Environmental health

Carbon monoxide (CO) is a highly poisonous gas which is impossible to see, taste or smell. Anyone who uses an appliance that burns a fossil fuel including gas, oil and coal, as well as peat and wood, is potentially at risk from carbon monoxide poisoning.

Aside from deaths, many more people may suffer lasting damage to their health by lower level exposure to CO. This causes a series of flu-like symptoms, such as headaches, nausea, breathlessness, dizziness, collapse and loss of consciousness, to more serious conditions such as nerve damage, memory loss and personality change.

The PHA has responded to a number of incidents recently in relation to CO poisoning and issued several media statements. A letter was also sent to acute hospitals and primary care from the CMO (HSS MD 45/2010) in December 2010 urging HSC staff to remain vigilant to ensure recognition and prevention of further CO poisonings. The letter contains useful information about the risks of CO poisoning, how to avoid them, and how to recognise those affected.

The PHA in conjunction with the HPA in England also adapted a HPA algorithm for HSC professionals on how to diagnose and manage cases of CO poisoning. In November 2010, there was PHA input to the Health & Safety Executive’s advertising campaign, Watch Out: Carbon Monoxide Kills

The Public Health Agency is advising everyone to be aware of carbon monoxide poisoning. CO poisoning can be fatal and affect anyone. However, children, older people, pregnant women and people with heart or breathing problems are more vulnerable to its effects.

During the cold weather people across Northern Ireland will be turning up the heating and lighting fires, increasing their risk of CO poisoning. CO is produced when fossil fuels such as gas, coal, oil, wood, petrol and paraffin burn without enough oxygen. It is a colourless, tasteless, odourless gas that is non-irritating, and as a result can be very hard to detect, so people need to be particularly vigilant for the signs and symptoms of carbon monoxide poisoning.

Bad weather and snow can also mean gas flues get blocked by ice, causing an increased risk of carbon monoxide poisoning.

Symptoms include:

• headaches
• nausea and vomiting
• exhaustion
• drowsiness
• dizziness and light-headedness
• ‘flu like’ symptom
• palpitations
• chest pain
• losing consciousness

Carbon monoxide poisoning can be fatal and can also cause long-term health problems if victims are exposed to low doses over a long period of time. The signs and symptoms of carbon monoxide poisoning are often mistaken for other illnesses, such as food poisoning or flu – the symptoms can be similar to flu but without a raised temperature. Please look out for these signs and symptoms and consider if carbon monoxide poisoning could be the cause. 

Anyone who suspects they may be suffering from carbon monoxide poisoning should immediately turn off all appliances, go outside and seek medical help from a qualified healthcare professional. Appliances should not be used again until they have been serviced by a registered engineer.

Carbon monoxide poisoning causes a number of deaths and hospital admissions each year. It is vital that we are all vigilant to ensure that we are protected from its dangers.  Advice on the risks and measures that can be taken to prevent carbon monoxide poisoning is available online from nidirect. It is essential that people take care when using appliances and ensure that they are safe and used in properly ventilated spaces.

To minimise the risk of carbon monoxide poisoning the PHA recommends the following:

• install an audible Carbon Monoxide alarm that meets British or European standards (BS Kitemark or EN 50291). These cost as little as £20.00 and can be purchased from large DIY stores and food retail stores. Alarms, however, should not be used as a substitute for regular servicing of appliances;
• have their fossil fuel and wood burning appliances - such as boilers, heaters and cookers - checked by an appropriately registered engineer;
• sweep chimneys and flues every year if you use solid fuel;
• if you are in rented accommodation ask your landlord to provide you with an up-to-date gas safety record. This is a requirement by law and is particularly important for students renting houses and flats;
• keep flues, air vents and grilles clear and ensure rooms are well ventilated.

Further information from the Health and Safety Executive for Northern Ireland can be found at:
https://www.hseni.gov.uk/topic/carbon-monoxide

Blue-green algae

Blue-green algae are not algae but a type of bacteria (called cyanobacteria) that are present in our lakes and rivers.

They are very small and can’t be seen with the naked eye. When environmental conditions are just right (they like warm still water with plenty of nutrients), they can multiply quickly forming a “bloom”

Blooms appear as a discolouration of the water (often a pea green colour) or as a visible scum layers or floating mats. Blooms usually occur in the summer and early autumn but can occur at other times of the year, if conditions are right.

There are no quick or easy remedies for the control of blooms once they appear in a lake or pond. 

What are the health risks?

Blue-green algae may produce several different toxins which are harmful to human health. You may be at risk when you use a lake or other body of water which contains a bloom.  You may be exposed during any activity where you may come into contact with the water, swallow water or breathe in water droplets for example swimming, sailing and boating, water skiing or even fishing.

These toxins can cause:

• Skin rashes,
• Nausea,
• Vomiting,
• Stomach pains,
• Fever,
• Headaches,
• Occasionally, more serious illness such as liver and brain damage.

How can the health risk be minimised?

Not all blue-green algae blooms are toxic but you cannot tell if a bloom is toxic by looking at it.  If you see an algal bloom it is best to assume it is harmful and take the following precautions:

• Do not swim in the water
• Do not swallow the water
• Avoid contact with the algae
• Observe and abide by any warning notices positioned around the water
• For advice on eating fish caught recreationally from the water see the Food Standards Agency website Executive Summary - Microcystins in Fish | Food Standards Agency In respect of commercial fisheries, food safety advice should be sought from the district council responsible for the fishery. The district council may also liaise with the Food Standards Agency

Anyone who has come into contact with water containing blue-green algae should shower with fresh water immediately. If you have come into contact or drunk affected water and feel unwell you should obtain medical attention. Symptoms generally begin within hours after exposure.

Further Information

Blue Green Algae website - Northern Ireland has been experiencing an increase in blue-green algae blooms. To find out more about blue-green algae see www.daera-ni.gov.uk/blue-green-algae

NIEA are encouraging the public to get involved in citizen science and help monitor blooms of blue-green algae (cyanobacteria) to help protect public health and continue to enjoy our local water environment. Read more at www.daera-ni.gov.uk/news/help-protect-public-health-risks-harmful-blue-green-algal-blooms-bloomin-algae-app

Flooding

During adverse weather some areas may experience flooding, the Public Health Agency (PHA) is reminding people of the potential public health risks associated with flooding.

In relation to flooding, the main risk relates to injuries caused by hidden dangers under the water such as missing manhole covers or people falling into fast flowing waters. The stress and strain of being flooded and cleaning up can have a notable impact on mental health and wellbeing.

The risk of contracting illness is generally low. However, as it is not always clear whether water is contaminated or not, the public are urged to exercise caution and assume that flood water is contaminated.

The PHA reminded residents there are a number of precautions to prevent health problems if there is a flood situation in the home. These include:

• wherever possible try to avoid coming into direct contact with floodwater;
• do not let children play in floodwater;
• When cleaning up after a flood, wear  rubber gloves , boots and eye protection, and wash hands afterwards
• wash hands after being in contact with flood water, sewage or anything contaminated by these;
• wash children’s hands regularly;
• clean toys that have been in flood water with disinfectant;
• cover cuts or open sores;
• don’t eat any food that has been in contact with flood water;
• clean all surfaces with disinfectant before any food is placed on them;
• contact your GP if you or a relative develops a stomach upset following flooding.

Avoid unnecessary journeys.

Check in on elderly neighbours and remain mindful of current COVID-19 guidance which can be found here.

Care must be taken when clearing up after flooding as there is a serious danger posed by carbon monoxide fumes from the indoor use of generators to dry out buildings.

If flooding occurs in your local area contact the Flooding Incident Helpline on 0300 2000 100 immediately. This service is available 24 hours a day every day of the year.

The Regional Community Resilience Group (RCSG) helps local communities prepare for and respond to weather related emergencies;

• Regional Community Resilience Group

Public health advice following flooding (2012)

Content in progress

Extreme weather can affect health throughout the year.

Find information on:

• keeping warm during cold weather
• staying safe during heatwaves
• preparing for severe weather
• looking after vulnerable people
• weather-related public health advice.

Resources:

• HPA extreme weather events and natural disasters
• Support networks for those affected by the adverse weather
• Keeping warm during adverse weather
• Looking after vulnerable and elderly neighbours
• Carbon monoxide poisoning
• Advice if flooding occurs
• Using emergency water supplies
• Water advice following restoration
• Sun safety/UV
• Take care in the sun | HSC Public Health Agency
• Living Well: 'Care in the sun' campaign 2026 | HSC Public Health Agency
• Early detection saves lives: Be UV aware, protect your skin and check for changes | HSC Public Health Agency
• Pharmacy campaign urges people to ‘Be UV aware’ | HSC Public Health Agency
• Skin cancer: What you need to know | HSC Public Health Agency
• Stay safe in the sun on your winter holiday | HSC Public Health Agency

Severe weather warnings
The Met Office's severe weather warning page provides up-to-date information about weather that is likely to cause disruption.

Reduce the risk of harm in the cold weather

Look after yourself this winter

Advice to the public during the current water shortage 

If you are considering embarking on a journey during bad weather, you should consult the Met Office for travel conditions: www.metoffice.gov.uk.

If you must drive during severe weather, make sure you are prepared for bad weather conditions.

For further advice see: https://www.nidirect.gov.uk/campaigns/be-ready-for-emergencies

Below are some of the support services that are in place for anyone who feels worried or stressed at this time.

It's important to stay protected against a drop in temperatures. By keeping warm, you can help yourself stay warm this winter. You can find out more here; Staying warm in winter | nidirect

Information from the NHS on how to stay well in winter can be found at How to stay well in winter - NHS (www.nhs.uk)

Rural Support
Bureaucracy, family circumstances, health and finances can cause stress and anxiety. We offer a listening and signposting service for farmers and rural families in Northern Ireland. All calls are confidential and the helpline operates from 8am to 11pm, seven days a week (voicemail and support options available at all other times), phone: 0800 138 16778. Rural Support website can be accessed at http://www.ruralsupport.org.uk/.

Information on the Rural Support Networks and the Warm, Well and Connect programme can be found here; Warm Well & Connected Programme (costaruralsupportnetwork.org)

These five directories list the names, numbers and web addresses (where applicable) of organisations that offer services to help improve mental health and emotional wellbeing within each Health and Social Care Trust area; Directory of services to help improve mental health and emotional wellbeing | HSC Public Health Agency (hscni.net)


Lifeline
If you, or someone you know, is in distress or despair, call Lifeline on 0808 808 8000. This is a free confidential service, where trained counsellors will listen and help immediately on the phone and follow up with other support if necessary. The helpline is available 24 hours a day, seven days a week. You can also access the Lifeline website at www.lifelinehelpline.info.

Samaritans
If something's troubling you, then get in touch. We're here 24 hours a day, 365 days a year. Contact us on 116 123 or visit our website at http://www.samaritans.org/.

For more information on looking after your mental health and the support available across Northern Ireland can be found at www.mindingyourhead.info. You can also visit your GP for advice.

HPA CBRN incidents: a guide to clinical management and health protection

Air quality

Extreme weather

Chemical incidents
Noise/environmental risks

HPA compendium of chemical hazards

HPA poisons information service