the Council Chair.
The Council concurred.
Delahunt stated they need to do this soon.
Fleetwood asked what to say to people who are opposed to this ban because
they have a right. Covert - Bowlds stated there is no right to expose other people to
smoke. The Americans with Disabilities Act (ADA) spoke in favor of a common law
for a safe workplace, which includes a non - smoking law. It's hazardous, toxic, and
easily preventable.
Caskey- Schreiber stated they are doing smokers a favor by helping them re-
think their health choices.
Brenner stated they are doing a favor to people who don't want to be
exposed to secondhand smoke. They've already banned certain pesticides. There
is no different.
Board of Health, 2/3/2004, Page 6
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DISCLAIMER: This document contains the Whatcom County Council or Committee
minutes, as approved. However, unless an attested signature page is attached, they
are not the final approved minutes.
Roy asked if they're certain about the statistics. She found the two -packs a
day equivalent of secondhand smoke for waitresses is defensible. One has to
smoke a lot to smoke two packs a day. She finds the credibility of that statistic as
a little bit shaky. Covert - Bowlds stated secondhand smoke is more concentrated
than what the smoker gets. It's smoldering at a lower temperature. The
carcinogens are in a higher concentration in secondhand smoke.
Stern stated the Environmental Protection Agency (EPA) website on
secondhand smoke says the epidemiologic studies are more useful than comparing
it to two packs per day. Comparing secondhand smoke to direct smoke will have
the same components, but in different ratios and concentrations. Stay away from
that comparison and just say the smoke exposure is higher, it's a known
carcinogen, and the disease rates are higher.
Roy stated she would rather see information that people working in smoking
workplaces have a certain higher rate of disease than workers who don't work in
smoking workplaces. Stern stated two studies reviewed employee exposure and
health effects on restaurant workers. They compared the smoke exposure in
restaurants and bars with offices where smoking was allowed. Another study
compared different types of establishments.
Roy stated she doesn't doubt the facts. Present the facts that way.
Fleetwood asked the percentage of Americans who smoke, and if there is a
decrease in the trend. Covert - Bowlds stated 25 percent nationally. Washington
State is 21.5 percent. Whatcom County is less than that. The smoking rates are
dropping, particularly with men.
Nelson moved to direct the Advisory Board to look at banning smoking in
public places if legislation is upheld.
Motion carried unanimously.
ADJOURN
The meeting adjourned at 11:39 a.m.
Jill Nixon, Minutes Transcription
These minutes were approved by Council on February 24 , 2004.
ATTEST: WHATCOM COUNTY COUNCIL
WHATCOM COUNTY, WASHINGTON
Board of Health, 2/3/2004, Page 7
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DISCLAIMER: This document contains the Whatcom County Council or Committee
minutes, as approved. However, unless an attested signature page is attached, they
are not the final approved minutes.
Dana Brown - Davis, Council Clerk Laurie Caskey- Schreiber, Council Vice -Chair
Board of Health, 2/3/2004, Page 8